Etiological, clinical and biochemical characteristics of 367 children with early pubertal development from the Trakya region of Turkey
Abstract
Background: Appearance of menarche before nine years of age, secondary sex characteristics before 8 in girls and 9 in boys is defined as Precocious Puberty (PP).
Objective: The aim of this study was to describe etiologies, clinical findings, and compare anthropometric properties and biochemical characteristics of children with PP.
Methods: In this single-centre study, 367 patients of whom medical records were reviewed diagnosed as premature thelarche (PT), premature adrenarche (PA), Central PP (CPP), and peripheral PP (PPP). The diagnosis was based on clinical, laboratory, and radiologic investigations and their follow-up.
Results: During six years, 349 girls (%95,1) and 18 boys (%4,9) diagnosed as PP. The most common etiologies were CPP;127 (%34,6), PT;117 (%31,9), PA;112(%30,5) and PPP 11(%3), respectively. CPP group had significantly higher levels of height, weight, body mass index (BMI) and obesity/overweight incidence, estradiol (E2), basal luteinizing hormone (LH), peak LH, and peak LH/ follicle-stimulating hormone (FSH) ratio and higher uterine dimensions compared to the PT group while the PT group had significantly higher levels of peak FSH compared to the CPP group (p<0,05). It is impossible for the laboratory results to exactly match in each case with CPP, and the cases should be evaluated along with other clinical findings.
Conclusion: We detected an increase in the frequency of girls referred with PP signs in our study. The majority of children with PP were revealed as an incomplete type with a very low incidence of endocrine pathology. The complexity of pathogenesis in PP should lead us to be cautious about the consequences of PP in patients and evaluate their complaints, physical findings, and laboratory work-up seriously, such as a piece of a puzzle.
Keywords
Central precocious puberty, premature thelarche, premature adrenarche, Estradiol, DHEA-S, FSH, LH.
Kaynakça
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