Aim of our study was to assess clinical characteristics and complementary studies, in patients who consulted the Endocrinology Department of our pediatric hospital, referred by pediatricians to discard precocious puberty.
Methodology: it is a descriptive study based on review of medical records, with first consultation between 2010 and 2018. Criteria were developed to assign patients to one of six diagnostic categories based on age, growth, and clinical findings, biochemical and imaging studies (bone age, pelvic ultrasound and MRI). We classified our 311 patients in 6 diagnostic groups: involute precocious breast development, early non-progressive breast development, central precocious puberty (PPC), peripheral precocious puberty (PPP), advanced puberty and rapidly progressive puberty. Exclusion criteria: not going to follow-up visits. Statistical analysis by SPSS 23.
Results: we examined a total of 311 medical records (14 men, 297 women), referred by their pediatricians by early onset pubertal signs, attended the first visit to the endocrinology department with an average age of 7.8 years (95%CI:7.7-8). The distribution of subjects was: involuted precocious breast development (n=25), non-progressive precocious breast development (n=19), PPC (n=156), PPP (n=3), advanced puberty (n=88) and rapidly progressive puberty (n=20). Male subjects who were diagnosed of precocious puberty had at first visit a mean age of 8.7 years (95%CI:7.8-9.5), and women had a mean age of 7.7 years (95%CI:7.5-8). There was a significant difference regarding bone age at diagnosis (more advanced in central precocious puberty and rapidly progressive puberty). There was a statistically significant association between precocious puberty and the fact of being adopted (X2: 11.262; p: 0.046). The LH at 3 hours of the GnRH test was significantly higher in the PPC group (mean value of LH 14UI/L, IC95%:11.5-16.6) compared to the others. Patients with PPC were identified who did not meet the classic criteria of the diagnosis of PPC in the Procrin test, however they presented clinical characteristics in the follow-up that led to the diagnosis. We found relation between having MRI findings and presenting PPC (X2: 38.262; p: 0. 000), however incidental findings where found in MRI of patients with advanced puberty. A total of 69% of patients with PPC and 17.6% patients with advanced puberty (including here the rapidly progressive forms) received treatment.
Conclusions: we present dates of a population of children of both sexes with clinical manifestations suggestive of precocious/advanced puberty evaluated and followed between the years 2010 and 2018.The results coincide with those described in previous studies.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology