Çocuk Sağlığı İzlem Birimine Başvuran Prematür Telarş Vakaları

Yıl 2011, Cilt: 11 Sayı: 4, 151 - 156, 01.10.2011

İsmail Yıldız Gülbin Gökçay Feyza Darendeliler Serpil Uğur Baysal

https://doi.org/10.5222/j.child.2011.151

Öz

Amaç: Son yıllarda, cinsel olgunlaşmanın erken başlamasına yol açan bazı çevresel etkenlerin varlığı düşünülmektedir. Bu nedenle, prematür telarş vakalarını değerlendirilmeyi amaçladık. Yöntemler: İstanbul Tıp Fakültesi, Çocuk Sağlığı İzlem Birimi’ne 2006-2008 yılları arasında başvuran 1163 çocuk arasında, klinik muayene ile prematür telarş belirlenen 15 vaka ayrıntılı olarak incelendi ve izlendi. Vakalar beslenme ve bazı ev içi etkenler açısından kontrol grubu ile karşılaştırıldılar. Bulgular: On beş vakada klinik prematür telarş saptandı. Prematür telarş vakalarının yaş ortalaması 8,2 ay 1-24 ay , ortalama tanı yaşı 6,2 ay bulundu. Bir vakada FSH, bir vakada E2 yüksekliği, pelvis ultrason incelemesinde üç vakada overlerde kist saptandı. Meme gelişimi ortalama 5,4 ayda aralık: 4-8 ay geriledi. Bir vaka, erken puberte tanısı aldı. Vakalar arasında normal doğum oranı yüksek bulundu. Vaka grubunda bitki çaylarının, kontrol grubunda gebelikte meyve tüketiminin daha yüksek olmasına karşın, her iki grup arasında, beslenme ve çevresel etkenler açısından anlamlı fark bulunmadı. Sonuç: Prematür telarş vakaları, erken puberte açısından yakın izlenmelidirler. Ailelerin kaygılarını giderecek yaklaşımda bulunmak, anne sütü ile beslenmeyi sonlandırmak gibi yanlış uygulamaları önlemek gerekmektedir. Vakalarımızın uzunca bir süre izlenmiş olmaları, olası etkenlerle ilgili bilgi toplanmış olması ve iki yaşından küçük çocuklar olmaları araştırmamızın üstün yanlarıdır.

Anahtar Kelimeler

Prematür telarş, çocuk, çevre

Premature Thelarche Cases Attending Well-Child Care Surveillance Unit

Öz

Objective: Early sexual maturation has been attributed to some environmental factors in recent years. Therefore, we aimed to evaluate the cases with premature telarche. Methods: Among 1163 children attending the Child HealthCare Surveillance Unit between January 2006-December 2008, 15 cases identified clinically as premature telarche had undergone a detailed examination and follow up. The cases were compared to the control group for nutrition of both mother and child, and some domestic factors. Results: Fifteen 1,2 percent cases were diagnosed as premature telarche clinically. The mean age was 8.2 months 1-24 mos , and the mean age of diagnosis was 6.2 months. One case had increased FSH and another increased E2 levels. Cysts were identified in three cases on pelvic ultrasound examination. The mean time to the regression of the breast development was 5.4 months 4-8 months . One case was referred with the diagnosis of early puberty. Normal delivery rate was higher among the cases. Although higher consumption of herbal tea was higher among the cases and the fruit consumption was higher among the controls during pregnancy, no significant difference was found between the two groups as for nutrition and environmental factors. Conclusion: The cases with premature thelarche should be closely followed-up as for early puberty. Concerns of the families should be resolved, and false practices such as cessation of the breastfeeding should be prevented. Our study has some superiorities in that the infants and toddlers were followed-up for a relatively longer period of time, substantial information related to potential causes were collected, and our study population consisted of children younger than 2 years

Anahtar Kelimeler

Premature thelarche, child, environment

Kaynakça

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