ESPE Abstracts

Background: Premature adrenarche is defined as the development of axillary and/or pubic hair in association of the DHEA-S concentrations >108.4 nmol/l (40 μg/dl) before the age of eight in girls.Objective and hypotheses: This retrospective study aimed to investigate the clinical presentation, metabolic status, growth velocity and pubertal timing of girls with premature adrenarche.Method: Medical records of 117 patients wer...

Background: Craniopharyngiomas are rare suprasellar tumours with good survival but high endocrine morbidity. The commonest endocrinopathy is GHd which can precede diagnosis. Later obesity (BMI >+2SDS) may be treatment or tumour related.Objective and hypotheses: To evaluate endocrinopathy, height, weight and BMI outcomes after a conservative surgical treatment strategy with pre-treatment pituitary provocation tests for children diagnosed between 2009 ...

Background: GnRH agonists are a common treatment modality for patients with central precocious puberty.Objective and hypotheses: Danazol-induced precocious puberty rats were used as an animal model to compare the effects of GnRH analogues and to assess combinations of treatment with agonistic and antagonistic GnRH analogues.Method: A 5-day-old female Sprague–Dawley rats were subcutaneously injected with a single dose of 300 &#...

Background: Precocious puberty, pubertal development in girls before 8 years, has considerable biological, psychosocial, and long-term health implications. It is classically ascribed to the premature activation of the hypothalamic-pituitary–gonadal axis, and hence an LH response >5 U/l in the LHRH test. Whilst this group of patients is well understood, there is a paucity of literature characterising patients who show pubertal development not driven by LH, atypical pre...

Background: Hypersexualized behaviour in the paediatric population is a rare phenomenon. The aetiology of paraphilia is not completely understood, but some studies suggest imbalance of the dopamine serotonin system. Paraphilia has also been described as a side-effect of treatment with monoaminooxidase inhibitors (MAOI) and dopamine agonists. Most of the currently used pharmacologic treatments of the paraphilias have serotonin and testosterone/dihydrotestosterone as their targe...

Background: Premature pubarche is the appearance of pubic hair before 8 years in girls and 9 years in boys, being more frequent in girls. Current literature demonstrates associations between premature pubarche and metabolic and cardiovascular diseases.Objective and hypotheses: To evaluate the frequency of cardiovascular disease risk factors in girls with isolated premature pubarche (IPP).Method: Observational study using data from ...

Background: GnRH agonist (GnRHa) has been used in treatment of idiopathic central precocious puberty (ICPP) girls for more than 20 years. However, the menstruation pattern after discontinuation of treatment has been rarely reported.Objective and hypotheses: To evaluate menstrual patterns in ICPP girls after discontinuing GnRHa therapy.Method: Menstrual diary was recorded for 3 consecutive months by ICPP girls after discontinuation ...

Background: The use of GnRHa in central precocious puberty is known to slow puberty progression, subsequently prevent early menarche, and attenuate the height loss by advanced skeletal maturation. But enhancing the final height was so controversial that an additional approach has been used.Objective and hypotheses: To investigate the age of menarche, and the height outcomes in central precocious girls treated with GnRHa (n=61) or combined GH (<e...

Background: In precocious puberty, girls experienced secondary sexual development earlier psychologically as well as physically. Self-stress due to a different body shape from the peer group, psychological concerns due to discrepancies between physical and chronological age, and long-term behavioural problems could occur.Objective and hypotheses: The aim of this study was to evaluate psychosocial changes in girls with precocious puberty between before an...

Background: The current diagnostic criteria for Prader–Willi syndrome (PWS) although widely accepted, is challenging to be implemented in Chinese population.Objective and hypotheses: The present study collected PWS cases from 12 centres across China. By analysing the clinical manifestation during early infancy, we aimed to provide data for clinical characteristics, screening strategy and effect of GH treatment in Chinese PWS patients.<p class="a...

Background: Glucose is the main energy source for the brain’s cells. Glucose transporter 1 (GLUT1), encoded by the SLC2A1 gene, is a membrane protein that plays an essential role in the transport of glucose across the blood-brain barrier. A mutation in GLUT1, so-called GLUT1 deficiency syndrome (GLUT1 DS; OMIM #606777), results in low levels of glucose in the cerebrospinal fluid despite normoglycaemia. GLUT1 deficiency causes a series of symptoms that ma...

Background: Treatment of precocious puberty with GnRH analogues is well established. But there are concerns about weight gain in patients on this treatment. There have been conflicting reports about the effect of GnRH analogues on weight.Objective and hypotheses: To assess the change in BMI in children treated with GnRH analogues within a UK Endocrine Service and to analyse the patient/parent experience of the treatment.Method: A r...

Background: Precocious puberty is one of the fastest-growing paediatric diseases in South Korea. As the UCC (User Created Contents) has provided lots of medical information, it becomes an easy and important source of medical information.Objective and hypotheses: This study aimed to investigate and to evaluate the quality and scientific accuracy of precocious puberty-related UCC on Youtube.Method: The key words ‘precocious pube...

Background: Premature adrenarche (PA) has been associated to increased metabolic risk. Areas of controversy regarding associated co-morbidities are precocious pubarche, PCOS and lower birth weight, which may depend on ethnic background.Objective and hypotheses: To describe the risk of precocious thelarche (PT, <8 years), pubarche (PP, <8 years F, <9 years M) and gonadarche (PG, <9 years) in children with premature adrenarche.<p class=...

Background: Children affected by cerebral palsy (CP) could experience central precocious puberty (CPP) 20 times more than general population. Nevertheless, the treatment is challenging.Objective and hypotheses: To compare CPP features and the effects of gonadotropin-releasing hormone agonist therapy (GnRHa) in children with CP and in controls.Method: The study involved 16 children with CPP and CP (median age (range) at diagnosis of...

Background: GNRH agonist (GnRHa) has been widely used for decades to treat in patients with central precocious puberty (CPP). There are severe studies concerning changes in body composition in CPP patients following GnRHa treatment, but the results are inconsistent.Objective and hypotheses: The aim of this study was to investigate the change of BMI in children treated with GnRHa for 2 years. Also, the present study was performed to assess whether BMI aff...

Background: ‘D’ was a 7 year old Caucasian female who presented with a history of adult-type body odour starting at age 3 years. At age 6y 9m her bone age was 7y 10m. She had had a sharp increase in her weight in the past 2 years and her PCP noticed pubic hair growth. Her very anxious single mother was convinced she had a serious illness that needed immediate intervention.Case presentation: At presentation, D had Tanner 2 pubic hair and Tanner ...

Background: Isolated prepubertal menarche is described in the absence of any other signs of precocious sexual development. This condition remains unclear in its aetiology and there is currently no consensus on investigations to be undertaken.Objective and hypotheses: The objective of our study is to evaluate the following factors associated with persistent isolated cyclical vaginal bleeding: clinical presentation, gonadotrophin-releasing hormone (GnRH) s...

Background: Hypothalamic hamartomas(HH)-rare heterotopic congenital malformations (incidence 1:200 000)-present with central precocious puberty (CPP) or gelastic seizures (GS) but their natural history and best treatment strategy are unknown. Given their proximity to the hypothalamus–pituitary axis, wider endocrine dysfunction may be expected.Objective and hypotheses: To describe clinical features and any evolving endocrinopathies in HH patients, by...

Background: Central precocious puberty is due to premature activation of the hypothalamo–pituitary–ovarian axis. In girls it is idiopathic in up to 95%. Children with clinical rapid progression are treated with prolonged activity GnRH agonist.Objective and hypotheses: Characterise cases of idiopathic central precocious puberty (ICPP) followed at our hospital comparing the group treated with GnRH agonist (group A) with the group not treated (gro...

Background: Gynaecomastia (GM) is common in boys with Klinefelter syndrome (KS) during adolescence due to the higher diurnal oestradiol–testosterone ratio in early-to-mid puberty. The physiological mid-late pubertal rise in testosterone (T) causes the GM to disappear in chromosomally normal boys, but GM persists in boys with KS if this rise in T is blunted.Aims and objectives: We aimed to examine the effect of routine T supplementation in boys with ...

Background: Endocrine disruptors cause harmful effects to human body through various exposure routes. These chemicals mainly appear to interfere with the endocrine or hormone systems. Bisphenol A (BPA) is known as an endocrine disruptor with an estrogenic effect and it is supposed that it may have a role on development of precocious puberty (PP). Kisspeptin, a hypothalamic peptide, is a neuromodulator of GnRH and it has a big role on regulation of the onset of puberty.<p c...

Background: Precocious puberty (PP) is one of its variations which defines as appearance of physical signs of sexual development in a child prior to the earliest accepted age of sexual maturation, 7 years in girls and 9 years in boy. The exact mechanisms and genetic background of ICPP are not well understood. It is suggested that the kisspeptin neuropeptide, encoded by the KISS1 gene, could have role in this regard.Objective and hypotheses: Considering t...

Background: Puberty is a dynamic period of physical growth. Genetic factors, increasing prevalence of adiposity, environmental factors and the widespread presence of endocrine-disrupting chemicals are suspected to contribute to the trend of earlier pubertal onset.Method: The study group consists of 32 girls diagnosed with central puberty precocious. The eating habits and physical activity status were evaluated with a detailed questionnaire. Daily calorie...

Background: The recent articles showed a kind of associations of the serum vitamin D levels and chronic diseases, for example, autoimmune diseases, vascular disorders, as well as malignancies. Also vitamin D deficiency impacts normal growth and maximal bone mineral accretion in puberty. Of pediatric population in Korea, the prevalence of cases of vitamin D deficiency and precocious puberty were continuously increasing nowadays.Objective and hypotheses: W...

Background: Familial precocious puberty is defined by the existence of more than one affected member either in the proband generation or in the pedigree. Recently, several gene mutation cause familial CPP is elucidated, gain of function mutations in KISS1 and KISS1R, loss of function mutations in the MKRN3, the feature of familial precocious puberty is not fully understood.Objective: To investigate the clinical characteristics of familial precocious pube...

Background: Eating disorders constitute serious mental disorders, characterized by a wide range of dysfunctional behaviors related to food. The term mainly includes anorexia nervosa, bulimia nervosa and binge eating disorder, and is closely related to onset during puberty. The study herein, presents the preliminary results of a school-based intervention trial regarding body weight disorders among Greek adolescents.Aims and objectives: To explore the prev...

Objective: To evaluate the endocrine function among Egyptian adolescent thalassemic patients.Patients and methods: 54 patients and 28 age-matched normal controls was included. Anthropometric measurements, clinical pubertal assessment were done for all patients. Oral glucose tolerance test (OGTT) was done to all patients and controls with measuring serum insulin level at 0.120 minutes. Insulin sensitivity and release index were calculated. 32 patients had...

Background: The GnRH-agonists are the drugs of choice for therapy of idiopathic-CPP. To assess two different GnRH-agonist (Leuprolide acetate: LA vs Triptorelin depot: TD) treatment effects on anthropometric measurements.Patients and methods: 74 girls with ICPP (mean age 33.8±8 years) were enrolled the study. Complaints had been begun before 8 years old. 50 girls underwent GnRH stimulation test. 58 girls with ICPP were followed up 18 months. Childre...

Background: Familial male-limited precocious puberty, known as testotoxicosis, is an autosomal dominant disease that leads to the activation of luteinizing hormone receptor. It presents with progressive virilization, advanced bone age and linear growth acceleration and may lead to loss in predicted adult height. We report the case of a patient diagnosed with testotoxicosis at two years of age.Case presentation: Two-year-old boy with penis enlargement and...

Background: Peripheral precocious puberty (GnRH independed): precocious development of secondary sexual characteristics may also be caused by mechanisms that do not involve activation of pulsatile GnRH secretion. Familial male-limited precocious puberty, also known testotoxicosis is a rare dominant form of gonadotropin independent precocity caused by constitutively activating mutations of the human LH choriogonadotropin receptor (LHCGR). If do not treat with appropriate drugs ...

Background: Accurate and differential diagnosis of preococious puberty (PP) have some important challenges. Many parameters have used to diagnose pubertal diseases so far. However LH-RH stimulation test is considered as a gold standard procedure, ıt has some difficulties in practise.Objective: We aimed to set a newly proposed clinical and laboratory finding-based diagnostic scoring in the differential diagnosis of preoccious puberty and premature te...

Background: Delayed puberty in girls is evoked at the absence of breast development after the age of 13 years. It is relatively rare and must look contrary to the boy an organic cause.Objective and hypotheses: Search the frequency and aetiology of delayed puberty in girls.Method: This is a retrospective study of patients consulting for delayed puberty and collected in 5 years. The of patients was compared to the number of delayed p...

Background: Pubertal timing is influenced by a complex interaction among genetic, nutritional, environmental and socioeconomic factors. Over the past 30 years a trend in pubertal timing anticipation has been demonstrated. Environmental factors involved in this phenomenon are mainly represented by endocrine disruptors compounds (EDCs), such as pesticides, industrial compounds and persistent organic pollutants, estrogens and phytoestrogens.Objective and hy...

Background: Xenoestrogens are artificial oestrogen compounds, found in our environment throughout various chemical products, and claimed to affect the process of early puberty among young females.Objective and hypotheses: To investigate the relationship between exposure to xenoestrogen products and early pubertal sex development.Method: Cross-sectional study conducted in Jeddah, Saudi Arabia in July 2014 (n=568), pubertal ...

Background: Children with bone-age advancement without any pubertal sign (asymptomatic precocious puberty, asmyptomatic PP) were reported (CW Ko,et al, at the Annual Meeting of ESPE, 2012 and 2013).Objective and hypotheses: In our follow-up study, some more children with asmyptomatic PP were enrolled additionally. We analysed their clinical and laboratory characteristics at the time of diagnosis, and they were followed-up prospectively t...

Background: A patient with both Prader-Willi syndrome and mosaic Turner syndrome is extremely rare. We performed fMRI and euglycaemic-hyperinsulinaemic clamp test for her.Case presentation: A 17-yr-old girl was diagnosed as Prader-Willi syndrome by her clinical investigations including poor feeding in infancy, hyperphagia, developmental delay, mental disorders, behavior problems, thin upper lip, almond-shaped eyes, acromicria and genital hypoplasia. Mate...

Introduction: GnRH analogues common used in precocious puberty are highly effective agents. The drug dose and injection frequency should be designed for each case. However these agents are common well tolerated, some rare adverse effects may be occur. We present a case of frequent leuprolid acetate injections-related sterile abscess.Case: The case was 16-month-old boy. He had rapid growth, big penis, and excessive pubic hair. These symptoms have appeared...

Background: Diamond–Blackfan anemia (DBA) is an inherited bone marrow failure syndrome, which presents with anemia in early infancy. Survival depends on blood transfusions, which in consequence lead to iron overload (IOL). The most common complications of IOL are hepatic cirrhosis, endocrinopathies and cardiomyopathy.Results: We present the case of 17 years old girl with DBA and IOL-associated endocrinopathies. Her treatment consists of multiple blo...