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Journal of Pediatric Nursing 2022Precocious puberty (PP) is an illness that appears when puberty, begins some years earlier than usual, provoking inferences in preadolescents and adolescents and their... (Review)
Review
PROBLEM
Precocious puberty (PP) is an illness that appears when puberty, begins some years earlier than usual, provoking inferences in preadolescents and adolescents and their families. Therefore, the aim is to analyze if psychological consequences can be observed in groups of preadolescents or adolescents with PP.
METHOD
A bibliographic search of the scientific literature was made following the PRISMA guide in the following databases: ProQuest, Psychinfo, Web Of Science, and Scopus. 592 studies were found, were uploaded to Covidence to make a screening, of which finally 6 were included for the revision according to the inclusion and exclusion criteria. Two independent evaluators made the search, selection, data extraction and quality evaluation of studies independently. The agreement degree between both was excellent in all of the cases.
RESULTS
211 preadolescents participated in total in all studies, of which 99 were preadolescents with PP, with a mean age of 8,94 years old. Studies evaluated so heterogeneous variables, such as psychopathology, self-image, neuropsychological and cognitive variables, and reasons to delay or stop PP. The quality of studies was moderated especially due to the low quality of the studies design, which were mostly transversal, and the representativity of the sample, being selected by convenience.
CONCLUSIONS AND IMPLICATIONS
More research is needed to evaluate the psychological consequences of the PP diagnosis in pediatrics, and its protection factors, because none of the studies approached this question. We consider that it is necessary to increment the quality of these studies, and that these take a biopsychosocial perspective.
Topics: Adolescent; Child; Humans; Puberty; Puberty, Precocious; Self Concept
PubMed: 35033399
DOI: 10.1016/j.pedn.2022.01.002 -
Pediatric Research Dec 2022Attention deficit-hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in children; however, studies delineating the association between...
BACKGROUND
Attention deficit-hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in children; however, studies delineating the association between ADHD and central precocious puberty are limited. This study aimed to understand whether children with ADHD are at a higher risk of central precocious puberty.
METHODS
This population-based retrospective cohort study was conducted using the National Health Insurance Research Database of Taiwan to investigate the association between ADHD and the incidence of central precocious puberty between 2000-2015. We identified ADHD individuals treated with methylphenidate, atomoxetine or not. The control cohort consisted of individuals without ADHD. The outcome measure was central precocious puberty diagnosis.
RESULTS
Among 290,148 children (mean age: 5.83 years), central precocious puberty incidence was 4.24 and 1.95 per 10 person-years in the ADHD and control groups, respectively. Children with ADHD treated with medication had a higher risk than those without ADHD. However, medication use did not affect the incidence of central precocious puberty among children with ADHD.
CONCLUSION
This study showed an association between ADHD and a higher risk of central precocious puberty. Early referral of children with ADHD to a pediatric endocrinologist for evaluation may facilitate correct diagnoses and early interventions.
IMPACT
ADHD is associated with a higher risk of central precocious puberty. This study provides relevant findings, as it is the first nationwide, population-based cohort study to investigate the association between ADHD and the risk of central precocious puberty with a 15-year follow-up. Early referral of children with ADHD to a pediatric endocrinologist for the evaluation of suspected precocious puberty could facilitate correct diagnosis. Early intervention treatment with gonadotropin-releasing hormone agonist might improve final height in children with central precocious puberty.
Topics: Child; Humans; Child, Preschool; Puberty, Precocious; Attention Deficit Disorder with Hyperactivity; Cohort Studies; Gonadotropin-Releasing Hormone; Retrospective Studies
PubMed: 35347278
DOI: 10.1038/s41390-022-02028-5 -
Hormone Research in Paediatrics 2019This update, written by authors designated by multiple pediatric endocrinology societies (see List of Participating Societies) from around the globe, concisely addresses... (Review)
Review
This update, written by authors designated by multiple pediatric endocrinology societies (see List of Participating Societies) from around the globe, concisely addresses topics related to changes in GnRHa usage in children and adolescents over the last decade. Topics related to the use of GnRHa in precocious puberty include diagnostic criteria, globally available formulations, considerations of benefit of treatment, monitoring of therapy, adverse events, and long-term outcome data. Additional sections review use in transgender individuals and other pediatric endocrine related conditions. Although there have been many significant changes in GnRHa usage, there is a definite paucity of evidence-based publications to support them. Therefore, this paper is explicitly not intended to evaluate what is recommended in terms of the best use of GnRHa, based on evidence and expert opinion, but rather to describe how these drugs are used, irrespective of any qualitative evaluation. Thus, this paper should be considered a narrative review on GnRHa utilization in precocious puberty and other clinical situations. These changes are reviewed not only to point out deficiencies in the literature but also to stimulate future studies and publications in this area.
Topics: Adolescent; Child; Female; Gonadotropin-Releasing Hormone; Humans; Male; Puberty, Precocious
PubMed: 31319416
DOI: 10.1159/000501336 -
Comprehensive Therapy Dec 1987
Review
Topics: Adolescent; Child; Female; Humans; Male; Puberty, Precocious
PubMed: 3326712
DOI: No ID Found -
Endocrine Development 2012Premature development of breast and/or pubic hair in a prepubertal girl used to raise questions and concerns from the families. There is actually a wide range of... (Review)
Review
Premature development of breast and/or pubic hair in a prepubertal girl used to raise questions and concerns from the families. There is actually a wide range of clinical expressions of precocious puberty in girls and not all presentations are considered to be true precocious puberty. Central precocious puberty occurs in 10-20% of girls, but beside the typical forms other clinical presentations have been identified. In 50-60% of the cases, only one secondary sex characteristic shows premature development and raises the diagnosis of premature thelarche, premature pubarche or isolated metrorrhagia. In 10% of the cases, autonomous ovarian overproduction of estrogens causes peripheral precocious puberty. Lastly, hyperestrogenism may have exogenous causes, such as exposure to environmental chemical pollutants. A decision on therapeutic management is based on clinical, biological and radiologic examinations, and LHRH analogous treatment should be limited to central precocious puberty before the age of 8 years.
Topics: Age Determination by Skeleton; Age Factors; Age of Onset; Breast; Child; Female; Humans; Models, Biological; Ovary; Puberty, Precocious
PubMed: 22846523
DOI: 10.1159/000334304 -
Endocrine Development 2004
Review
Topics: Child; Child Health Services; Gonadotropin-Releasing Hormone; Gynecology; Humans; Puberty, Precocious; Ultrasonography
PubMed: 15045786
DOI: 10.1159/000077077 -
Journal of Pediatric Endocrinology &... 1998Clinicians should now be fully aware of this intriguing condition of GIPP. The condition is characterized by pubertal sex steroid concentrations and gametogenesis in the... (Review)
Review
Clinicians should now be fully aware of this intriguing condition of GIPP. The condition is characterized by pubertal sex steroid concentrations and gametogenesis in the presence of prepubertal or suppressed gonadotrophins. In patients with MPP especially without a family history, one should exclude the possibility of pseudoprecocious puberty due to premature production of sex steroids without pituitary gonadotrophins resulting from a primary disorder of the gonad or adrenal gland or to autonomous secretion of gonadotrophin by a tumor. Similarly in patients with recurrent ovarian cyst formation, persistence of the cysts especially with a significant solid component beyond three months should alert a clinician to the possibility of juvenile granulosa cell tumor of the ovary /75/. After confirmation of the diagnosis appropriate treatment should be instituted.
Topics: Amino Acid Substitution; Fibrous Dysplasia, Polyostotic; Gonadotropins; Humans; Male; Point Mutation; Puberty, Precocious
PubMed: 9777570
DOI: 10.1515/jpem.1998.11.4.497 -
Journal of Endocrinological... Aug 2017Puberty is a major developmental stage. Damaging mutations, considered as "mistakes of nature", have contributed to the unraveling of the networks implicated in the... (Review)
Review
Puberty is a major developmental stage. Damaging mutations, considered as "mistakes of nature", have contributed to the unraveling of the networks implicated in the normal initiation of puberty. Genes involved in the abnormal hypothalamic-pituitary-gonadal (HPG) axis development, in the normosmic idiopathic hypogonadotropic hypogonadism (nIHH), in the X-linked or autosomal forms of Kallmann syndrome and in precocious puberty have been identified (GNRH1, GNRHR, KISS1, GPR54, FGFR1, FGF8, PROK2, PROKR2, TAC3, TACR3, KAL1, PROK2, PROKR2, CHD7, LEP, LEPR, PC1, DAX1, SF-1, HESX-1, LHX3, PROP-1). Most of them were found to play critical roles in HPG axis development and regulation, the embryonic GnRH neuronal migration and secretion, the regulation and action of the hypothalamic GnRH. However, the specific neural and molecular mechanisms triggering GnRH secretion remain one of the scientific enigmas. Although GnRH neurons are probably capable of autonomously generating oscillations, many gonadal steroid-dependent and -independent mechanisms have also been proposed. It is now well proven that the secretion of GnRH is regulated by kisspeptin as well as by permissive or opposing signals mediated by neurokinin B and dynorphin. These three supra-GnRH regulators compose the kisspeptin-neurokinin B-dynorphin neuronal (KNDy) system, a key player in pubertal onset and progression. Moreover, an ongoing increasing number of inhibitory, stimulatory and permissive networks acting upstream on GnRH neurons, such as GABA, NPY, LIN28B, MKRN3 and others integrate diverse hormonal and peripheral signals and have been proposed as the "gate-keepers" of puberty, while epigenetic modifications play also an important role in puberty initiation.
Topics: Epigenesis, Genetic; Humans; Puberty, Precocious
PubMed: 28251550
DOI: 10.1007/s40618-017-0627-9 -
Problemy Endokrinologii Sep 2021The precocious puberty is an urgent problem of pediatric endocrinology characterized by clinical and pathogenetic heterogeneity. The appearance of secondary sex...
The precocious puberty is an urgent problem of pediatric endocrinology characterized by clinical and pathogenetic heterogeneity. The appearance of secondary sex characteristics before the age of 8 years in girls and 9 years in boys requires timely diagnosis and the appointment of pathogenetically justified treatment in order to achieve the target indicators of final growth and prevent social deprivation. The developed clinical guidelines are the main working tool of the practitioner. They briefly and structurally present the main information about the epidemiology and modern classification of рrecocious puberty, methods of its diagnosis and treatment based on the principles of evidence-based medicine.
Topics: Child; Female; Humans; Male; Puberty; Puberty, Precocious
PubMed: 34766494
DOI: 10.14341/probl12821 -
Endocrinology and Metabolism Clinics of... Jun 2024A thorough history and physical examination including Tanner staging and growth assessments can guide differential diagnosis and aid in the evaluation of precocious...
A thorough history and physical examination including Tanner staging and growth assessments can guide differential diagnosis and aid in the evaluation of precocious puberty. Basal luteinizing hormone levels measured using a highly sensitive assay can be helpful in diagnosing central precocious puberty (CPP). Brain MRI is indicated with males diagnosed with CPP and females under the age of 6 with CPP. As more information becomes available regarding the genetic etiologies of CPP, genetic testing may preclude the need for imaging studies and other hormonal testing, especially in familial cases.
Topics: Child; Child, Preschool; Female; Humans; Male; Luteinizing Hormone; Magnetic Resonance Imaging; Puberty, Precocious
PubMed: 38677865
DOI: 10.1016/j.ecl.2024.02.002