ESPE Abstracts

Introduction: Precocious puberty, is the development of sexual characteristics occurring before the age of 8 in girls and 9 years in boys, it is a reason for consultation which is becoming frequent, the etiologies are numerous, it Central forms mainly act by early activation of hypothalamic-pituitary-gonadal (HPG) axis which can be idiopathic or secondary to congenital or acquired lesions, rarely the peripheral origin can be the cause.

Material and Methods: This is an 8-year retrospective study (2016-2023) including all patients explored and treated for PP in the pediatric endocrinology unit and aim ed at describing the etiologies, the modalities of exploration and management as well as response to treatment

Results: We collected 74 patients (4 boys and 70 girls), the majority of children benefited from a test with Triptorelin 0.1 mg (LH-RH not available), the central origin was predominant in 72 patients (94%). and peripheral in only 2 patients (McCune-Albright syndrome), Central precocious puberty (CPP) was idiopathic in 49 patients (68%) and secondary in 23 patients (32%), the analysis of the etiologies of secondary central PP highlighted a tumor etiology. malignancies in 2 boys (1 died who also had a history of tuberculous meningitis), an hamartoma in a girl, a craniopharyngioma in the 2nd and a tuberculoma in the 3rd, a convulsive encephalopathy in 4 girls, severe hypothyroidism in in the context of Van Wyk Grumbach syndrome in 2 girls, CPP in the context of multiple endocrine neoplasia in 2 sisters and congenital adrenal hyperplasia by 21 hydroxylase enzymatic block in 5 patients (2 cases by late revelation and 3 cases by lifting of inhibition of the gonadotropic axis by underdosing with hydrocortisone) and 3 patients born with low birth weight by adrenarche, one of whom presents 3M syndrome. A PP was also highlighted in 2 girls with notion of adoption. All patients with CPP benefited from LH-RH agonists to suppress pituitary gonadotropin secretion. This treatment made it possible to stop the progression or even regression of clinical signs; surgical treatment was carried out in forms with tumor or cerebral malformation.

Conclusion: CPP is the result of early activation of the gonadal HPG axis, this activation is idiopathic in the majority of cases, tumors can be life-threatening requiring surgical intervention, medical treatment is indicated in all cases of CPP, peripheral PP remains a rare cause, and the management is different.