ESPE Abstracts

Purpose: We aimed to determine the frequency and distribution of intracranial pathologies in patients over 8 years of age by evaluating MRI images of patients diagnosed with early puberty-rapidly progressive.

Materials and Methods: The study comprised 118 female patients diagnosed with precocious puberty (PP) and rapidly progressive early puberty (RPEP). The onset of puberty in girls before the age of 8 years is defined as PP. Early puberty is characterized as the onset of puberty between the ages of eight and nine. RPEP was identified by the following indicators: (i) breast development after 8 years of age which reached Tanner stage 3 or 4 within 3-6 months, (ii) breast development before the age of 9 at Tanner stage 3 or 4, (iii) onset of menstruation before the age of 10, or (iiii) a predicted adult height below target height with a decline during follow-up. The patients were divided into 2 groups, normal and abnormal, according to MRI findings. According to recent literature brain insults of Abnormal MRI findings were classified into 3 groups: Pathological findings, Questionable relationship with CPP, and Incidental findings. The patients were divided into 4 groups according to MRI findings (normal or abnormal) and PP or RPEP (PP +Normal MR, RPEP + Normal MRI, PP years +Abnormal MRI, RPEP +Abnormal MRI).

Results: Seventy-four of the 118 girls were included. MRI was normal in 54% (n:40) of the cases, abnormal MRI was detected in 46% (n:34). No malignant lesion was detected in cases with abnormal MRI findings. The MRI findings were abnormal in 46% of cases PP group and MRI findings were abnormal in 45% of cases RPEP group. The most MRI finding was incidental findings in both groups. The rate of the cases with the Pathological, Questionable relationship with CPP was similar in both groups(p:0.06). Basal LH concentration of the patients was found to be higher in the RPEP+ Abnormal MRI group compared to the PP +Normal MRI group(p:0.01)

Conclusion: Our study showed that there was no difference in terms of intracranial findings between cases with precocious puberty the age of 6-8 years and cases with rapidly progressive early puberty above 8 years. Exaggerated LH response may be a warning sign for pathological findings on MRI in rapidly progressive early puberty cases.