Pelvic ultrasound and color Doppler findings in different isosexual precocities

Battaglia, Cesare; Mancini, Fulvia; Regnani, Giorgia; Persico, Nicola; Iughetti, Lorenzo; Aloysio, Domenico De

doi:10.1002/uog.154

Cited by 48 publications

(43 citation statements)

References 36 publications

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“…These rates are in accordance with the study of Battaglia et al (33) wherein 33% of the girls had PT and 67% had CPP. Pescovitz et al (12) reported rates of 26% PT, 38% CPP, and the rest intermediate forms of PP; the average chronological age of the girls with PT was 2.5 years.…”

Section: Discussionsupporting

confidence: 93%

“…However, the androstenedione level by itself was not a sensitive parameter for differentiation of PP from PT. A similar observation was reported in one study comparing 3 girls with PT to 3 girls with CPP (23), but not in another study, which failed to find any such difference (33). No significant difference was found in mean estradiol level between the groups.…”

Section: Discussionsupporting

confidence: 85%

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Ultrasonographic and clinical parameters for early differentiation between precocious puberty and premature thelarche

Vries¹,

Horev²,

Schwartz³

et al. 2006

eur j endocrinol

147

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Objective: To determine if uterine and ovarian measurements can significantly distinguish between precocious puberty (PP) and premature thelarche (PT) and whether ultrasound has any advantage over the gonadotropin-releasing hormone (GnRH) stimulation test. Design: Prospective. Methods: One hundred and three girls referred consecutively for evaluation of breast budding before age 8 years underwent physical examination, GnRH stimulation test, bone age assessment, and transabdominal pelvic ultrasound. The diagnosis of PP or PT was based on clinical judgment. The clinical, laboratory, and ultrasound data of the PP and PT groups were compared. Results: Eighty-one girls were diagnosed with PP and 22 with PT. Significant differences in most of the uterine and ovarian measurements were found between the groups. On logistic regression analysis, bone age standard deviation score, uterine transverse diameter, and uterine volume were the most significant variables predicting PP. Comparison of 30 girls with PP and 21 with PT in whom peak luteinizing hormone was !5 mIU/ml on the GnRH stimulation test, using analysis of variance, yielded significant differences in uterine width (P!0.001), fundus diameter (P !0.04), uterine volume (PZ 0.006), and ovarian circumference (P !0.02). Conclusions: Increased uterine and ovarian measurements may be an early and sensitive sign of PP. Pelvic ultrasound, a noninvasive, inexpensive, and reliable tool, may give the clinician a complementary indication to the GnRH test in distinguishing isolated PT from early-stage PP in girls with early breast budding.European Journal of Endocrinology 154 891-898

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 85%

Ultrasonographic and clinical parameters for early differentiation between precocious puberty and premature thelarche

Vries¹,

Horev²,

Schwartz³

et al. 2006

eur j endocrinol

147

View full text Add to dashboard Cite

show abstract

“…This assessment is based on the pulsatility index (PI) of the uterine artery (a difference between the peak systolic and end-diastolic flow divided by the flow velocity). However, this method requires an experienced examiner (43). After laboratory confirmation of CPP, anatomical assessment of the central nervous system (CNS) should be performed in all patients, preferably by magnetic resonance imaging (MRI) (10,44).…”

Section: Imagingmentioning

confidence: 99%

“…In females, an increased prevalence of polycystic ovary syndrome has been reported, although the findings are controversial (44,60). In males, a few studies that have been carried out have shown normal gonadal function (43). The few studies that have evaluated the psychosocial impact of CPP suggest that antisocial behavior is limited to adolescence and that there are no differences in psychosocial adjustment (44).…”

Section: Long-term Follow-upmentioning

confidence: 99%

Central precocious puberty: revisiting the diagnosis and therapeutic management

Brito

Spinola-Castro

Kochi

et al. 2016

Arch. Endocrinol. Metab.

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Clinical and laboratory diagnosis and treatment of central precocious puberty (CPP) remain challenging due to lack of standardization. The aim of this revision was to address the diagnostic and therapeutic features of CPP in Brazil based on relevant international literature and availability of the existing therapies in the country. The diagnosis of CPP is based mainly on clinical and biochemical parameters, and a period of follow-up is desirable to define the "progressive" form of sexual precocity. This occurs due to the broad spectrum of pubertal development, including isolated premature thelarche, constitutional growth and puberty acceleration, progressive and nonprogressive CPP, and early puberty. Measurement of basal and stimulated LH levels remains challenging, considering that the levels are not always in the pubertal range at baseline, short-acting GnRH is not readily available in Brazil, and the cutoff values differ according to the laboratory assay. When CPP is suspected but basal LH values are at prepubertal range, a stimulation test with short-acting or long-acting monthly GnRH is a diagnostic option. In Brazil, the treatment of choice for progressive CPP and early puberty is a long-acting GnRH analog (GnRHa) administered once a month or every 3 months. In Brazil, formulations of GnRHa (leuprorelin and triptorelin) are available and commonly administered, including 1-month depot leuprorelin 3.75 mg and 7.5 mg, 1-month depot triptorelin 3.75 mg, and 3-month depot leuprorelin 11.25 mg. Monthly or 3-month depot GnRHa are effective and safe to treat CPP. Arch Endocrinol Metab. 2016;60(2):163-72

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“…A ultra-sonografia pélvica provou ser técnica não invasiva e precisa na avaliação da genitália interna de meninas com puberdade precoce central. Vários parâmetros ultra-sonográficos são citados como indicadores do efeito da secreção estrogênica, destacando-se o aumento dos volumes uterino [11][12][13][14] e ovariano [15][16][17] , o incremento do comprimento longitudinal do útero 16 e da relação entre as medidas do corpo e do colo uterinos 17,18 e a presença do eco endometrial 11,14,17,18 . Após e durante o tratamento, a ultra-sonografia pélvica pode monitorizar se essas mudanças puberais precocemente desenvolvidas estão regredindo.…”

Section: Introductionunclassified