International Journal of
Reproductive Biomedicine
Wed, Jan 15, 2025
[Archive]
Volume 10, Issue 1 (7-2012)
IJRM 2012, 10(1): 1-6 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Rohani F, Salehpur S, Safari F. Etiology of precocious puberty, 10 years study in Endocrine Reserch Centre (Firouzgar), Tehran. IJRM 2012; 10 (1) :1-6
URL: http://ijrm.ir/article-1-254-en.html
URL: http://ijrm.ir/article-1-254-en.html
1- Endocrine Research Centre (Firouzgar), Institute of Endocrinology and Metabolism (Hemmat Campus), Tehran University of Medical Sciences, Tehran, Iran , dr_rohani@yahoo.com
2- Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3- Booali Metabolic Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
2- Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3- Booali Metabolic Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
Abstract: (3601 Views)
Background: Precocious puberty, as early physical development and low final height might lead to psychosocial problems.
Objective: To evaluate etiology and clinical feature of precocious puberty in a cohort of Iranian children.
Materials and Methods: In this case-series study, 44 girls and 8 boys with precocious puberty referred to Endocrine Reserch Centre (Firouzgar), Institute of Endocrinology and Metabolism (Hemmat Campus), were examined in a 10 years period of time.
Results: Mean age of girls and boys was 7.43±1.4 years and 5.8±2.1 years respectively. Most of the patients fell within the age category of 7-7.9 years old (40.9% for girls and 50% for boys). Patients, concerning etiology of precocious puberty were classified in three categories: 42.6% of patients had central precocious puberty (CPP), including idiopathic CPP (87.5%) and neurogenic CPP (12.5%). 23.3% of patients had peripheral precocious puberty (PPP), including congenital adrenal hyperplasia (CAH) (42.8%), ovarian cysts (28.4%), McCune-Albright syndrome (14.2%) and adrenal carcinoma (14.2%). 34.1% of girls and 25% of boys had normal variant puberty including premature thelarche (57%), premature adrenarche (38%) as well as premature menarche (4.7%l).
Conclusion: The most common etiology of precocious puberty in girls was idiopathic central precocious puberty and premature thelarche, while in boys they were neurogenic central precocious puberty and CAH. Therefore precocious puberty in girls is usually benign. In boys, CNS anomalies should first be considered in the differential diagnosis of CPP. Therefore brain Magnetic Resonance Imaging (MRI) is mandatory in all cases.
Objective: To evaluate etiology and clinical feature of precocious puberty in a cohort of Iranian children.
Materials and Methods: In this case-series study, 44 girls and 8 boys with precocious puberty referred to Endocrine Reserch Centre (Firouzgar), Institute of Endocrinology and Metabolism (Hemmat Campus), were examined in a 10 years period of time.
Results: Mean age of girls and boys was 7.43±1.4 years and 5.8±2.1 years respectively. Most of the patients fell within the age category of 7-7.9 years old (40.9% for girls and 50% for boys). Patients, concerning etiology of precocious puberty were classified in three categories: 42.6% of patients had central precocious puberty (CPP), including idiopathic CPP (87.5%) and neurogenic CPP (12.5%). 23.3% of patients had peripheral precocious puberty (PPP), including congenital adrenal hyperplasia (CAH) (42.8%), ovarian cysts (28.4%), McCune-Albright syndrome (14.2%) and adrenal carcinoma (14.2%). 34.1% of girls and 25% of boys had normal variant puberty including premature thelarche (57%), premature adrenarche (38%) as well as premature menarche (4.7%l).
Conclusion: The most common etiology of precocious puberty in girls was idiopathic central precocious puberty and premature thelarche, while in boys they were neurogenic central precocious puberty and CAH. Therefore precocious puberty in girls is usually benign. In boys, CNS anomalies should first be considered in the differential diagnosis of CPP. Therefore brain Magnetic Resonance Imaging (MRI) is mandatory in all cases.
Keywords: Central precocious puberty, Peripheral precocious puberty, Premature thelarche, Congenital adrenal hyperplasia.
Type of Study: Original Article |
References
1. Grumbach MM, Styne DM. Puberty: ontogeny, neuroendocrinology, physiology, and disorders In: Wilson. Foster. Kronenberg. Williams Textbook of Endocrinology. 9th Ed. Philadelphia; Saunders; 1998: 1573-1623.
2. Bellin M, Sarafoglou K, Nathan B. Precocious Puberty. In: Sarafoglou K, Hoffmann GF, Roth KS, Pediatric Endocrinology and Inborn errors of Metabolism. China; Ma Graw- Hill; 2009: 495-499.
3. Rosenfield RL, Cook Radovicks. Puberty and its disorder in the female. In: Sperling MA, Pediatric Endocrinology, 3rd Ed. Philadelphia; W.B. Saunders Co.; 2008: 565-569. [DOI:10.1016/B978-141604090-3.50019-3]
4. Bourguignon JP. Delayed puberty and hypogonadism. In: Bertrand J, Raprecocious pubertyaport R, Sizonenko PC. Pediatric Endocrinology. 2nd Ed. Baltimore; Williams & Willkins; 1993: 387-403.
5. Rogol A, Blizzard R. Variations and disorders of pubertal development. In: Kapy MS, Blizzard RM, Migeon CJ. Wilkins. The Diagnosis and Treatment of Endocrin Disorders in Childhood and Adolescence. 4th Ed. Springfield, IL; charles C Thomas; 1994: 872-886.
6. Garibaldi L. Disorders of pubertal development. In: Kliegman RM.: Behrman RE, Jenson HB. Stanton BF. Nelson Text Book of pediatrics, 18th Ed. Philadelphia; W.B. Saunders; 2007: 2309-2315.
7. Dattani MT, Tziaferi V, Hindmarsh C. Evaluation of Disordered Puberty. In: Brook's Clinical Pediatric Endocrinology. Brook CGD, Clayton PE, Brown RS, 6th Ed. Oxford; Black Well's; 2009: 224-230. [DOI:10.1002/9781444316728.ch10]
8. Brook CG. Precocious puberty. Clin Endocrinol (0xf) 1995; 42: 647-650. [DOI:10.1111/j.1365-2265.1995.tb02693.x]
9. Largo RH, Parader A. Pubertal development in Swiss girls. Helv Paediatr Acta 1983; 38: 229-243.
10. Largo RH, Parader A. Pubertal development in Swiss boys. Helv Paediatr Acta 1983; 38: 211-228.
11. Clark PA. Puberty: when it comes too soon guidelines for the evaluation of sexual precocity. J Ky Med Assoc 1998; 96: 440-447.
12. Elder MJ, Scott CR, Frindik JP, Kemp SF. Clinical work-up for precocious puberty. Lancet 1997; 350: 457-458. [DOI:10.1016/S0140-6736(05)63075-9]
13. Brooke CGD, Brown RS. Problems of puberty and adolescence. In: Brooke CGD, Brown RS. Handbook of Clinical Pediatric Endocrinology. 1st Ed. USA; Blackwell; 2008: 59-67.
14. Lee PA. Early pubertal development. In: Moshang T Jr. Pediatric Endocrinology. USA; Mosby; 2005: 75-78. [DOI:10.1016/B978-0-323-01825-8.50034-X]
15. Partsch CJ, Sippell WG. Pathogenesis and epidemiology of precocious puberty. Effects of exogenous oestrogens. Hum Reprod Update 2001; 7: 292-302. [DOI:10.1093/humupd/7.3.292]
16. Ghaemi N, Vakili R. The study of precocious puberty in 55 girls referred to Pediatric Endocrine Ward in Mashhad University. Iran J Obstet Gynecol Infertil 2002; 5: 20-29.
17. Moayeri H, Rabbani A. Frequency of different types of precocious puberty, determining the predisposing factor and need to treatment in children, Imam Hospital, 1993- 2000. Tehran University Medical Journal 2002; 60: 124-130.
18. Greulich MM, Pyle SI. Radiographic Atlas of Skeletal Development of the Hand and Wrist. 2nd Ed. Stanford; University Press; 1959.
19. Marshall WA, Tanner JM. Variations in the pattern of pubertal changes in boys. Arch Dis Child 1970; 45: 13-23. [DOI:10.1136/adc.45.239.13]
20. Marshall WA, Tanner JM. Variations in pattern of pubertal changes in girls. Arch Dis Child 1969; 44: 291-303. [DOI:10.1136/adc.44.235.291]
21. Garnier PE, Chaussain JL, Binet E, Schlumberger A, Job JC. Effect of synthetic luteinizing hormone releasing hormone (LH - RH) on the release of gonadotropins in children and adolescents. VI. Relations to age, sex and puberty. Acta Endocrinol (Copenh) 1974; 77: 422-434. [DOI:10.1530/acta.0.0770422]
22. Dennis M, Styne and Melvin M, Grumbach MM. Puberty: ontogeny, neuroendocrinology, physiology, and disorders In: Kronenberg HM, Melmed S, Polonsky KS, larsen PR. Williams Textbook of Endocrinology. 11th Ed. Philadelphia; Saunders; 2008: 1068-1069.
23. Brauner R, Thibaud E, Pomarede R, Cachin O, Hausser C, Czernichow P, et al. Precocious puberty. Comment on the diagnostic conditions and etiological aspects. Ann Endocrinol (Paris) 1982; 43: 497-508.
24. Bridges NA, Christopher JA, Hindmarsh PC, Brook CG. Sexual precocity: sex incidence and aetiology. Arch Dis Child 1994; 70: 116-118. [DOI:10.1136/adc.70.2.116]
25. Chemaitilly W, Trivin C, Adan L, Gall V, Sainte-Rose C, Brauner R. Central precocious puberty: clinical and laboratory features. Clin Endocrinol (Oxf) 2001; 54: 289-294. [DOI:10.1046/j.1365-2265.2001.01229.x]
26. Bajpai A, Sharma J, Kabra M, Kumar Gupta A, Menon PS. Precocious puberty: Clinical and endocrine profile and factors indicating neurogenic precocity in Indian children. J Pediatr Endocrinol Metab 2002; 15: 1173-1181. [DOI:10.1515/JPEM.2002.15.8.1173]
27. Soriano- Guillén L, Corripio R, Labarta JI, Ca-ete R, Castro- Feijóo L, Espino R, et al. Central precocious puberty in children living in Spain: incidence, prevalence and influence of adoption and immigration. J Clin Endocrinol Metab 2010; 95:4305-4313. [DOI:10.1210/jc.2010-1025]
28. De Sanctis V, Corrias A, Rizzo V, Bertelloni S, Urso L, Galluzzi F, et al. Etiology of central precious puberty in males: the results of the Italian Study Group for Physiopathology of Puberty. J Pediatr Endocrinol Metab 2000; 13: 687-693. [DOI:10.1515/JPEM.2000.13.S1.687]
29. Thamdrup E. (Somatic development in puberty: a survey) Den somatiske udvikling: pubertetsarene: En oversigt. Nord Med 1965; 74: 1013-1018.
30. Wilkins L. The Diagnosis and Treatment of Endocrine Disorders in childhood and Adolescent. Springfield, IL; Charlec C Thomas; 1965.
31. Sigurjonsdottir TJ, Hayles AB. Precocious puberty: a report of 96 cases. AM J Dis child 1968; 115: 309-321. [DOI:10.1001/archpedi.1968.02100010311003]
32. Kaplan SL, Grumbach MM. Pathogenesis of sexual precocity. In: Grumbach MM, eds. Control of the Onset of Puberty. Baltimore; Williams &Wilkins; 1990; 620-660.
33. Cisternino M, Arrigo T, Pasquino AM, Tinelli C, Antoniazzi F, Beduschi L, et al. Etiology and age incidence of precocious puberty in girls: a multicentric study. J Pediatr Endocrinol Metab 2000; 13: 695-701. [DOI:10.1515/JPEM.2000.13.S1.695]
34. Lee CT, Tung YC, Tsai WY. Etiology and clinical features of isosexual precocious puberty in Taiwanese girls: twenty-three years' experience in National Taiwan University Hospital. J Pediatr Endocrinol Metab 2009; 22: 947-953. [DOI:10.1515/JPEM.2009.22.10.947]
35. Zou CC, Liang L, Dong GP, Zhao ZY. Peripheral precocious puberty: a retrospective study for six years in Hangzhou, China. J Paediatr Child Health 2008; 44: 415-418. [DOI:10.1111/j.1440-1754.2008.01320.x]
36. Lee PA, Kerrigan JR. Precocious Puberty, In: Pescovitz OH, Eugster EA. Pediatric Endocrinology, Philadelphiya, Liprecocious pubertyincott. Williams and Wilknis; 2004; 318-332.
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
