For Premature Thelarche and Premature Adrenarche, the Case for Waiting before Testing

Kaplowitz, Paul B.

doi:10.1159/000512764

Cited by 9 publications

(2 citation statements)

References 14 publications

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“…Moreover, in the same group of subjects, BMI-SDS, serum IGF-1 SDS, and DHEAS SDS were identified as factors associated with an increased risk for advanced bone age [ 77 ]. The majority of sources in the literature assert that these mild forms of precocious puberty are self-limited [ 76 ] and usually do not need any treatment [ 68 , 78 ]. Nevertheless, follow-up is recommended [ 79 ] as they could potentially be a manifestation of central precocious puberty that may manifest in later years [ 76 ].…”

Section: Non-metabolic Complications Of Obesity In Childrenmentioning

confidence: 99%

Not Only Metabolic Complications of Childhood Obesity

Ciężki,

Odyjewska,

Bossowski

et al. 2024

Nutrients

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The increasing incidence of obesity in the pediatric population requires attention to its serious complications. It turns out that in addition to typical, well-known metabolic complications, obesity as a systemic disease carries the risk of equally serious, although less obvious, non-metabolic complications, such as cardiovascular diseases, polycystic ovary syndrome, chronic kidney disease, asthma, thyroid dysfunction, immunologic and dermatologic conditions, and mental health problems. They can affect almost all systems of the young body and also leave their mark in adulthood. In addition, obesity also contributes to the exacerbation of existing childhood diseases. As a result, children suffering from obesity may have a reduced quality of life, both physically and mentally, and their life expectancy may be shortened. It also turns out that, in the case of obese pregnant girls, the complications of obesity may also affect their unborn children. Therefore, it is extremely important to take all necessary actions to prevent the growing epidemic of obesity in the pediatric population, as well as to treat existing complications of obesity and detect them at an early stage. In summary, physicians treating a child with a systemic disease such as obesity must adopt a holistic approach to treatment.

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Section: Non-metabolic Complications Of Obesity In Childrenmentioning

confidence: 99%

Not Only Metabolic Complications of Childhood Obesity

Ciężki,

Odyjewska,

Bossowski

et al. 2024

Nutrients

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“…To diagnose active puberty following either GnRH or GnRHa stimulation tests, the cutoff point of LH should be more than 5 IU/L [87,88]; however, further cutoff points, varying from 4 to 8 IU/L, have also been proposed [7]. Another peak of the LH-to-FSH ratio of 0.6-1.0 following a GnRHa-stimulated test was introduced as a sign of active puberty; however, its sensitivity and specificity were low compared with LH alone [89].…”

Section: Hormonal Assessmentmentioning

confidence: 99%

Precocious Puberty: Types, Pathogenesis and Updated Management

Alghamdi

2023

Cureus

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Precocious puberty (PP) means the appearance of secondary sexual characters before the age of eight years in girls and nine years in boys. Puberty is indicated in girls by the enlargement of the breasts (thelarche) in girls and in boys by the enlargement of the testes in either volume or length (testicular volume = 4 mL, testicular length = 25 mm, or both). Two types of PP are recognized -namely central PP (CPP) and peripheral PP (PPP). This paper aims to describe the clinical findings and laboratory workup of PP and to illustrate the new trends in the management of precocious sexual maturation. Gonadotropin-releasing hormone (GnRH)independent type (PPP) refers to the development of early pubertal maturation not related to the central activation of the hypothalamic-pituitary-gonadal (HPG) axis. It is classified into genetic or acquired disorders. The most common forms of congenital or genetic causes involve McCune-Albright syndrome (MAS), familial male-limited PP, and congenital adrenal hyperplasia. The acquired causes include exogenous exposure to androgens, functioning tumors or cysts, and the pseudo-PP of profound primary hypothyroidism. On the other hand, CPP is the most common and it is a gonadotropin-dependent form. It is due to premature maturation of the HPG axis. CPP may occur as genetic alterations, such as MKRN3, DLK1, or KISS1; as a part of mutations in the epigenetic factors that regulate the HPG axis, such as Lin28b and let-7; or as a part of syndromes, central lesions such as hypothalamic hamartoma, and others. A full, detailed history and physical examination should be taken. Furthermore, several investigations should be conducted for both types of PP, including the estimation of serum gonadotropins such as luteinizing and folliclestimulating hormones and sex steroids, in addition to a radiographic workup and thyroid function tests. Treatment depends on the type of PP: Long-acting GnRHa, either intramuscularly or implanted, is the norm of care for CPP management, while in PPP, especially in congenital adrenal hyperplasia, the goal of management is to suppress adrenal androgen secretion by glucocorticoids. In addition, anastrozole and letrozole -third-generation aromatase inhibitors -are more potent for MAS.

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