ESPE Abstracts

Background: Precocious puberty refers to the early development of secondary sexual characteristics in girls before the age of eight. It is classified into two categories based on the cause: central (GnRH dependent) and peripheral (GnRH independent) precocious puberty. Brain MRI is the most commonly used method to assess underlying brain pathology, particularly in girls under the age of six.

Objective: The aimof this study is to present the brain MRI findings in Saudi girls with central precocious puberty in a single center in Riyadh, Saudi Arabia.

Methods: A retrospective study of all girls diagnosed with Central Precocious Puberty was conducted at Riyadh's King Abdullah Specialized Children's Hospital (KASCH). Data were acquired from electronic medical records from 2015 to 2023.

Results: A total of 71 girls included in the study, with 14 (19.71%) exhibiting CNS symptoms. 44 girls (61.9%) got brain MRI scans, with 17 (38.63%) having an abnormal scan and 27 (61.3%) having a normal scan. 10 (22.7%) of the patients who had brain MRI exhibited CNS symptoms at the time of presentation. The abnormal MRI findings were as follows: 7/44 (16%) girls had non-pituitary lesions such as corpus callosum dysgenesis, thick and droopy corpus callosum, supratentorial ventriculomegaly and bilateral subependymal heterotopia, periventricular leukomalacia, hydrocephalus, subgleal hematoma, and myelomeningocele, while 6/44 (14%) girls had pituitary lesions such as a bulky pituitary gland and thickened pituitary, 4/44 (9%) girls had hypothalamic hamartoma. The mean age at diagnosis for the girls with hamartomas was 3.29 years (±3.14), and only 1 of them had CNS symptoms.

Conclusion: Abnormal MRI findings were reported in almost 40 percent of the girls who presented with central precocious puberty and underwent brain MRI. This finding could be influenced by the fact that not all girls had a brain MRI scan. A further analysis of the clinical and biochemical predictors of the abnormal MRI finding will be conducted.