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[Clinical study on treatment of female idiopathic precocious puberty with combined therapy of Chinese medicine and megestrol acetate].

OBJECTIVE: To find effective therapeutic approach for treating true idiopathic precocious puberty suitable to our national condition and different from gonadotrophin releasing hormone agonist. METHODS: One hundred and six girls with idiopathic precocious puberty were divided into 3 groups. The 51 girls in the combination therapy group were treated with megestrol acetate (MA) and Chinese medicine for nourishing Yin and removing Fire, the 35 girls in the MA treated group were treated with MA alone and the other 20 girls were given no treatment at all as control. Luteinizing hormone releasing hormone (LHRH) stimulating test was performed before and after treatment, and size of uterus and ovary, linear growth rate, X-ray bone age measurement and final height prediction were also observed simultaneously. RESULTS: After being treated with combination therapy for 2.7 years in average, in the combination therapy group, the luteinizing hormone peak value of LHRH stimulating test was reduced from 48.5 +/- 37.1 IU/L to 12.2 +/- 9.3 IU/L (P < 0.001), size of uterus and ovary decreased, secondary sexual characteristics regressed, the bone age difference/chronological age difference value (delta BA/delta CA) reduced from 1.35 +/- 0.64 to 0.65 +/- 0.36(P < 0.001), and predictive final height increased from 153.3 +/- 3.6 cm to 158.5 +/- 4.3 cm (P < 0.001). CONCLUSION: Combination therapy could not only modulate the function of hypothalamic-pituitary-ovarian axis and the development of internal genitalia, but also could slow down skeletal growth, delay skeletal maturation, and thereby prevent premature epiphyseal fusion and increase the final height of patients.

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[Peripheral precocious puberty caused by a juvenile granulosa cell ovarian tumor, with iso and heterosexual manifestations in a six years old girl].

A six years old girl consulted due to mammary development. On physical examination, clitoris enlargement and a tumor localized in the abdominal-pelvic region were observed. Hormonal study disclosed elevated testosterone and estradiol levels. On exploratory laparotomy, a right ovarian tumor was observed and a right salpingooophorectomy was performed. The contemporary biopsy informed a disgerminoma, leading to a surgical staging of the tumor. The definitive pathological diagnosis was a juvenile granular cell tumor, limited to the ovary. In the postoperative period, estradiol and testosterone levels returned to normal values and the pseudopuberty reverted. The patient did not receive adjuvant treatment and after three years of follow up, there is no evidence of tumor recidivism.

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