Accelerated pubertal development in patients with shunted hydrocephalus.
OBJECTIVE
To evaluate pubertal development and peripheral concentrations of gonadotrophins and sex hormones in children with shunted hydrocephalus compared with healthy controls.


METHODS
114 patients (52 females, 62 males) and 73 healthy controls (35 females, 38 males) aged 5 to 20 years were analysed for stage of puberty, age at menarche, testicular volume, basal serum follicle stimulating hormone (FSH), luteinising hormone (LH), sex hormone binding globulin (SHBG), testosterone and oestradiol concentrations, and free androgen index.


RESULTS
Male gonadal and male and female pubic hair development occurred significantly earlier in the patients than in the controls. The mean age at menarche was significantly lower in the female patients than in their controls (11.7 v 13.2 years; p < 0.001), and lower than it had been for their mothers (v 13.1 years; p < 0.001). Relative testicular volume was higher in the male patients than in their controls (1.2 standard deviation score (SDS) v 0.2 SDS; p < 0.001). The prepubertal patients had higher basal LH (0.13 U/l v 0.08 U/l; p < 0.001) and SHBG (132.3 nmol/l v 109.1 nmol/l; p < 0.01) than the controls. Both the prepubertal and pubertal females had significantly higher basal FSH than their controls (1.57 U/l v 1.03 U/l; p < 0.05, and 4.0 U/l v 2.9 U/l; p < 0.01, respectively).


CONCLUSIONS
Hydrocephalic children experience accelerated pubertal maturation, reflected in a younger age at menarche in females and an increased testicular volume in males. This may be because of enhanced gonadotrophin secretion, possibly resulting from unphysiological variations in intracranial pressure.
Löppönen
T
T
Department of Paediatrics, University of Oulu, Finland.
Saukkonen
A L
AL
Serlo
W
W
Tapanainen
P
P
Ruokonen
A
A
Knip
M
M
D000293:Adolescent; D000886:Anthropometry; D001940:Breast / Q000254:growth & development; D002557:Cerebrospinal Fluid Shunts; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood; D006065:Gonadotropins, Pituitary / Q000097:blood; D006801:Humans; D006849:Hydrocephalus / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008572:Menarche / Q000502:physiology; D011627:Puberty / Q000502:physiology; D011629:Puberty, Precocious / Q000209:etiology*; D013737:Testis / Q000254:growth & development
D012739:Gonadal Steroid Hormones; D006065:Gonadotropins, Pituitary