title: Isosexual precocity: the clinical and etiologic profile.
abstract: Eighty children (58 girls and 22 boys) with isosexual precocity seen in the past eight years were evaluated clinically and investigated to identify the underlying cause. Of these, 50% (29 girls and 11 boys) had centrally mediated true precocious puberty (TPP). The girls could be classified into five major groups (I) Central precocious puberty 29-subclassified into idiopathic (ITPP, 15) and organic or neurogenic (NTTP, 14), (II) Premature thelarche (PT, 20), (III) Premature menarche (PM, 2), (IV) Premature adrenarche (PA, 5), and, (V) Others: hypothyroid (n = 1), and McCune Albright Syndrome (n = 1). ITPP as a cause of precocity in girls was seen less often (52%) and NTPP more often (48%) compared to most Western series, with tubercular meningitis as the cause in 31% and hypothalamic hamartomas in 10%. Though the LH and estradiol levels were significantly higher (p < 0.05) in TPP, compared to PT, these were not helpful in differentiating because of considerable overlap. LH-predominant-response (LH/FSH ratio > 1) to LHRH testing was seen in TPP. Amongst the 22 boys, 11 (50%) had TPP, ITPP in 27% and NTPP in 73%. Hamartomas (n = 4) and TBM (n = 3) contributed equally to NTPP; pineal tumor was seen in one. The adrenal (n = 7) and testicular (n = 2) causes together involved 41% of the boys with precocity, congenital adrenal hyperplasia (CAH) CAH, 11-beta hydroxylase being the commonest cause. Of the 6 boys witdeficiency was found in four and nonsalt losing form of 21-hydroxylase deficiency in 2. Testicular and adrenal tumors and testotoxicosis were noted in one case each. The etiologic factors were more varied in boys.
authors.affiliation: Division of Pediatric Endocrinology, Bai Jerbai Wadia Hospital for Children, Bombay.
authors.forename: M
authors.initials: M
authors.lastname: Desai
authors.forename: M P
authors.initials: MP
authors.lastname: Colaco
authors.forename: C S
authors.initials: CS
authors.lastname: Choksi
authors.forename: M C
authors.initials: MC
authors.lastname: Ambadkar
authors.forename: F E
authors.initials: FE
authors.lastname: Vaz
authors.forename: C
authors.initials: C
authors.lastname: Gupte
mesh_terms: D000307:Adrenal Gland Diseases / Q000150:complications; D000365:Age Determination by Skeleton; D001940:Breast / Q000254:growth & development; D002493:Central Nervous System Diseases / Q000150:complications; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008572:Menarche / Q000502:physiology; D010413:Penis / Q000254:growth & development; D011629:Puberty, Precocious / Q000145:classification / Q000209:etiology* / Q000503:physiopathology*; D012189:Retrospective Studies; D013733:Testicular Diseases / Q000150:complications