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Endokrinoloji Polikliniğine Puberte Bulguları ile Başvuran Olguların Etiyolojik Dağılımı ve Klinik Özellikleri

Year 2016, Volume: 10 Issue: 4, 233 - 236, 01.12.2016

Abstract

Amaç: Çalışmamızda ergenlik bulgularının başlaması şikayeti ile başvuran kız hastaların etiyolojik nedenlere göre değerlendirilmesi ve bulguların literatür eşliğinde tartışılması amaçlanmıştır.Gereç ve Yöntemler: Çocuk Endokrinolojisi polikliniğine başvuran 96 kız hasta çalışmaya dahil edildi. Hastaların antropometrik ölçümleri, puberte durumları değerlendirildi. Erken puberte şüphesi olan hastaların değerlendirilmesinde Folikül stimüle edici hormon (FSH), Lüteinize edici hormon (LH), estradiol (E2), dehidroepiandrosteron sülfat (DHEA-SO4), 17 hidroksiprogesteron (17OHP) değerleri, luteinize edici hormon releasing hormon (LHRH) uyarı testi sonuçları kullanıldı. Yapılan kemik yaşı değerlendirilmesi, pelvik ultrasonografi sonuçları kaydedildi.Bulgular: Hastaların yaş ortalaması 8.38 ±1.72 yıldı. Hastaların % 14.6’sında (n=14) prematüre telarş,% 4.2’sinde (n=4) prematüre pubarş, %3.1’inde (n=3) prematüre menarş, %8.3’ünde (n=8) erken puberte tespit edildi. Normalin varyantı pubertal gelişim hastaların %21.9’unu (n=21) oluşturmaktaydı. Başvuran olguların %46.9’u (n=45) normal pubertal gelişime,% 22.9’u (n=22) sekiz yaşın üzerinde pubertal gelişimde hızlanmaya sahipti. %21.9 (n=21) hastada pubertal gelişim atipik başlangıçlıydı.Sonuç: Günümüzde puberte bulgularının başlama yaşının düşmesiyle endokrinoloji kliniklerine başvuru artmıştır. Başvuruların çoğunu ise normal puberte varyantları oluşturmaktadır. Bu çalışma ile hastaların tanı aşamasında iyi değerlendirilmesini vurgulamak istedik.

References

  • 1. Çayır Y, Çayır A. Birinci basamakta erken puberteli çocuğa yaklaşım. Tıp Araştırmaları Dergisi 2013;11:1-4.
  • 2. Kletter GB, Klein KO, Wong YY. A pediatrician’s guide to central precocious puberty. Clin Pediatr (Phila) 2015;54:414-24.
  • 3. Berberoglu M. Precocious puberty and normal variant puberty: definition, etiology, diagnosis and current management. J Clin Res Ped Endo 2009;1:164–74.
  • 4. Sağsöz N, Orbak Z, Tan H. Precocious puberty in girls. T Klin J Gynecol Obst 1999;9:67-78.
  • 5. Neyzi O, Gunoz H, Furman A, Bundak R, Gokcay G, Darendeliler F, et al. Weight, height, head circumference and body mass index references for Turkish children. Cocuk Sağlığı ve Hastalıkları Dergisi 2008;51:1-14.
  • 6. Neyzi O, Furman A, Bundak R, Gunoz H, Darendeliler F, Bas F. Growth references for Turkish children aged 6 to 18 years. Acta Paediatr 2006;95:1635-41.
  • 7. Bundak R, Furman A, Gunoz H, Darendeliler F, Bas F, Neyzi O. Body mass index references for Turkish children. Acta Paediatr 2006;95:194-198.
  • 8. Marshall WA, Tanner JM. Variations in the pattern of pubertal changes in boys. Arch Dis Child 1970;45:13-23.
  • 9. Marshall WA, Tanner JM. Variations in the pattern of pubertal changes in girls. Arch Dis Child 1969;44:291-303.
  • 10. Bundak R, Darendeliler F, Günöz H, Bas F, Saka N, Neyzi O. Puberty and Pubertal Growth in Healthy Turkish Girls: No evidence for secular trend. J Clin Res Ped Endo 2008;1:8–14.
  • 11. Neely EK, Crossen SS. Precocious puberty. Curr Opin Obstet Gynecol 2014;26:332-8.
  • 12. Ucar A, Saka N, Baş F, Bundak R, Gunoz H, Darendeliler F. Is premature thelarche in the first two years of life transient. J Clin Res Pediatr En docrinol 2012;4:140-5.
  • 13. Akinci A, Cetin D, Ilhan N. Plasma kisspeptin levels in girls with premature thelarche. J Clin Res Pediatr Endocrinol 2012;4:61-5.
  • 14. Atay Z, Turan S, Guran T, Furman A, Bereket A. The prevalence and risk factors of premature thelarche and pubarche in 4- to 8-year-old girls. Acta Paediatr 2012;101:e71-5.
  • 15. Kılıç A, Durmuş MS, Ünüvar E, Yıldız I, Aydın BK, Uçar A, et al. Clinical and laboratory characteristics of children referred for early puberty: Preponderance in 7-8 years of age. J Clin Res Pediatr Endocrinol 2012;4:208-12.
  • 16. Çatlı G, Erdem P, Anık A, Abacı A, Böber E. Clinical and laboratory findings in the differential diagnosis of central precocious puberty and premature thelarche. Turk Pediatri Ars 2015;50:20-6.
  • 17. Battaglia C, Mancini F, Regnani G, Persico N, Iughetti L, De Aloysio D. Pelvic ultrasound and color Doppler findings in different isosexual precocities. Ultrasound Obstet Gynecol 2003;22:277-83.
  • 18. Lee DS, Ryoo NY, Lee SH, Kim S, Kim JH. Basal luteinizing hormone and follicular stimulating hormone: Is it sufficient for the diagnosis of precocious puberty in girls? Ann Pediatr Endocrinol Metab 2013;18:196-201.
  • 19. Gönç N. Normal puberte gelişimi ve puberte prekoks. Hacettepe Tıp Dergisi 2009;40:164-8.

The Etiologic Distribution and Clinical Features of Cases Presenting with the Findings of Puberty to the Pediatric Endocrinology Clinic

Year 2016, Volume: 10 Issue: 4, 233 - 236, 01.12.2016

Abstract

Objective: In our study we aimed to evaluate the findings of female patients presenting with a complaint of the onset
of puberty according to the etiological factors and to discuss the findings in the literature.
Material and Methods: Ninety-six girls presenting to the pediatric endocrinology clinic patients were enrolled in
the study. Anthropometric measurements and pubertal status of the patients were evaluated. In the evaluation of
patients with suspected early puberty, follicle stimulating hormone (FSH), Luteinising Hormone (LH), estradiol (E2),
dehydroxyepiandrostenedione sulfate (DHEA-SO4), 17-hydroxyprogesterone (17OHP) levels, and luteinizing hormone
releasing hormone (LHRH) stimulation test results were used. The bone age and pelvic ultrasound results were recorded.
Results: The mean age of the patients was 8.38 ± 1.72 years. We found premature thelarche in 14.6% of the patients
(n = 14), premature pubarche in 4.2% (n = 4), premature menarche in 3.1% (n = 3), and precocious puberty in 8.3% (n =
8) while 21.9% (n = 21) were normal variants of pubertal development. 46.9% of admitted patients (n = 45) had normal
pubertal development, 22.9% (n = 22) had an acceleration in pubertal development over eight years. 21.9% (n = 21) of
patients had atypic pubertal development.
Conclusion: The decrease in the age of the onset of puberty has increased applications to the endocrine clinic. Most of
the applications are normal variants of puberty. We wanted to highlight the good diagnostic evaluation of these patients
in this study.

References

  • 1. Çayır Y, Çayır A. Birinci basamakta erken puberteli çocuğa yaklaşım. Tıp Araştırmaları Dergisi 2013;11:1-4.
  • 2. Kletter GB, Klein KO, Wong YY. A pediatrician’s guide to central precocious puberty. Clin Pediatr (Phila) 2015;54:414-24.
  • 3. Berberoglu M. Precocious puberty and normal variant puberty: definition, etiology, diagnosis and current management. J Clin Res Ped Endo 2009;1:164–74.
  • 4. Sağsöz N, Orbak Z, Tan H. Precocious puberty in girls. T Klin J Gynecol Obst 1999;9:67-78.
  • 5. Neyzi O, Gunoz H, Furman A, Bundak R, Gokcay G, Darendeliler F, et al. Weight, height, head circumference and body mass index references for Turkish children. Cocuk Sağlığı ve Hastalıkları Dergisi 2008;51:1-14.
  • 6. Neyzi O, Furman A, Bundak R, Gunoz H, Darendeliler F, Bas F. Growth references for Turkish children aged 6 to 18 years. Acta Paediatr 2006;95:1635-41.
  • 7. Bundak R, Furman A, Gunoz H, Darendeliler F, Bas F, Neyzi O. Body mass index references for Turkish children. Acta Paediatr 2006;95:194-198.
  • 8. Marshall WA, Tanner JM. Variations in the pattern of pubertal changes in boys. Arch Dis Child 1970;45:13-23.
  • 9. Marshall WA, Tanner JM. Variations in the pattern of pubertal changes in girls. Arch Dis Child 1969;44:291-303.
  • 10. Bundak R, Darendeliler F, Günöz H, Bas F, Saka N, Neyzi O. Puberty and Pubertal Growth in Healthy Turkish Girls: No evidence for secular trend. J Clin Res Ped Endo 2008;1:8–14.
  • 11. Neely EK, Crossen SS. Precocious puberty. Curr Opin Obstet Gynecol 2014;26:332-8.
  • 12. Ucar A, Saka N, Baş F, Bundak R, Gunoz H, Darendeliler F. Is premature thelarche in the first two years of life transient. J Clin Res Pediatr En docrinol 2012;4:140-5.
  • 13. Akinci A, Cetin D, Ilhan N. Plasma kisspeptin levels in girls with premature thelarche. J Clin Res Pediatr Endocrinol 2012;4:61-5.
  • 14. Atay Z, Turan S, Guran T, Furman A, Bereket A. The prevalence and risk factors of premature thelarche and pubarche in 4- to 8-year-old girls. Acta Paediatr 2012;101:e71-5.
  • 15. Kılıç A, Durmuş MS, Ünüvar E, Yıldız I, Aydın BK, Uçar A, et al. Clinical and laboratory characteristics of children referred for early puberty: Preponderance in 7-8 years of age. J Clin Res Pediatr Endocrinol 2012;4:208-12.
  • 16. Çatlı G, Erdem P, Anık A, Abacı A, Böber E. Clinical and laboratory findings in the differential diagnosis of central precocious puberty and premature thelarche. Turk Pediatri Ars 2015;50:20-6.
  • 17. Battaglia C, Mancini F, Regnani G, Persico N, Iughetti L, De Aloysio D. Pelvic ultrasound and color Doppler findings in different isosexual precocities. Ultrasound Obstet Gynecol 2003;22:277-83.
  • 18. Lee DS, Ryoo NY, Lee SH, Kim S, Kim JH. Basal luteinizing hormone and follicular stimulating hormone: Is it sufficient for the diagnosis of precocious puberty in girls? Ann Pediatr Endocrinol Metab 2013;18:196-201.
  • 19. Gönç N. Normal puberte gelişimi ve puberte prekoks. Hacettepe Tıp Dergisi 2009;40:164-8.
There are 19 citations in total.

Details

Other ID JA36NF79SF
Journal Section Research Article
Authors

Beray Selver Eklioğlu This is me

Mehmet Emre Atabek This is me

Nesibe Akyürek This is me

Emre Sarıkaya This is me

Publication Date December 1, 2016
Submission Date December 1, 2016
Published in Issue Year 2016 Volume: 10 Issue: 4

Cite

Vancouver Eklioğlu BS, Atabek ME, Akyürek N, Sarıkaya E. The Etiologic Distribution and Clinical Features of Cases Presenting with the Findings of Puberty to the Pediatric Endocrinology Clinic. Türkiye Çocuk Hast Derg. 2016;10(4):233-6.


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