Marisa M Fisher, Deborah Lemay, Erica A Eugster
OBJECTIVES: To determine time to menarche in girls and testicular volume increase in boys after removal of a histrelin implant, which causes profound hypothalamic-pituitary-gonadal axis suppression. STUDY DESIGN: Medical records of patients treated with a histrelin implant were reviewed. Seventy-one patients (56 girls) treated with the histrelin implant were identified, of these patients, 37 explanted girls (68% naïve) and 6 explanted boys (83% naïve) were included in the analysis...
April 2014: Journal of Pediatrics
P S N Menon, M Vijayakumar
The term 'precocious puberty' signifies the onset of secondary sexual characters before the age of 9 y in boys and 8 y in girls. Menarche before 9.5 y is also considered precocious. These definitions are constantly evolving due to the secular trends observed all over the world. It is crucial to decide whether the child has central (gonadotropin-dependent, GDPP) or peripheral (gonadotropin-independent, GIPP) form of precocious puberty. Some benign conditions such as premature thelarche and premature pubarche may mimic precocious puberty...
January 2014: Indian Journal of Pediatrics
Daniel J DeSalvo, Rinku Mehra, Priya Vaidyanathan, Paul B Kaplowitz
BACKGROUND: Premature adrenarche (PA) is often associated with bone age (BA) advanced by ≥2 years, which increases the concern for underlying pathology, but the frequency and clinical significance of this is unknown. Our objective was to identify the proportion of PA patients with very advanced BA and normal BA and compare the clinical characteristics of the two groups. METHODS: Charts of 427 patients aged 5-9 years, referred for early puberty over a 2-year period, were reviewed for clinical diagnosis, growth, parental heights, hormone levels and BA...
2013: Journal of Pediatric Endocrinology & Metabolism: JPEM
Ellen M Chung, David M Biko, Jason W Schroeder, Regino Cube, Richard M Conran
Precocious puberty represents a unique diagnostic problem in which imaging plays an important role. Development of secondary sex characteristics may result from inappropriate activation of the hypothalamic-pituitary axis with release of gonadotropin, or from gonadotropin-independent secretion of sex steroids by the adrenal glands or gonads. A variety of lesions can manifest with precocious puberty, including various central nervous system (CNS) lesions, adrenal lesions, and sex cord-stromal tumors of the testis or ovary...
November 2012: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Hae Sang Lee, Hong Kyu Park, Jung Hee Ko, You Jin Kim, Jin Soon Hwang
OBJECTIVE: Excess adiposity may influence various aspects of pubertal development, including the timing of pubertal initiation and hormonal parameters during puberty. The aim of the study was to evaluate the impact of body mass index (BMI) on luteinizing hormone (LH) secretion to gonadotropin-releasing hormone (GnRH) stimulation test in boys with precocious puberty. METHODS: Boys with precocious puberty, who were normal weight, overweight, and obese underwent GnRH stimulation tests between 2003 and 2010...
2013: Neuroendocrinology
Julia von Oettingen, Joaquim Sola Pou, Lynne L Levitsky, Madhusmita Misra
OBJECTIVES: To describe the phenotype of premature adrenarche (PA) patients, elucidate historical and physical correlates, and distinguish PA from late-onset congenital adrenal hyperplasia (LOCAH). STUDY DESIGN: Retrospective chart review of 122 patients (91 female and 31 male) with PA and 11 with LOCAH. RESULTS: In PA patients, birth weight was <2 standard deviation scores (SDSs) in 6%, and 14% were premature. Body mass index SDSs were high (2...
December 2012: Clinical Pediatrics
Anna Jakubowska, Magdalena Grajewska-Ferens, Michał Brzewski, Barbara Sopyło
BACKGROUND: Precocious puberty (PP) is defined as the appearance of symptoms of puberty in girls before 8 years of age and in boys under 9. Statistically, it occurs much more frequently in girls, while it is a rare pathology in boys. MATERIAL/METHODS: Over the period of 10 years, between 1999 and 2009, 39 girls and 17 boys aged 18 months - 9 years were diagnosed with precocious puberty,, and treated at the Endocrinology Clinic. THE FOLLOWING TESTS WERE PERFORMED IN ALL CHILDREN: physical and anthropometric examinations, abdominal ultrasound scan (US) with evaluation of adrenal glands, examination of testes in boys or breasts and pelvic organs in girls, evaluation of skeletal age and, in selected cases, CT scans of the abdomen, MRI of the CNS, and hormonal laboratory tests...
October 2011: Polish Journal of Radiology
Peter A Lee, Karen Klein, Nelly Mauras, E Kirk Neely, Clifford A Bloch, Lois Larsen, Cynthia Mattia-Goldberg, Kristof Chwalisz
CONTEXT: GnRH agonist (GnRHa) monthly injections are frequently used in the treatment of central precocious puberty (CPP). The 3-month leuprolide depot 11.25- and 30-mg formulations are newly approved treatment options. OBJECTIVE: The aim of the study was to investigate the safety and efficacy of leuprolide acetate 3-month depot formulations for the treatment of CPP in children. DESIGN: This was a phase III, randomized, open-label, dose-ranging 6-month study...
May 2012: Journal of Clinical Endocrinology and Metabolism
Rachel M Williams, Caleb E Ward, Ieuan A Hughes
Premature adrenarche refers to the presence of secondary sexual hair in girls younger than 8 years old and boys younger than 9 years old. It is a relatively common presentation to paediatricians and is more frequent in girls than boys. It is a benign diagnosis, but other causes of androgen excess such as congenital adrenal hyperplasia or adrenal tumours should be excluded first. In conjunction with history and clinical examination, first line investigations should include determination of serum androgen concentrations, along with bone age, proceeding to synacthen stimulation test (for 17OHP levels) and adrenal ultrasound if indicated...
March 2012: Archives of Disease in Childhood
Erica A Eugster, William Clarke, Gad B Kletter, Peter A Lee, E Kirk Neely, Edward O Reiter, Paul Saenger, Dorothy Shulman, Lawrence Silverman, Lisa Flood, William Gray, David Tierney
CONTEXT: GnRH analog (GnRHa) therapy for central precocious puberty (CPP) typically involves im injections. The histrelin implant is a new treatment that provides a continuous slow release of the GnRHa histrelin. OBJECTIVE: The objective of the study was to investigate the safety and efficacy of the subdermal histrelin implant for the treatment of CPP in treatment naive and previously treated children. DESIGN: This was a phase III, open-label, prospective study of 1-yr duration...
May 2007: Journal of Clinical Endocrinology and Metabolism
Jean-Claude Carel, Joëlle Blumberg, Christine Seymour, Catherine Adamsbaum, Najiba Lahlou
OBJECTIVE: Depot GnRH agonists are commonly used in the treatment of central precocious puberty (CPP). The triptorelin 11.25 mg 3-month depot, currently used in adult indications, had not previously been evaluated in CPP. DESIGN: This was a multicenter, open-label, 12 month trial conducted in 64 CPP children (54 girls and 10 boys), treated quarterly. METHODS: Children with a clinical onset of pubertal development before the age of 8 years (girls) or 9 years (boys), pubertal response of LH to GnRH > or = 7 IU/l, advanced bone age > 1 year, enlarged uterus (> or = 36 mm) and testosterone level > or = 0...
January 2006: European Journal of Endocrinology
Jean-Claude Carel, Najiba Lahlou, Marc Roger, Jean Louis Chaussain
Precocious puberty results mostly from the precocious activation of the gonadotropic axis. Although the age limits have recently been discussed, most physicians consider that onset of pubertal development before the age of 8 years in a girl or 9 years in a boy warrants at least a clinical and bone age evaluation by a paediatric endocrinologist. The major concern in precocious puberty is the underlying condition, and central nervous system or gonadal neoplasm have to be formally excluded as a first step in the diagnosis...
March 2004: Human Reproduction Update
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