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The Journal of Pediatrics Mar 2010To determine whether age at premature thelarche (PT) onset affects the clinical characteristics, course, and risk of progression to precocious puberty (PP).
OBJECTIVES
To determine whether age at premature thelarche (PT) onset affects the clinical characteristics, course, and risk of progression to precocious puberty (PP).
STUDY DESIGN
Data regarding course of growth and puberty were retrieved from the medical files of 139 girls with PT followed up from 1995 to 2005. Analysis was based on age at PT appearance (birth, 1-24 months, and 2-8 years); course was categorized as regressive, persistent, progressive, or cyclic.
RESULTS
At diagnosis, height standard deviation score, bone age-chronological age ratio, and hormonal values were comparable in the 3 age groups. PT regressed in 50.8%, persisted in 36.3%, progressed in 3.2% and had a cyclic course in 9.7%. A progressive or cyclic course was significantly more prevalent among girls presenting after 2 years (52.6%) compared with girls presenting at birth (13.0%) or at 1 to 24 months (3.8%) (P < .001). PP occurred in 13% irrespective of age at PT presentation or clinical course.
CONCLUSIONS
Clinical and anthropometric characteristics at admission and risk of PP were similar in all girls with PT, regardless of age at onset. There are currently no clinical or laboratory tests that can predict the risk of progression to PP at presentation.
Topics: Age of Onset; Breast; Child; Child, Preschool; Disease Progression; Female; Follicle Stimulating Hormone; Humans; Infant; Infant, Newborn; Luteinizing Hormone; Puberty, Precocious; Remission, Spontaneous; Risk Factors
PubMed: 19914634
DOI: 10.1016/j.jpeds.2009.09.071 -
Hormone Research in Paediatrics 2016Polybrominated diphenyl ethers (PBDEs) are widely used as flame retardants and have shown endocrine disruption properties in experimental studies. The aim of this study... (Clinical Trial)
Clinical Trial
BACKGROUND/AIMS
Polybrominated diphenyl ethers (PBDEs) are widely used as flame retardants and have shown endocrine disruption properties in experimental studies. The aim of this study was to investigate the association between the exposure to PBDEs and alterations of puberty in girls referred for idiopathic central precocious puberty (ICPP) and premature thelarche (PT).
METHODS
A case-control study was conducted in 124 girls: 37 girls with ICPP (mean age 7.4 ± 0.9 years), 56 with PT (mean age 5.7 ± 2.1 years) and 31 controls (mean age 5.4 ± 1.9 years). PBDE serum concentrations, hormone levels and anthropometry were assessed. PBDE concentrations were corrected for total serum lipid content. Individual exposure to PBDEs was evaluated through ad hoc questionnaires.
RESULTS
PBDE serum concentrations corrected for total lipid content were significantly higher in girls with PT (mean 1.49 ± 0.63 log ng/g) than in controls (mean 1.23 ± 0.54 log ng/g; p < 0.05). PT girls showed higher levels of PBDE than ICPP girls (1.49 ± 0.63 vs. 1.37 ± 0.49 log ng/g), though this was not significant. An analysis of the questionnaires revealed no significant differences in exposure between the three groups.
CONCLUSION
Our findings suggest that higher concentrations of serum PBDEs are associated with PT in girls.
Topics: Breast; Child; Child, Preschool; Cross-Sectional Studies; Female; Halogenated Diphenyl Ethers; Humans; Puberty, Precocious
PubMed: 27035145
DOI: 10.1159/000444586 -
Journal of Clinical Research in... Nov 2020Premature thelarche (PT) is defined as isolated breast development in girls before eight years of age. Gonadotropin-releasing hormone (GnRH) stimulation test is...
OBJECTIVE
Premature thelarche (PT) is defined as isolated breast development in girls before eight years of age. Gonadotropin-releasing hormone (GnRH) stimulation test is sometimes used to distinguish between PT and central precocious puberty (CPP), although the interpretation of the test at early ages is challenging. The objective of this study was to determine the follicle stimulating hormone (FSH) and luteinizing hormone (LH) responses to GnRH stimulation in girls with PT below 3 years of age.
METHODS
A standardized GnRH stimulation test, bone age and pelvic ultrasound were evaluated and those without pubertal progression after a minimum of one-year follow up were included in the study.
RESULTS
On GnRH stimulation test, the median (range) baseline LH was 0.29 (0.10-0.74) IU/L, baseline FSH was 4.96 (3.18-7.05) mIU/mL, and the peak median LH was 5.75 (3.31-8.58) IU/L with the peak mean±standard deviation FSH was 40.38±20.37 mIU/mL. Among the patients, 33.3% (n=10) had baseline LH >0.3 IU/L, 67% (n=20) had peak LH >5 IU/l and 16.6% (n=5) >10 IU/L. The mean peak LH/FSH ratio was 0.17±0.09 and was ≤0.43 in all participants.
CONCLUSION
Although consensus statements usually define baseline LH >0.3-0.5 IU/L, peak LH >5 IU/L, and LH/FSH ratios >0.66-1.0 as diagnostic cut-offs for CPP, in children below 3 years of age, the baseline and peak LH values may be similar to pubertal values, possibly due to mini-puberty. A dominant FSH response on GnRH stimulation test is more valuable than the peak LH response in the diagnosis of PT.
Topics: Breast; Child, Preschool; Female; Follicle Stimulating Hormone; Follow-Up Studies; Gonadotropin-Releasing Hormone; Humans; Infant; Luteinizing Hormone; Male; Prognosis; Puberty, Precocious
PubMed: 32349465
DOI: 10.4274/jcrpe.galenos.2020.2019.0202 -
Journal of Paediatrics and Child Health Feb 2015
Topics: Administration, Cutaneous; Breast; Female; Humans; Infant; Lavandula; Oils, Volatile; Plant Oils; Puberty, Precocious
PubMed: 25677490
DOI: 10.1111/jpc.12837 -
Hormone Research in Paediatrics 2019The aim of this work was to investigate the prevalence of premature thelarche (PT) in 18-month-old girls, and the incidence of clinically evaluated PT for girls aged... (Clinical Trial)
Clinical Trial
Prevalence of Premature Thelarche at 18 Months of Age: A Population- and Hospital-Based Study of Prevalence and Incidence in Girls Born at Northern Älvsborg County Hospital in Sweden.
OBJECTIVE
The aim of this work was to investigate the prevalence of premature thelarche (PT) in 18-month-old girls, and the incidence of clinically evaluated PT for girls aged 18-36 months.
METHODS
In the prevalence substudy, a prospective population-based cohort of 3,140 girls born at Northern Älvsborg county hospital (NÄL) in Trollhättan, Sweden, was followed for 2 years. Girls with breast development at the 18-month health check were referred to one pediatric center in NÄL for evaluation. All girls with PT were included and followed for clinical outcome and 17β-estradiol. The prospective incidence substudy covered 8 years in a 10-year period and included all girls aged 18-36 months born at NÄL who were clinically evaluated for PT.
RESULTS
The prevalence of PT at 18 months in our cohort was 1.6/1,000. The 5 girls with PT no longer showed symptoms at the follow-up 3-6 months later. The incidence was 1.1/1,000 for girls aged 18-36 months and 1.0/1,000 for girls aged 18-30 months who were clinically evaluated for their PT.
CONCLUSION
This is the first prospective population-based study of PT and it shows a prevalence of PT at age 18 months of 1.6/1,000. The incidence of clinically evaluated PT was 1.1/1,000. Our result is in line with other studies reporting the incidence of PT from medical records (0.4-40/1,000). The outcome of PT in our study, as in the other studies, is that the great majority of girls show only benign symptoms.
Topics: Breast; Child; Child, Preschool; Estradiol; Female; Follow-Up Studies; Hospitals, County; Humans; Incidence; Infant; Prevalence; Prospective Studies; Puberty, Precocious; Retrospective Studies; Sweden
PubMed: 31167216
DOI: 10.1159/000500356 -
Monatsschrift Fur Kinderheilkunde Oct 1965
Topics: Breast; Child, Preschool; Female; Humans; Infant; Male; Puberty, Precocious
PubMed: 5881762
DOI: No ID Found -
American Journal of Medical Genetics.... Aug 2003
Topics: Agenesis of Corpus Callosum; Breast; Facies; Female; Growth Disorders; Humans; Infant; Intellectual Disability; Nails, Malformed; Syndrome
PubMed: 12910500
DOI: 10.1002/ajmg.a.20158 -
Journal of Clinical Research in... Jun 2012Premature thelarche (PT) is defined as isolated breast development without secondary sex characteristics in girls below the age of eight. We aimed to determine whether...
OBJECTIVE
Premature thelarche (PT) is defined as isolated breast development without secondary sex characteristics in girls below the age of eight. We aimed to determine whether the level of kisspeptin, which plays a role in the release of gonadotropins, is associated with PT.
METHODS
The patient group included children with PT aged 3-8 years (n=20) and the control group included healthy children in the same age range (n=20). Height standard deviation scores (HSDSs), bone maturation and growth velocity were evaluated in the two groups. Basal follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), prolactin (PRL), and sex hormone-binding globulin (SHBG) levels were also measured in the two groups by immunochemiluminometric assay (ICMA). A gonadotropin-releasing hormone (GnRH) test was also conducted in the patient group and the peak levels of FSH and LH were determined. Kisspeptin levels were measured using enzyme immunoassay (EIA).
RESULTS
No differences were found between the groups in terms of age, HSDS, annual growth rate and bone age. While the plasma basal FSH, LH and E2 levels in the patient and control groups did not show statistically significant differences, PRL levels were higher in the patient group (p<0.05). Peak LH response to GnRH test was at the prepubertal level (<5 ng/mL) in patients with PT. In the patient group, kisspeptin levels were significantly higher compared to the levels in the control group (2.96 ± 1.21 ng/dL vs. 1.19 ± 0.41 ng/dL, p<0.05), and kisspeptin levels showed a significant correlation with PRL, FSH, LH, and E2 levels (p<0.05).
CONCLUSIONS
In this study, plasma kisspeptin levels were found to be higher in patients with PT and to show a positive correlation with increased PRL levels. Kisspeptin is one of the neuropeptides that plays a role in the onset of puberty. Our results support the hypothesis that PT may result from the temporary activation of central stimulants.
Topics: Age Determination by Skeleton; Breast; Child; Child, Preschool; Estradiol; Female; Follicle Stimulating Hormone; Humans; Immunoenzyme Techniques; Kisspeptins; Luteinizing Hormone; Prolactin; Puberty, Precocious; Sex Hormone-Binding Globulin
PubMed: 22672861
DOI: 10.4274/jcrpe.615 -
Factors affecting bone maturation in Chinese girls aged 4-8 years with isolated premature thelarche.BMC Pediatrics Jul 2020In isolated premature thelarche (IPT) girls, bone age (BA) is considered consistent with chronological age. However, some IPT girls confirmed by gonadotropin-releasing...
BACKGROUND
In isolated premature thelarche (IPT) girls, bone age (BA) is considered consistent with chronological age. However, some IPT girls confirmed by gonadotropin-releasing hormone (GnRH) stimulation test could show another trend. We analysed BA and possible potentiating factors in a selected group of girls aged 4-8 years with IPT.
METHODS
IPT girls confirmed by GnRH stimulation test aged 4-8 years hospitalized from January 2015 to April 2018 at Shenzhen Children's Hospital were included in this retrospective study. They were divided into two groups with advanced BA of 2 years as the cut-off. Body mass index (BMI) and hormone levels were the main outcome measures, and regression analysis was used to identify independent risk factors. IPT girls were divided into subgroups according to the levels of BMI standard deviation score (SDS), insulin-like growth factor-1 (IGF-1) SDS and dehydroepiandrosterone sulfate (DHEAS) SDS for comparisons of advanced BA.
RESULTS
Overall, 423 subjects were included and classified into the advanced BA group (48.7%, n = 206) and control group (51.3%, n = 217). The advanced BA group had significantly higher BMI SDS, serum DHEAS SDS, IGF-1 SDS, androstenedione and fasting insulin and significantly lower sex hormone binding globulin (all p < 0.001). Serum IGF-1 SDS (OR = 1.926, p<0.001), BMI SDS (OR = 1.427, p = 0.001) and DHEAS SDS (OR = 1.131, p = 0.005) were independent risk factors for significantly advanced BA. In the multiple linear regression model, serum IGF-1 SDS, BMI SDS and DHEAS SDS were the strongest predictors of advanced BA, accounting for 19.3% of the variance. According to BMI, 423 patients were classified into three groups: normal weight (56.03%, n = 237), overweight (19.15%, n = 81) and obesity (24.82%, n = 105). The proportion of advanced BA in obesity group was significantly higher than those of normal weight and overweight groups (χ = 18.088, p<0.001). In the subgroup with normal weight, higher serum IGF-1 SDS (p = 0.009) and DHEAS SDS (p = 0.003) affected BA advancement independent of BMI SDS.
CONCLUSIONS
Girls with IPT confirmed by GnRH stimulation test aged 4-8 years might have significantly advanced BA. Obesity was highly associated with advanced BA. Age-specific serum IGF-1 SDS and DHEAS SDS were risk factors for BA advancement independent of BMI.
Topics: Body Mass Index; Child; Child, Preschool; China; Female; Humans; Obesity; Puberty, Precocious; Retrospective Studies
PubMed: 32727432
DOI: 10.1186/s12887-020-02256-w -
Bratislavske Lekarske Listy 2007Premature thelarche presents as an appearance of breasts and glandular tissue in girls before the age of 8 years. It is mostly a benign and transitory variation of...
INTRODUCTION
Premature thelarche presents as an appearance of breasts and glandular tissue in girls before the age of 8 years. It is mostly a benign and transitory variation of premature sexual development.
AIM OF THE STUDY
We evaluated a group of girls with premature thelarche for clinical and auxologic characteristics for a period of three years. We investigated the duration of the condition and eventual progression toward true idiopathic central precocious puberty.
PATIENTS, MATERIALS, METHODS
At the Department of Endocrinology and Genetics at the Pediatric Clinic in Skopje, 127 girls with premature thelarche, from all over the country, were analyzed and followed-up for a period of 3 years (2000-2003).
RESULTS AND CONCLUSIONS
Premature thelarche as a partial form of premature sexual development, in our study included 98 girls, and showed to be a benign condition, the girls are with normal height, slightly elevated weight, but with increased bone maturation and height velocity in the first year. A progression toward central precocious puberty was not registered. The duration of the condition was about two years in most of the girls, with a regression of enlarged breasts in smaller patients and with occurrence of normal puberty in older patients (Tab. 1, Fig. 3, Ref. 16). Full Text (Free, PDF) www.bmj.sk.
Topics: Breast; Child; Child, Preschool; Diagnosis, Differential; Female; Follow-Up Studies; Humans; Puberty, Precocious; Republic of North Macedonia; Sexual Maturation
PubMed: 18203537
DOI: No ID Found