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Praxis Feb 2017
Review
Topics: Adolescent; Child; Child, Preschool; Diagnosis, Differential; Female; Gonadotropins; Gynecomastia; Humans; Hypogonadism; Infant; Infant, Newborn; Male; Pregnancy; Puberty, Delayed; Puberty, Precocious; Reference Values
PubMed: 28169596
DOI: 10.1024/1661-8157/a002594 -
Hormone Research 1994Premature pubarche, premature thelarche and complete precocious puberty are usually simply normal phenomena occurring at an early age. This is not necessarily the case,... (Review)
Review
Premature pubarche, premature thelarche and complete precocious puberty are usually simply normal phenomena occurring at an early age. This is not necessarily the case, however, and they may sometimes be harbingers of reproductive endocrine disturbances in adulthood. Consequently, girls with these complaints cannot be entirely reassured that they are of no consequence, and they should be followed to ascertain whether pubertal reproductive function is eventually normal.
Topics: Androgens; Breast; Child; Child, Preschool; Female; Hair; Humans; Puberty, Precocious; Pubic Bone
PubMed: 8088707
DOI: 10.1159/000183950 -
Acta Paediatrica Scandinavica Nov 1984Data obtained during long-term follow-up of 68 girls with premature thelarche were analysed. In 85% onset was before the age of 2 years, in 30.8% being present at birth.... (Comparative Study)
Comparative Study
Data obtained during long-term follow-up of 68 girls with premature thelarche were analysed. In 85% onset was before the age of 2 years, in 30.8% being present at birth. In 44.1% there was a regression after 3 2/12 +/- 2 8/12 years (SD). Basal levels of plasma FSH and response to LH-RH were significantly higher than prepubertal controls (1.93 +/- 1.56 vs. 0.8 +/- 0.1 mU/ml and peaks 12.3 +/- 5.4 vs. 7.9 +/- 1.0 mU/ml respectively; p less than 0.001). Twenty-seven of 52 patients tested had increased plasma estradiol and in 27 of 40 patients tested, urocytograms or vaginal smear showed estrogenization. Basal levels of LH and response to LH-RH were prepubertal. The girls with premature thelarche were significantly taller than normal controls of the same age (p less than 0.001). These results suggest that premature thelarche is an incomplete form of precocious sexual development probably due to derangement in the maturation of the hypothalamo-pituitary-gonadal axis which results in a higher than normal secretion of FSH, as well as a defect in the peripheral sensitivity to the sex hormones.
Topics: 17-Ketosteroids; Age Factors; Body Height; Breast; Child; Child, Preschool; Dehydroepiandrosterone; Estradiol; Female; Follicle Stimulating Hormone; Gonadal Steroid Hormones; Gonadotropin-Releasing Hormone; Humans; Hypothalamo-Hypophyseal System; Infant; Infant, Newborn; Luteinizing Hormone; Ovary; Prolactin
PubMed: 6240890
DOI: 10.1111/j.1651-2227.1984.tb17771.x -
American Journal of Diseases of... Aug 1981The natural history of premature thelarche was investigated by contacting 46 patients with previously diagnosed cases. Palpable breast tissue had persisted for at least...
The natural history of premature thelarche was investigated by contacting 46 patients with previously diagnosed cases. Palpable breast tissue had persisted for at least three to five years in 57% of these girls. Only 11% reported that the breasts had continued to enlarge. Those cases in which breast tissue had been present at birth and persisted were significantly more likely to have progressive enlargement. Comparing the cases with matched control subjects showed no relationship between premature thelarche and maternal obstetrical problems, exposure to medications, diet, or prenatal infections. Girls with premature thelarche were no more likely than control subjects to have other sexual or medical problems develop during the period of follow-up.
Topics: Breast; Child; Child, Preschool; Diet; Female; Follow-Up Studies; Humans; Infant; Infant, Newborn; Pregnancy; Puberty, Precocious
PubMed: 7270520
DOI: No ID Found -
The Journal of Pediatrics Aug 1960
Topics: Adolescent; Child; Female; Humans; Infant; Menstruation; Puberty; Puberty, Precocious; Sexual Maturation
PubMed: 14444403
DOI: 10.1016/s0022-3476(60)80055-8 -
Revista Do Hospital Das Clinicas 2002Two groups of girls with premature breast development were studied retrospectively. We tried to identify clinical, radiological, and hormonal parameters that could... (Comparative Study)
Comparative Study
PURPOSE
Two groups of girls with premature breast development were studied retrospectively. We tried to identify clinical, radiological, and hormonal parameters that could distinguish between a benign, nonprogressive premature thelarche and a true precocious puberty.
METHODS
The clinical outcome of 88 girls with breast enlargement before 6.1 years of age was analyzed. Taking into account the progression of their sexual maturation, we allocated the children into 2 groups: "Isolated Premature Thelarche" (n = 63) and "Precocious Puberty" (n = 25) groups. Chronological and bone ages, height and growth velocity centiles, computerized tomography of hypothalamus-pituitary area, pelvic ultrasonography, gonadotropin response to luteinizing hormone-releasing hormone stimulation as well as basal levels of luteinizing hormone, follicle-stimulating hormone, estradiol, and prolactin were studied in both groups. Statistical analysis were performed using the Student t test to compare the sample means. Fisher's exact test and chi2 test were used to analyze the nonparametric variables.
RESULTS
Isolated premature thelarche most frequently affected girls younger than 2 years who presented exaggerated follicle-stimulating hormone response to luteinizing hormone-releasing hormone stimulation test. The precocious puberty group had higher initial stature, accelerated growth rate and bone age, increased uterine and ovarian volumes, high spontaneous luteinizing hormone levels by immunofluorimetric assay, as well as a high luteinizing hormone response and peak luteinizing hormone/follicle-stimulating hormone ratio after luteinizing hormone-releasing hormone stimulation.
CONCLUSION
At initial presentation, girls who undergo true precocious puberty present advanced bone age, increased uterine and ovarian volumes in addition to breast enlargement, as well as an luteinizing hormone-predominant response after a luteinizing hormone-releasing hormone stimulation test.
Topics: Age Determination by Skeleton; Age of Onset; Anthropometry; Breast; Chi-Square Distribution; Child; Child, Preschool; Estradiol; Female; Gonadotropins, Pituitary; Humans; Puberty, Precocious; Retrospective Studies
PubMed: 11981584
DOI: 10.1590/s0041-87812002000200001 -
Indian Journal of Pediatrics Mar 2015To estimate the association between serum bisphenol A and premature thelarche in female infants aged 4-mo to 2-y.
OBJECTIVES
To estimate the association between serum bisphenol A and premature thelarche in female infants aged 4-mo to 2-y.
METHODS
A total of 251 female infants (aged 4 mo to 2 y) with premature thelarche and 33 healthy age-matched control subjects were analyzed. All participants underwent physical examination and serum bisphenol A was measured by ultra-performance liquid chromatography tandem mass spectrometry.
RESULTS
Serum bisphenol A concentration in the premature thelarche group (3.48 ng/ml, 95%CI: 0.09-140.26) was significantly higher than that in the control group (1.70 ng/ml, 95%CI: 0.06-51.78) (p = 0.039). There was no correlation between age and serum bisphenol A (BPA) level. Univariate logistic regression analysis showed that serum BPA concentration positively associated with premature thelarche, and the effect of BPA fell down as the age grew.
CONCLUSIONS
This hospital-based study implied that there is an association between serum BPA concentrations and premature thelarche. Additionally, serum BPA levels were markedly higher in infants aged 4-mo to 2-y-old, raising a concern for public health authorities.
Topics: Benzhydryl Compounds; Breast; China; Chromatography, Liquid; Female; Humans; Infant; Phenols; Puberty, Precocious; Statistics as Topic
PubMed: 25120062
DOI: 10.1007/s12098-014-1548-7 -
The Journal of Clinical Endocrinology... Jan 2024Nonprogressive premature thelarche (PT) is a self-limiting variant of early puberty, while idiopathic central precocious puberty (ICPP) is a disorder that causes...
CONTEXT
Nonprogressive premature thelarche (PT) is a self-limiting variant of early puberty, while idiopathic central precocious puberty (ICPP) is a disorder that causes progressive development of secondary sexual characteristics and often requires treatment. The diagnostic differentiation between these conditions is important but can be challenging since they often both initially present clinically with isolated breast development.
OBJECTIVE
To describe relevant clinical variables in a large cohort of girls referred for early puberty, and to evaluate clinical and biochemical parameters to distinguish between girls with ICPP and PT.
METHODS
This retrospective study included 1361 girls referred with signs of early puberty to a single, tertiary center from 2009 to 2019. We evaluated clinical presentation, medical history, growth velocity, bone age, hormonal serum concentrations, and gonadotropin-releasing hormone (GnRH) test results.
RESULTS
Central precocious puberty was diagnosed in 11% (ICPP: n = 143, organic CPP: n = 11) girls, whereas 8% (n = 91 girls) presented with PT. Receiver operating characteristic (ROC) analysis showed several biochemical and anthropometric markers as potential parameters to differentiate between ICPP and PT; however, none were individually adequate. Principal component analysis (PCA)-derived clinical and hormone profiles could predict girls with ICPP from girls with PT with a specificity of 90% and sensitivity of 84%, outperforming any single marker.
CONCLUSION
Differentiation of girls with ICPP and PT can be supported by individual clinical and biochemical parameters. However, dimension reduction of clinical and hormonal profiles by PCA improved the diagnostic value, which in the future may support the diagnostic process as a supplement to the GnRH test in evaluation of pubertal disorders.
Topics: Female; Humans; Puberty, Precocious; Retrospective Studies; Principal Component Analysis; ROC Curve; Gonadotropin-Releasing Hormone
PubMed: 37698163
DOI: 10.1210/clinem/dgad535 -
Journal of Clinical Research in... Sep 2012Premature thelarche (PT) refers to isolated onset of thelarche in girls younger than 8 years of age. Most cases have an onset under 2 years of age. We aimed to establish... (Comparative Study)
Comparative Study
OBJECTIVE
Premature thelarche (PT) refers to isolated onset of thelarche in girls younger than 8 years of age. Most cases have an onset under 2 years of age. We aimed to establish whether the onset of thelarche under 2 years of age certifies a transient clinical course, as suggested by several authors.
METHODS
Sixty-seven girls with an onset of PT under 2 years of age were classified as having early puberty (EP) or classical PT after one year of follow-up. Progression of pubertal findings or absolute growth velocity (GV) standard deviation score (SDS) above 1 SDS constituted the criteria for a diagnosis of EP.
RESULTS
Twenty (29.1%) girls were classified as having EP and 47 (70.1%) girls as having classical PT. Basal serum luteinizing hormone (LH; ICMA) values at a cut-off level of 0.3 IU/L were found to be a significant risk factor for having an atypical course [OR=7.8; CI (95%): 2.04-30.4, p=0.003].
CONCLUSIONS
Onset of thelarche under 2 years of age does not assure a transient course in a remarkable proportion of girls with PT. An absolute GV value of >1 SDS or a basal LH level ≥0.3 IU/L are suggested as indicators for close follow-up.
Topics: Age of Onset; Breast; Child Development; Child, Preschool; Disease Progression; Disorders of Sex Development; Estradiol; Female; Follicle Stimulating Hormone, Human; Follow-Up Studies; Gonadotropin-Releasing Hormone; Humans; Infant; Luteinizing Hormone; Medical Records; Puberty, Precocious; Remission, Spontaneous; Retrospective Studies; Risk Factors; Turkey
PubMed: 22985613
DOI: 10.4274/Jcrpe.709 -
Nutrients Oct 2023The prevalence of central precocious puberty (CPP) in girls has increased worldwide and is often associated with obesity in childhood as well as high fat/high glycemic... (Review)
Review
The prevalence of central precocious puberty (CPP) in girls has increased worldwide and is often associated with obesity in childhood as well as high fat/high glycemic index diets. Evidence suggests that subjects with obesity present with alterations in appetite-regulating hormones. The arcuate and paraventricular nuclei of the hypothalamus are the centers of action of appetite hormones, as well as the location of gonadotropin-releasing hormone (GnRH) neurons, the activation of which results in the onset of puberty. This anatomical proximity raises the question of possible alterations in appetite-regulating hormones in patients with CPP. Furthermore, diet-induced hypothalamic inflammation constitutes a probable mechanism of the pathophysiology of CPP, as well as alterations in appetite-regulating hormones in young children. In this article, we summarize the evidence investigating whether girls with CPP present with alterations in appetite-regulating hormones. We present evidence that leptin concentrations are elevated in girls with CPP, ghrelin concentrations are lower in girls with CPP, nesfatin-1 and orexin-A concentrations are elevated among girls with premature thelarche, and insulin concentrations are increased in girls with early menarche.
Topics: Female; Child; Humans; Child, Preschool; Puberty, Precocious; Luteinizing Hormone; Appetite; Pediatric Obesity; Gonadotropin-Releasing Hormone; Follicle Stimulating Hormone
PubMed: 37836591
DOI: 10.3390/nu15194306