Precocious Puberty or Premature Thelarche: Analysis of a Large Patient Series in a Single Tertiary Center with Special Emphasis on 6- to 8-Year-Old Girls

Varimo, Tero; Huttunen, Heta; Miettinen, Päivi J.; Kariola, Laura; Hietamäki, Johanna; Tarkkanen, Annika; Hero, Matti; Raivio, Taneli

doi:10.3389/fendo.2017.00213

Cited by 36 publications

(30 citation statements)

References 40 publications

(52 reference statements)

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“…Craniopharyngioma is not a common cause of precocious puberty, but there are multiple case reports in the literature in both girls and boys; the condition can be managed with GnRH analogues as in other cases of central precocious puberty, and no specific preparation has been recommended . Clinical evidence of gonadotrophin deficiency at presentation with CP includes menstrual disorders in over half of female CP patients, impaired sexual function and loss or lack of evolution of secondary sexual characteristics .…”

Section: Anterior Pituitary Dysfunctionmentioning

confidence: 99%

Management of hypothalamic disease in patients with craniopharyngioma

Thompson

Costello

Crowley

2019

Clinical Endocrinology

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Patients with craniopharyngioma experience excess morbidity and mortality when compared with the background population and with other hypopituitary patients.Large, suprasellar tumours which form micropapillae into surrounding structures can cause hypothalamic damage before any therapeutic intervention; attempted gross total resection can lead to hypothalamic obesity, sleep disorders, thirst disorders and dysregulation of temperature as well as panhypopituitarism. The management of tumour bulk and the pathophysiology of hypothalamic complications have been reviewed extensively. We present a practical, clinical approach to management of hypothalamic disease in a patient with craniopharyngioma and highlight potential targets for future pharmacological or surgical intervention. K E Y W O R D Scraniopharyngioma, hypopituitarism, hypothalamus, obesity, sleep disorders, thirst

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Section: Anterior Pituitary Dysfunctionmentioning

confidence: 99%

Management of hypothalamic disease in patients with craniopharyngioma

Thompson

Costello

Crowley

2019

Clinical Endocrinology

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“…In ∼90% of girls, CPP is idiopathic (1). The prevalence of unsuspected intracranial lesions is 8-13% in girls and decreases with age (6). Among girls with CPP (onset age of 6-8 years), unsuspected pathology and tumors were only involved in 2-7% and 1% of the them, respectively (4).…”

Section: Introductionmentioning

confidence: 99%

“…Among girls with CPP (onset age of 6-8 years), unsuspected pathology and tumors were only involved in 2-7% and 1% of the them, respectively (4). However, brain MRI continues to be routinely performed to identify potential intracranial lesions in all girls with CPP (6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Pathological and Incidental Findings in 403 Taiwanese Girls With Central Precocious Puberty at Initial Diagnosis

Chiu

Chen

2020

Front. Endocrinol.

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Background: Whether girls with central precocious puberty (CPP) should undergo routine brain magnetic resonance imaging (MRI) to identify potential intracranial pathologies is controversial. Aims: To evaluate the brain MRI results of girls with CPP and identify the clinical and endocrine predictors of brain abnormalities. Methods: This retrospective study obtained data from pediatric endocrine clinics at Chang Gung Children's Hospital. From 1997 and 2017, 403 girls were consecutively diagnosed with CPP. After the exclusion of patients with a history of central nervous system (CNS) insults or associated neuropsychiatric symptom or signs, we studied the prevalence of brain abnormalities in 251 girls with CPP who received detailed MRI examinations of the hypothalamus and pituitary area. We also recorded the demographic data of the participants, including the onset of puberty; initial pubertal status; height; weight; uterus and ovary sizes; and basal luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol levels, and the response to GnRH stimulation test. Results: Among the 251 girls with CPP, we observed no brain alterations in 190 (75.70%), abnormalities in the hypothalamic-pituitary (H-P) area in 54 (21.51%), and abnormalities in the non-H-P area in 7 (2.79%). Among the 54 patients that had H-P lesions, we noted pathological findings related to CPP (hypothalamic hamartoma) in only one (0.4%) girl aged below 6 years old. We also identified incidental findings in the other girls with H-P lesions, including non-functioning pituitary microadenomas (12.35%), pituitary pars intermedia cysts (4.38%), Rathke's pouch cysts (1.99%), pituitary hypoplasia (1.59%), and pineal gland cysts (0.8%). The patients that had non-H-P lesions were found to have arachnoid cysts (1.59%), Chiari I malformation (0.4%), prepontine nodule (0.4%), and choroidal fissure cyst (0.4%). Of all the patients with brain lesions, 45 (73.77%) underwent regular MRI follow-up. While none of the H-P and non-H-P lesions showed progression, 19.67% of these regressed during the follow-up. None of the participants exhibited other hormonal abnormalities or underwent surgery. Conclusion: The prevalence of true pathological brain lesions related to CPP in girls without prior symptoms or signs of CNS lesions was low (0.4%). None of the girls with intracranial lesions required further intervention besides the GnRH agonist treatment. These data question the routine use of brain MRI in all girls with CPP, especially in those who are healthy without neurologic symptoms.

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“…Physiological age of puberty is influenced by many nutritional, metabolic, genetic and environmental factors [ 1 , 2 ]. During the last century, a trend toward an earlier puberty and menarcheal age was noticed in girls [ 1 , 3 ]. Many authors associated precocious puberty, which is defined by the appearance of the secondary sexual characteristics before the age of 8 years in girls [ 3 , 4 ], to the development of many diseases later on [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…characteristics before the age of 8 years in girls [3,4], to the development of many diseases later on [4]. These include a higher risk of development of cardiovascular, oncologic, gynecologic, obstetric, gastrointestinal, musculoskeletal and neurocognitive diseases during adolescence and adulthood according to some studies [4].…”

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confidence: 99%

Association between factors related to the pregnancy, neonatal period, and later complications (especially asthma) and menarcheal age in a sample of Lebanese girls

2020

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Background Studies about the majority of the factors that may potentially influence the pubertal timing and menarche were controversial. The objective was to evaluate the association between factors related to the pregnancy, neonatal period, and the complications that may happen later in life and the menarcheal age in a sample of Lebanese girls admitted or not to the NICU at birth. Our secondary objective was to try to find, for the first time in literature, a correlation between respiratory distress at birth and the need of oxygen therapy with the age of the first menses in these girls. Methods It is a cross-sectional retrospective study, conducted between January and March 2019. Our sample included all the 2474 girls born in Notre-Dame-de-Secours hospital, between 2000 and 2005; the sample consisted of 297 girls (97 girls admitted to the NICU and 200 randomly chosen to participate in our study with a ratio of 1:2 (1 girl admitted to the NICU vs 2 girls born in the nursery). Results Asthma later in life was significantly associated with lower age at menarche in girls, whereas a higher mother’s age at menarche and a higher gestational age were significantly associated with higher age at menarche in girls. When taking each cause of NICU admission as an independent variable, showed that a higher mother’s age at menarche was significantly associated with higher age at menarche in girls, whereas a higher number of days of phototherapy, a preeclampsia in the mother during pregnancy and asthma later in life in the girl were significantly associated with a lower age at menarche in girls. Conclusion The timing of menarche seems to be associated with many factors in Lebanese girls that should not be disregarded by physicians.

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Precocious Puberty or Premature Thelarche: Analysis of a Large Patient Series in a Single Tertiary Center with Special Emphasis on 6- to 8-Year-Old Girls

Cited by 36 publications

References 40 publications

Management of hypothalamic disease in patients with craniopharyngioma

Management of hypothalamic disease in patients with craniopharyngioma

Pathological and Incidental Findings in 403 Taiwanese Girls With Central Precocious Puberty at Initial Diagnosis

Association between factors related to the pregnancy, neonatal period, and later complications (especially asthma) and menarcheal age in a sample of Lebanese girls

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