Peculiarities of the clinical course, diagnostics, and therapy of premature sexual development in the children presenting with its idiopathic form and with hypothalamic hamartoma

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The idiopathic form of premature sexual development (PSD) is the commonest variety among the central forms of PSD (accounting for 30 to 70% of the total). It occurs primarily in the girls. The prevalence of hypothalamic hamartoma (HH) as a cause of premature sexual development is on the whole lower, but it is most frequently diagnosed in the children of either sex under the age of 3 years with the clinical manifestations of true PSD. Diagnostics and treatment of different forms of premature sexual development constitute an appreciable part of the practical work of a pediatric endocrinologist. The efficacy of PSD therapy with luliberin analogs has been definitively demonstrated in the context of increasing the final height of the children and suppressing the progression of their sexual development. Moreover, the reversibility of the effects of luliberin analogs on the gonadostatic activity has been confirmed. Nevertheless, peculiarities of the clinical course of various etiological variants of central PSD, principles of its treatment, and its efficacy remain a matter of debate. In the present paper, the special emphasis is laid on the consequences of PSD therapy using luliberin analogs including the recovery of the process of normal puberty, effects on the reproductive function, body weight, and the dependence of the treatment on the clinical form of central PSD. The data on the peculiarities of the clinical course of premature sexual development and the efficacy of its treatment in the children with the idiopathic form of gonadotropin-dependent PSD and hamartoma-associated PSD are presented