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Results for “Puberty, Precocious”

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PubMed1994

Psychosocial aspects of precocious puberty.

This paper will deal with the psychologic correlates of abnormal puberty and the implications for assessment and treatment. The main areas of adolescent behavior, equally relevant to the child who undergoes normal or abnormal puberty, are psychosexual development, psychopathology and mental functioning in terms of level of intelligence and cognitive strengths and weaknesses. Regarding psychosexual development, the important findings are that adolescents with precocious puberty tend to be somewhat earlier in starting their adolescent sex life, though they still remain within the normal range of current standards. The reports on psychopathology in children with precocious puberty on a short-term or long-term basis are based on clinical case reports and systematic studies and suggest that a history of precocious puberty may carry with it an increased risk of psychopathology. IQ and school achievement are typically not negatively affected in precocious puberty; in fact, there is a suggestion of the opposite. It may be that there is an advantage in intellectual development associated with early pubertal maturation, which may be temporary rather than long-term.

Adolescent↗

PubMed1999

Central precocious puberty. An overview of diagnosis, treatment, and outcome.

Central precocious puberty (CPP) is physiologically normal puberty beginning early. It is the consequence of early increased regulation of gonadotropin releasing hormone (GnRH) stimulation of pituitary gonadotropin release causing pubertal changes and accelerated growth. GnRH stimulation testing is the definitive diagnostic test--pubertal gonadotropin responses being indicative of CPP. Among patients with progressive CPP, GnRH analogue therapy is effective by decreased regulation of gonadotropin secretion. Pubertal progression is stopped, and accelerated growth rate and compromised adult height are precluded or alleviated. Outcome data have not identified unusual sequelae.

Bone Development↗

PubMed1995

Identification of constitutively activating mutation of the luteinising hormone receptor in a family with male limited gonadotrophin independent precocious puberty (testotoxicosis).

A family of male limited gonadotrophin independent precocious puberty was examined for activating mutation of the LH receptor. A transition of A to G in nucleotide 1733 of the human LH receptor gene was identified in all affected males and in an unaffected carrier female. The mutation was shown by identifying a new restriction site created by the mutation. This mutation appears to be a common feature of the disorder, as it has been reported previously in unrelated families. Therefore, the presence of this new restriction site can serve as a diagnostic tool in males at risk before the onset of symptoms, as well as identifying carrier females.

Adenylyl Cyclases↗

PubMed1999

Is obesity an outcome of gonadotropin-releasing hormone agonist administration? Analysis of growth and body composition in 110 patients with central precocious puberty.

Concern has been raised that children with central precocious puberty (CPP) are prone to the development of obesity. Here we report longitudinal height, weight, and body mass index (BMI) data from 96 girls and 14 boys with CPP before, during, and after GnRH agonist (GnRHa) administration. Skinfold thickness (n = 46) and percent body fat by dual energy x-ray absorptiometry (n = 21) were determined in subsets for more accurate assessment of body composition and to validate the use of the BMI SD score as an index of body fatness in our subjects. Before the initiation of therapy (PRE), the girls with CPP had a mean BMI SD score for chronological age (CA) of 1.1+/-0.1 and for bone age (BA) of 0.1+/-0.1. By the end of the study, 12-24 months after the discontinuation of GnRHa, the mean BMI SD score was 0.9+/-0.1 for CA and 0.6+/-0.1 for BA. At the visit when GnRHa was discontinued, 41% and 22% of the girls had a BMI SD score for CA more than the 85th and 95th percentiles, respectively, indicating that obesity was present at a high rate among our subjects; the BMI SD score for CA at the PRE visit was its strongest predictor. Indeed, 86% of the girls with BMI SD score for CA above the 85th percentile when GnRHa was discontinued also had BMI SD score for CA above the 85th percentile at the PRE visit. The proportion of boys with elevated BMI SD score for CA was also high. Fifty-four percent and 31% of the SD scores were greater than the 85th and 95th percentiles after 36 months of GnRHa therapy; the BMI SD score for CA PRE had been above the 85th percentile in 71% of these overweight subjects. Obesity occurs at a high rate among children with CPP, but does not appear to be related to long term pituitary-gonadal suppression induced by GnRHa administration. Children with CPP should have a baseline BMI SD score calculated, and those at risk for obesity should be counseled appropriately.

Adolescent↗

PubMed2006

Bone mineral density and body composition in Thai Precocious Puberty girls treated with GnRH agonist.

Treatment of true Precocious Puberty (PP) with GnRH agonist can improve final adult height by suppressing gonadotropin and sex hormone levels that delays the fusion of long bone epiphyseal growth plates. However, deprivation of estrogen may affect the acquisition of peak bone mass, especially in individuals with low calcium intake. Ten Thai girls with idiopathic true PP were evaluated for Bone Mineral Density (BMD) and body composition by DXA scanner (Hologic, Inc) before and after GnRH agonist therapy for 1 year. During treatment, all children were allowed to consume a normal diet without extra calcium supplementation. In addition, serum calcium, phosphate, alkaline phosphatase and osteocalcin were also measured. The results showed that GnRH agonist could improve predicted adult height from 149.4 +/- 5.4 to 153.6 +/- 6.8 cm (p < 0.001). Serum osteocalcin, representing the bone marker formation, decreased from 184.2 +/- 66.7 to 108.6 +/- 35.3 ng/mL (p = 0.012) However, the treatment had no negative effects on BMD lumbar spine and total BMD but increased percentage of fat mass from 25.7 +/- 5.2 to 31.6 +/- 5.5%. (p =0.007). In conclusion, treatment with GnRH agonist in Thai girls with true PP for 1 year can improve PAH without negative effects on BMD but a longer period of treatment needs to be studied.

Body Composition↗

PubMed1979

Precocious puberty due to a hypothalamic hamartoma.

A case of precocious puberty due to a hypothalamic hamartoma is presented. Concentrations of plasma LH and FSH, testosterone and its derivatives were found to be elevated. Circadian rhythms of LH were also observed. After removal of the mass, plasma LH and FHS concentrations declined to nearly half the preoperative levels.

Brain Neoplasms↗

PubMed2005

Female precocious puberty, obesity and polycystic-like ovaries.

OBJECTIVE: To evaluate the characteristics of obese girls with gonadotropin releasing hormone-dependent precocious puberty with and without polycystic-like ovaries. METHODS: Forty-seven overweight (> 75(th) centile of the Italian reference data) girls with a diagnosis of isosexual precocious puberty underwent auxological analysis, hormonal assay and utero-ovarian sonographic and Doppler evaluation. On the basis of sonography the patients were subdivided into two groups, girls presenting normal ovaries (Group I; n = 31) and those with polycystic-like ovaries (Group II; n = 16). RESULTS: The mean body weight was significantly higher (P = 0.003) in Group II than it was in Group I. In addition, the patients with polycystic-like ovaries fell within our definition of superobese (> or = 97(th) centile of the Italian reference data) in 44% of cases. The uterine and ovarian volumes were significantly greater in Group II compared with Group I patients. The Doppler evaluation showed intraparenchymal ovarian vascularization and low downstream impedance to flow in all patients in Group II. CONCLUSIONS: Girls with precocious puberty and polycystic ovaries, compared with those without polycystic ovaries, have a higher incidence of body weight exceeding the 85(th) centile of the Italian reference data (obesity).

Child↗

PubMed2000

A cost-benefit of gnRH stimulation test in diagnosis of central precocious puberty (CPP).

The GnRH stimulation test is the gold standard to diagnose central precocious puberty (CPP). Conventionally, we need at least 2 hours to finish the test which seems to be costly and time consuming. In this study, we described the pattern of LH and FSH levels during the GnRH test in 27 girls who presented with various degrees of precocious puberty. We found that the blood samples at 90 and 120 min after GnRH were not necessary. To save the cost of diagnosis, the basal LH/FSH ratio > 0.2, the 30 min LH/FSH ratio after GnRH > 0.9 and the peak LH/FSH ratio > 1.0 can be used to diagnose CPP with positive predictive values (PPV) of 87.3, 89.4 and 93.8 per cent respectively.

Child↗

PubMed2004

Adopted girls with idiopathic central precocious puberty: observations about character.

The aim of this study was to investigate the psychological traits of adopted girls affected by idiopathic central precocious puberty (ICPP). Twelve adopted girls were evaluated before, during GnRH agonist (GnRHa) treatment, and after the treatment was stopped. Before, during and after treatment, adopted girls with ICPP showed a normal degree of anxiety, an adequate level of maturity, and a correct sexual identification. None of them had symbiotic character traits as previously reported in non-adopted girls with ICPP. The perception of their body was poor before treatment, but improved during GnRHa treatment and psychological support. The changes in the life of adopted girls are so numerous that precocious puberty may represent an additional risk for psychological discomfort. Therefore to treat precocious puberty it may not only be necessary to prevent premature changes in their body but also to give them enough time to face up to their emotional and psychological problems and to become competent adolescents.

Adolescent↗

PubMed1995

Bone age at discontinuation of medroxyprogesterone acetate therapy in girls with precocious puberty: effect on final height.

To determine the final height of patients with precocious puberty treated with medroxyprogesterone acetate (MPA; 150 mg every week) for a period > 1 year (mean +/- SD = 3.24 +/- 1.85 years), data from a group of 26 girls were analyzed. The attained final height was 155.6 +/- 8.06 cm (-1.1 SD of the normal population). In a group of 8 untreated girls with precocious puberty, adult height was 149.2 +/- 5.07 (-2.16 SD, p < 0.02). In 9 patients in whom treatment was stopped at a bone age < or = 12 years, final height was 159.2 +/- 10.05 cm, while in 16 girls who had a bone age > 12 years at the end of treatment, the final height was 153.03 +/- 6.28 cm. Our data demonstrate the effectiveness of MPA treatment on ultimate height. The better height observed in those patients who stopped treatment with a bone age < 12 years suggests the advantage of discontinuing therapy before reaching a more advanced degree of skeletal maturation.

Age Determination by Skeleton↗

PubMed1956