International Journal of Clinical Case Reports 2015, Vol.5, No. 49, 1-5
1
Research Report
Open Access
Phenotypic and Evolutionary Characteristics of Precocious Puberty: About 30
Cases
HaddamA.E.M.
1
, Meskine D.
1
, Chentli F.
2
, Fedala S.N.
2
,
1.Department of Endocrinology, EPH Bologhine Algiers, Algeria
2. Department of Endocrinology, CHU BEO Algiers, Algeria
Corresponding author email
International Journal of Clinical Case Reports, 2015, Vol.5, No.49 doi: 10.5376/ijccr.2015.05.0049
Received: 21 Jul., 2015
Accepted: 22 Aug., 2015
Published: 02 Sep., 2015
Copyright
©
2015 Fedala et al., This is an open access article published under the terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original work is properly cited.
Preferred citation for this article:
Fedala S.N., Chentli F., Meskine D., Haddam A.E.M., 2015, Phenotypic and Evolutionary Characteristics of Precocious Puberty: About 30 Cases,
International Journal of Clinical Case Reports, 5(49) 1
-
5
Summary
Thirty children with precocious puberty (PP) were followed in Endocrinology department, from 2000 to 2015. The
disorder was more common in girls than in boys with a sex ratio (F/M) of 3.
The mean age at diagnosis was 4.2 ±1.4 years (1-8.5) in girls and 5.6 ±1.4 years (17 months - 9 years) in boys. The average delay
for consultation, relative to the ascertainment of the first sign of that early puberty is 2.5 years (6 months - 6 years) in girls and 3.2
years (6 months - 4 years) in boys.
The PP was scalable for all boys and half of girls (52.5%). Pubertal precocity was of central origin (CPP) in 83% of girls and in 70%
of cases it was idiopathic. In boys organic cause was noted in all of them, it was central in 28.5%. The peripheral origin noted in 72%
of cases is related to a congenital adrenal hyperplasia.
Keywords
Precocious puberty; Secondary sexual characteristics; Brain MRI; Congenital adrenal hyperplasia; Hypothalamic
hamartoma
I
ntroduction
Precocious puberty (PP) is an uncommon condition
(1/5000 to 1/10000 per year) which is difficult to
manage ((Brauner, 1992; Mogensen et al., 2011).
When the disease is suspected, a diagnostic procedure
should be followed to allow an efficient therapeutic
indication. In the absence of specific treatment, the
abnormal early secretion of sex steroids led to early
development of puberty and to an acceleration of
linear growth and bone maturation, and consequently
to a small final size with all the repercussions that
result (Carel and Léger, 2008).
The objective of this study is to report the etiological
and evolutionary clinical characteristics of PP in
children.
Materials and Methodology
30 children (21 girls and 9 boys) with a PP
were hospitalized in Endocrinology department
between 2000 and 2014.
The diagnosis of PP was made on a beam of clinical
and laboratory arguments: development of secondary
sexual characteristics as classified by Tanner,
acceleration of the growth rate higher than 6 cm per
year, bone age advance and development of genitals
objectified on ultrasound (external genitalia in boys,
internal genitalia in girls). The diagnostic was
confirmed by plasma sex steroid hormone assays:
plasma estradiol in girls and testosterone in boys.
The assessment was completed by an etiological
explora tion gu ided by clinical examina t ion:
measurement of serum gonadotropins (FSH and LH),
LHRH test to search for a central origin (positive
answer of gonadotropin) or peripheral (no reply) to
the PP. On suspicion of congenital adrenal hyperplasia,
the balance sheet is completed by an adrenal
stimulation test by the common synacthen wi th
plasma cortisol assay, adrenal precursors and
measurement of plasma ACTH. When the PP was of
central origin, brain magnetic resonance imaging was
performed to eliminate an organic cause. In t he
presence of peripheral origin, abdominopelvic
radiological investigation is conducted.
The evolution of the PP is evaluated depending
to the importance of sexual impregnation according
