ESPE Abstracts

Introduction: Central precocious puberty (CPP) occurs when the HPG axis is activated prematurely. As a result, the affected child develops secondary sexual characteristics earlier than is typical for the average pediatric population. The child experiences accelerated bone maturation and premature closure of the epiphyseal growth plates, resulting in reduced adult stature. The mainstay of CPP treatment is a gonadotropin-releasing hormone analog (GnRHa) that suppresses the HPG axis.

Aim: First, we aim ed to identify the etiological frequency of CPP in Albanian children, covering various aspects such as age of diagnosis, clinical presentation, anthropological data, hormonal profile, and radiological characteristics. Second, we evaluated the effectiveness of treating CPP with GnRHa, particularly regarding the Adult Predicted Height (APH) at the start and end of the treatment, compared each with mid-Parenteral Height (MPH).

Patients and Methods: A prospective cohort study included children with CPP diagnosed and followed up at “Mother Teresa” University Hospital Center, Tirana, Albania, from2014 to 2024. Mandatory inclusion criteria were clinical signs of precocious puberty and biochemical signs of central puberty (Unequivocal positive GnRH Stimulation Test). Clinical data was collected from their medical records. Brain MRI was performed to identify all patients' potential organic causes of CPP. Growth indicator data were elaborated on using Anthro-plus software, and statistical processing was done using SPSS.

Results: During the abovementioned period, 62 patients with CPP were diagnosed, 58 (93,55%) female and 4 (6,45%) male. 54 out of 62 (87,1%) had ICPP, and 8 (22,9 %) had pathogenic CPP. The age of the diagnosis was 6,99±1,99 years. Thirty-seven out of 62 (59,67 %) patients completed GnRHa treatment. The height (expressed in HAZ=Height for Age Z-score) of patients who completed treatment changed from 0,35±1,06 z-score at the beginning of therapy to 1,11±1,41 z-score after 3,79±1,37 years treatment duration. APHcalculated at the start of therapy was 162,19±6,90 cm, and APH at the end of treatment was 168,16±7,10 cm, resulting in about +2,37±4,40 cm compared with MPH, which was 165,81±6,94 cm.

Conclusion: We found that ICPP is the most common cause of CPP, with the highest incidence in girls. Boys with CPP were found to have a neoplastic process of the CNS as a cause. Importantly, our study provides compelling evidence that using GnRHa in patients with CPP effectively improves the APH.

Keywords: Central precocious puberty (CPP), gonadotropin-releasing hormone analog (GnRHa), Adult predicted height (APH).