Precocious puberty in girls: early diagnosis of a slowly progressing variant.
An attempt was made to identify the less severe cases of precocious puberty and to describe their natural course. A group of 17 girls with precocious puberty and a bone age advance over chronological age of less than two years (group 1) was compared with a group of 19 patients with severe precocious puberty and bone age advance of two years or more (group 2). Mean (SEM) plasma oestradiol concentrations were 82 (30) pmol/l and 164 (21) pmol/l (p less than 0.05), vaginal maturation indexes were 16 (5) and 41 (4), and plasma somatomedin C concentrations were 1.0 (0.2) U/ml (n = 8) and 2.1 (0.3) U/ml (n = 16) in groups 1 and 2, respectively. The time between onset and diagnosis of secondary sexual characteristics was about one year in both groups. After two years' follow up the untreated patients in group 1 had maintained their predicted final height. These changes were in contrast to those observed at first examination in patients in group 2 who had a mean (SD) predicted final height of -1.3 (0.2) and a mean bone age advance of 3.0 (0.2) years. These data show that bone age advance to chronological age, and plasma somatomedin C concentrations measured at initial evaluation are helpful in identifying less severe and potentially slow progressing forms of central precocious puberty.
Paediatric Endocrinology Unit, Hôpital des Enfants Malades, Paris, France.
M
M
Fontoura
R
R
Brauner
C
C
Prevot
R
R
Rappaport
D000365:Age Determination by Skeleton; D001827:Body Height; D001940:Breast / Q000254:growth & development; D002648:Child; D002675:Child, Preschool; D004958:Estradiol / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000097:blood; D011379:Prognosis; D011629:Puberty, Precocious / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology*
D004958:Estradiol; D007334:Insulin-Like Growth Factor I