ESPE Abstracts

Background: Central precocious puberty (CPP) presents a clinical challenge due to early physical development and the potential for a reduction in final height, which may lead to psychosocial issues. The most common etiology of central precocious puberty among girls is idiopathic central precocious puberty, while among boys, neurogenic central precocious puberty and congenital adrenal hyperplasia (CAH) are more prevalent. Gonadotropin-releasing hormone analogs (GnRHas), known for their impressive record of safety and efficacy, are considered the gold standard for the treatment of central precocious puberty (CPP).

Aims: To provide updated insights into the etiology and therapeutic outcomes of central precocious puberty at the referral pediatric center of Vietnam.

Patients and Methods: Between April 2021 and March 2024, a total of 1106 girls and 35 boys were diagnosed with central precocious puberty at the Center for Endocrinology, Metabolism, Genetics/Genomics, and Molecular Therapy, Vietnam National Children's Hospital. Among them, 45 girls received treatment with triptorelin 11.25 mg every three months. Patients underwent monitoring for the progression of secondary sexual characteristics and laboratory tests to assess both effectiveness and safety.

Results: The median age at diagnosis for boys was 7.5 years (range: 2.4-9.83), while for girls, it was 7.7 years (range: 1.2-10). The etiology of central precocious puberty in boys included: 16 cases (46%) with neurogenic lesions, 3 cases (8%) with congenital adrenal hyperplasia, 1 case with a testicular tumor, and 1 case suspected to be associated with HC McCune Albright syndrome; in 14 cases (40%), the cause remained undetermined. In girls, the causes of early puberty were as follows: 763 cases (90.5%) had idiopathic CPP, 79 cases (9.4%) had primary and secondary neurogenic damage, and one case (0.1%) had an adrenal cortical tumor. Among the 45 girls treated with triptorelin 11.25 mg, the median age at the start of treatment was 7.5 years. Six months into treatment, 89% and 93% of the children showed no further progression in secondary sexual characteristics, including breast development and pubic hair, respectively. The medication effectively suppressed LH secretion, reduced the disparity between bone age and chronological age, and decreased uterine size. No adverse effects were reported, indicating the safety profile of the drugs.

Conclusion: Neurogenic lesions should be excluded in children with CPP. Treatment with GnRH agonists for puberty suppression is considered safe and efficacious.

Keywords: Central precocious puberty