Abstract
BackgroundIt is sometimes difficult to distinguish between premature thelarche and precocious puberty in girls who develop breasts before the age of 8 years. We evaluated the frequencies of the signs associated with breast development and the factors influencing the presentation of girls with idiopathic central precocious puberty (CPP).Methods353 girls monitored 0.9 ± 0.7 year after the onset of CPP.ResultsThe age at CPP was < 3 years in 2%, 3–7 years in 38% and 7–8 years in 60% of cases. Pubic hair was present in 67%, growth rate greater than 2 SDS in 46% and bone age advance greater than 2 years in 33% of cases. Breast development was clinically isolated in 70 (20%) cases. However, only 31 of these (8.8% of the population) had a prepubertal length uterus and gonadotropin responses to gonadotropin releasing hormone and plasma estradiol. The clinical picture of CPP became complete during the year following the initial evaluation.25% of cases were obese. The increase in weight during the previous year (3.7 ± 1.4 kg) and body mass index were positively correlated with the statural growth and bone age advance (P < 0.0001).There was no relationship between the clinical-biological presentation and the age at puberty, the interval between the onset of puberty and evaluation, or the presence of familial CPP.ConclusionThe variation in presentation of girls with CPP does not depend on their age, interval between the onset and evaluation, or familial factors. This suggests that there are degrees of hypothalamic-pituitary-ovarian activation that are not explained by these factors.
Highlights
It is sometimes difficult to distinguish between premature thelarche and precocious puberty in girls who develop breasts before the age of 8 years
We analyzed the clinical-biological presentation of 353 girls with idiopathic central precocious puberty (CPP) in order to evaluate the frequencies of the signs associated with breast development and the factors influencing the presentation of CPP
CPP was diagnosed on the appearance of breast development before the age of 8 years accompanied by the presence of one or more of the following: pubic or axillary hair, growth rate greater than 2 SDS or bone age greater than 2 years above chronological age [9]
Summary
It is sometimes difficult to distinguish between premature thelarche and precocious puberty in girls who develop breasts before the age of 8 years. We evaluated the frequencies of the signs associated with breast development and the factors influencing the presentation of girls with idiopathic central precocious puberty (CPP). Precocious breast development is usually due to the premature activation of the hypothalamo-pituitary-ovarian axis, defining central precocious puberty (CPP) [1]. It is rarely of ovarian [2] or adrenal origin. We analyzed the clinical-biological presentation of 353 girls with idiopathic CPP in order to evaluate the frequencies of the signs associated with breast development and the factors influencing the presentation of CPP
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