ESPE Abstracts

Introduction: Peripheral or gonadotropin-independent PP is due to the production of sex steroids by gonadal or adrenal tissues independently of gonadotropins (which are usually suppressed). Peripheral PP may result from gonadal, adrenal or hCG-producing tumors (in boys) and exposure to exogenous sex steroids. Peripheral PP may rarely lead to activation of pulsatile GnRH secretion and PPC due to prolonged priming of the HPG axis. The pattern of pubertal development in peripheral PP may be asynchronous, in contrast to normal puberty or PPC, for example, with menarche occurring at an early stage of breast development. Autonomous ovarian cysts may manifest as vaginal bleeding and breast development.

Materials and Methods: during the study period from January 01, 2018 to December 31, 2020, we collected all cases of precocious puberty referred to our specialized pediatric endocrinology consultation, pole Pédiatrique de Sétif, Algeria.

Results: We collected 45 cases of precocious puberty in girls. Peripheral causes accounted for 11 cases (24.4%). The mean age of onset of symptoms was 3.77 years, with a consultation age of 4.69 years. The mean height was 110.54cm, i.e. +0.81 SDS, with a BMI of 16.45 Kg/M2, i.e. -0.35SDS. Mean bone age was 6.81 years with a delta BA/CA: 2.65. Mean baseline LH was 0.5 Mui/l, baseline E2 187.03pg/ml. Mean peak LH 0.53mui/l. Causes were dominated by McCune Albright syndrome 3 cases, indeterminate 3 cases, 1 case hypothyroidism, 1 case ovarian cyst, 1 case granulosa tumor and 2 cases HCS.

Conclusion: Peripheral precocious puberty represents an important part of precocious puberty, in our series it was McCune Albright syndrome that dominated followed by indeterminate causes or a careful search made but alas no cause was found.