ESPE Abstracts

Background: Precocious puberty is considered a stressful condition leading to psychosocial and behavioral problems in children. Many factors are involved in these changes such as early body changes which make them feeling strange and cause the sense of isolation from social groups. On the other hand, GnRHa treatment can affect psychological functioning of children with CPP through several pathways. There is controversy in the results of studies dealing with that issue, thus this study aimed at assessing the effect of CPP on quality of life among these children cohort.

Objectives: The main objective was to assess the quality of life in children with CPP. Moreover, the study aimed at determining the effect of GnRHa treatment on reversal of these psychological changes if they occurred.

Patients and Methods: It was a prospective case-control study conducted on children with CPP attending the pediatric endocrinology clinic of Alexandria University Children’s Hospitals. The study included two groups. Group 1 included 30 patients with CPP and group 2 included 30 healthy controls. After approval of Ethics Committee, all patients were assessed on emphasis of detailed history taking, anthropometric measurement (height, weight, body mass index), and Tanner staging of pubertal signs. Furthermore, hormonal assay of patients was assessed including basal LH, FSH, testosterone/ estradiol, and GnRH stimulation test. Bone age, pelvic or testicular ultrasonography and magnetic resonance imaging of brain were done for all patients. Furthermore, The Arabic form of pediatric quality of life inventory TM 4.0 (PedsQLTM) generic core scale parent-report form was done by parents of patients.

Results: The age of patients ranged from 2.0 – 9.50 years. Besides, the age of controls ranged from 2.0 – 10.0 years. Twenty-nine patients (96.7%) were females. The most common presenting symptom was isolated thelarche in 15 patients (50%). Height SD of patients was significantly higher than that of controls. Twenty-five patients underwent GnRH stimulation test with pubertal response in all patients except one patient. According to MRI brain results, 73.3% of patients were idiopathic CPP and the remaining 8 patients were organic CPP. Children with CPP scored significantly lower than controls in all health-related quality of life (HRQoL) domains except school functioning. After one year of GnRHa treatment, Children with CPP had significantly higher scores in the quality of life domains.

Conclusion: Central precocious puberty has significant negative effect on children’s quality of life. All pediatric quality of life domains showed significant improvement after GnRHa treatment.