Peripheral precocious puberty including congenital adrenal hyperplasia: causes, consequences, management and outcomes

Haddad, Nadine; Eugster, Erica A.

doi:10.1016/j.beem.2019.04.007

Cited by 35 publications

(46 citation statements)

References 77 publications

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Section: Discussionmentioning

confidence: 99%

“…MAS is a rare cause of PPP caused by post zygotic somatic activating mutations in the GNAS1 gene [5,6]. Classic triad of MAS is precocious puberty, fibrous dysplasia of bones and café au lait macules with irregular borders (coast of Maine) [5]. Other endocrine manifestations are GH excess, hypercortisolemia, hyperprolactinemia,hyperthyroidism,andhypophosphat emia [1,5].…”

Section: Discussionmentioning

confidence: 99%

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Precocious menarche in a 9 years old girl due to autonomous ovarian cyst treated with letrozole

Vlachoapapadopoulou

Moisidou

Fotiadou

et al. 2021

DAH

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Background: Peripheral precocious puberty (PPP) is defined as the early pubertal maturation independent of gonadotropin stimulation. Autonomous ovarian cysts can be a cause of PPP or isolated precocious menarche. The differential diagnosis of ovarian cysts is important because of distinct management options. Case presentaion: A 9 7/12-year-old girl presented because of rapid evolution of breast development and premature menarche. Estrogen levels were elevated while GnRH stimulation test revealed a blunt response. Pelvic sonogram demonstrated an ovarian cyst. She was started on oral letrozole. There was no further episode of menstruation. The cyst resolved spontaneously after three months. Conclusion:Functional ovarian cysts usually regress spontaneously. This case highlights the effectiveness of letrozole therapy in promptly decreasing estrogen levels and immediately controlling menstrual bleeding.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Precocious menarche in a 9 years old girl due to autonomous ovarian cyst treated with letrozole

Vlachoapapadopoulou

Moisidou

Fotiadou

et al. 2021

DAH

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“…Inclusion criteria are as follows: [5,6] (1) Secondary sexual characteristics appeared in advance (definition of age: breast development or pubic hair premature appearance before 8 years in girls) (2) In gonadotropin-releasing hormone (GnRH) stimulation test, the peak value of LH was less than 3.3-5.0 IU/L, and the ratio of LH/FSH was less than 0.6 (3) Breast Tanner stage does not exceed stage III (4) Gonadal ultrasound: ovarian volume was less than 1 ml, follicle diameter was less than 4 mm, and no ovarian cyst (5) Bone age over actual age should not exceed one year (6) Without medication or any other intervention treatment Exclusion criteria are as follows: [7] (1) Central precocious puberty (2) Premature puberty caused by gonadal tumors, adrenal diseases, or other organic diseases (3) Heterosexual precocious puberty in girls (4) Chromosome abnormalities or hereditary diseases (5) Figure 1) from July 2017 to June 2018. Ten participants who did not meet inclusion criteria were excluded, five participants dropped out after accepting part sessions of acupuncture treatment, three participants did not complete serum test, the remaining 20 completed the acupuncture treatment, but 1 participant did not complete the follow-up.…”

Section: -12mentioning

confidence: 99%

Acupuncture Improving Early Sexual Development of Girls with Peripheral Precocious Puberty: A Prospective Cohort Study

Liu

Wan

Sun

2020

Evidence-Based Complementary and Alternative Medicine

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Objective. To study primarily on the effect of acupuncture on breast Tanner stage, serum sex hormone level, and TCM symptom scores in girls with peripheral precocious puberty (PPP). Methods. 19 eligible patients diagnosed with PPP received acupuncture intervention for 12 weeks, twice a week for 12 weeks, 24 sessions of acupuncture treatment in all, and then follow-up for 12 weeks. The primary outcome was the change in serum luteinizing hormone (LH) level, follicle-stimulating hormone (FSH) level, and breast Tanner stage at 12-week treatment and 12-week follow-up. Serum estradiol (E2) level and TCM symptom scores were also assessed. Results. Nineteen patients with peripheral precocious puberty were treated with acupuncture. After the 12-week acupuncture intervention, the serum LH level, breast Tanner stage, and TCM symptom scores decreased significantly compared with baseline (P<0.05); the serum FSH and E2 level did not change significantly after the 12-week treatment (P>0.05). After the 12-week follow-up, breast Tanner stage and TCM symptom scores decreased significantly compared with baseline (P<0.05), and there was no statistical difference between serum sex hormone (LH, FSH, and E2) level and baseline level (P>0.05). During the period of acupuncture treatment, no side effects or serious adverse events occurred. Conclusions. Acupuncture is effective in regulating the hormone level and controlling early development process. It may be a viable alternative to the treatment of peripheral precocious puberty in girls. However, further randomized controlled trials are needed.

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“…Rarely congenital adrenal hyperplasia (CAH) can be a peripheral cause of CPP. Very exceptional case reports of this etiology are described in the literature [2,3]. CAH is an autosomal-recessive disorder caused by enzymatic defects in the corticosteroid synthesis pathway, characterized by deficient production of end steroid hormones: cortisol and/or aldosterone.…”

Section: Introductionmentioning

confidence: 99%

Central Precocious Puberty as a Sign of Congenital Adrenal Hyperplasia: Case Presentations

Markosyan¹,

Navasardyan²

2020

Int. J. Child Health Nutr.

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Central precocious puberty results from the premature activation of the hypothalamic-pituitary-gonadal axis. Rarely congenital adrenal hyperplasia and/or its inappropriate treatment can be a peripheral cause of CPP. There are very few case reports of this etiology. Chronic mildly to moderately elevated adrenal androgens or intermittent hyperandrogenemia in congenital adrenal hyperplasia may trigger the precocious activation of the hypothalamic-pituitary axis, leading to CPP. In the current work, we describe 6 cases of late diagnosis of congenital adrenal hyperplasia associated with central precocious puberty. Central precocious puberty seems to be a complication of congenital adrenal hyperplasia, particularly in countries where a routine neonatal screening program for this condition is lacking. It is unclear whether these patients could avoid central precocious puberty development if the congenital adrenal hyperplasia was diagnosed in the neonatal period and appropriately treated. The current work underlines the need for congenital adrenal hyperplasia neonatal screening implementation and further investigation of the association of these two endocrine disorders.

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Peripheral precocious puberty including congenital adrenal hyperplasia: causes, consequences, management and outcomes

Cited by 35 publications

References 77 publications

Precocious menarche in a 9 years old girl due to autonomous ovarian cyst treated with letrozole

Precocious menarche in a 9 years old girl due to autonomous ovarian cyst treated with letrozole

Acupuncture Improving Early Sexual Development of Girls with Peripheral Precocious Puberty: A Prospective Cohort Study

Central Precocious Puberty as a Sign of Congenital Adrenal Hyperplasia: Case Presentations

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