Central Precocious Puberty (CPP) in Two Girls With Autism Spectrum Disorder (ASD)

Abstract

In recent years, some cases of central precocious puberty (CPP) have been reported in patients with autism spectrum disorder (ASD). Here, we report CPP in two girls with ASD. The first case was a girl, 7 years and 9 months of age. Breast budding was observed at 7 years and 2 months and pubic hair at 7 years and 8 months of age. She was diagnosed with CPP based on guidelines and ASD according to her developmental history. Considering the psychosocial burden caused by the discrepancy between her cognitive and behavioral development and the progression of secondary sex characteristics, gonadotropin-releasing hormone (GnRH) analog therapy was initiated. Case 2 was a girl, 9 years and 8 months of age. She was diagnosed with ASD according to her developmental history. Treatment using oral aripiprazole for hypersensitivity to touch and taste had been initiated, with the onset of menarche at 9 years and 10 months of age. Breast budding had been observed before 7 years and 6 months old. She was diagnosed with CPP based on guidelines. Considering that menarche was not a significant psychosocial burden and the difficulty for her and her family to attend regular follow-ups, GnRH analog therapy was not initiated. Although the pathophysiological pathway linking ASD and CPP remains to be elucidated clinically, attention to CPP in ASD is needed, considering the increase in reported cases. In addition, the indication of GnRH analog therapy should be judged considering the psychosocial burden associated with secondary sexual characteristics.

The Association between Autism Spectrum Disorder and Precocious Puberty: Considering Effect Modification by Sex and Neuropsychiatric Comorbidities

“…Our results are consistent with those of previous studies [ 18 , 19 , 20 ]. As mentioned before, only one cohort study by Geier et al examined this relationship [ 20 ].…”

“…ASD that is comorbid with specific neuropsychiatric disorders may suggest a unique pathophysiology that differs from ASD alone [ 16 , 17 ]. In our review, sporadic case reports documented precocious puberty in patients with ASD [ 18 , 19 ]. However, large-scale studies on the association between these two medical conditions remain scarce.…”

The Association between Autism Spectrum Disorder and Precocious Puberty: Considering the Effect Modification by Sex and the Neuropsychiatric Comorbidities

“…ASD comorbid with specific neuropsychiatric disorders may suggest a unique pathophysiology that differs from ASD alone [16,17]. In our review, sporadic case reports documented precocious puberty in patients with ASD [18,19]. However, large-scale studies on the association between these two medical conditions remain scarce.…”