ESPE Abstracts

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 to see their clinical and laboratory changes during 12 months.

Method: Among children who visited to predict their final adult heights between July 2007 and May 2014, children with significant bone-age advancement (>1 year) without any pubertal sign under the age of 8 years in girls and 9 years in boys were enrolled. Their clinical and laboratory data including GnRH stimulation were analysed at the time of diagnosis. In order to see their start of pubertal signs and changes of laboratory characteristics including GnRH stimulation test, 48 and 33 children with asymptomatic PP were followed-up at 6 and 12 months later, respectively.

Results: Fifty-five children with asympomatic PP were enrolled. Male:female ratio was 1:2.2. Positive value (peak LH>5 IU/l) of GnRH stimulation test was found in 23 out of 55 children (42%). Positive results of GnRH stimulation test were significantly more common in boys than in girls, 67 and 30%, respectively (P<0.05). Positive results of GnRH test were observed 80 and 90%, at 6 mo and 12 mo follow-ups, respectively, in boys. In girls, the frequency of positive GnRH test at 12 mo follow-up was not increased compared to ‘at the time of diagnosis’, 25 and 23.6%, respectively. Pubertal signs appeared in 24 (50%) out of 48 patients, 80 and 35%, in boys and girls, respectively. Pubertal signs appeared more common in boys than in girls during 6 mo (P<0.05).

Conclusion: Boys with bone-age advancement without any pubertal sign should be closely followed-up. Long-term observatory study is necessary in terms of need for GnRHa treatment and final height.