title: Etiology and age incidence of precocious puberty in girls: a multicentric study.
abstract: We review the etiology and age incidence of precocious puberty in 438 girls examined between 1988-1998; 428 (97.7%) had central precocious puberty (CPP), the remaining 10 (2.3%) gonadotropin-independent precocious puberty (GIPP) of ovarian origin. The majority of CPP girls (59.6%) were aged between 7-7.9 yr, 22.4% were 6 year olds, and only 18% were under 6 years old. Cranial CT and/or MRI performed in 304/428 girls, showed neurogenic abnormalities in 56/304 (18.4%) CPP girls; 30 (9.9%) were due to previously diagnosed intracranial abnormalities and the remaining 26 (8.5%) were detected at the diagnosis of CPP. The frequency of neurogenic CPP tended to be higher in girls under 4 years of age while the frequency of idiopathic CPP tended to be higher in girls aged between 7-7.9 years, but no statistically significant differences were found. Interestingly, some CNS anomalies either of tumoral or congenital origin were detected at presentation in 7% of the girls aged over 7 years. Other related or coincidental clinical anomalies, mainly due to genetic diseases, were observed in 22/304 (7.2%) patients. History of precocious maternal menarche was found in 12/304 (4%) girls. In conclusion, idiopathic CPP was observed in 74% of the girls in this study. Neurogenic anomalies or other coincidental or related clinical findings were observed in the remaining 26%. The increased frequency of idiopathic CPP in girls aged over 7 years may suggest an early, but otherwise normal onset of puberty in many of these girls as a consequence of the trend towards earlier maturation. Nonetheless, the finding of CNS anomalies also in the older patients, raises the question of whether these patients should undergo a complete diagnostic work-up.
authors.affiliation: Department of Pediatrics, IRCCS Policlinico S. Matteo, University of Pavia, Italy. m.cisternino@smatteo.pv.it
authors.forename: M
authors.initials: M
authors.lastname: Cisternino
authors.forename: T
authors.initials: T
authors.lastname: Arrigo
authors.forename: A M
authors.initials: AM
authors.lastname: Pasquino
authors.forename: C
authors.initials: C
authors.lastname: Tinelli
authors.forename: F
authors.initials: F
authors.lastname: Antoniazzi
authors.forename: L
authors.initials: L
authors.lastname: Beduschi
authors.forename: G
authors.initials: G
authors.lastname: Bindi
authors.forename: P
authors.initials: P
authors.lastname: Borrelli
authors.forename: V
authors.initials: V
authors.lastname: De Sanctis
authors.forename: G
authors.initials: G
authors.lastname: Farello
authors.forename: F
authors.initials: F
authors.lastname: Galluzzi
authors.forename: L
authors.initials: L
authors.lastname: Gargantini
authors.forename: D
authors.initials: D
authors.lastname: Lo Presti
authors.forename: M
authors.initials: M
authors.lastname: Sposito
authors.forename: L
authors.initials: L
authors.lastname: Tatò
mesh_terms: D000015:Abnormalities, Multiple; D017677:Age Distribution; D001927:Brain Diseases / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D005260:Female; D030342:Genetic Diseases, Inborn; D006801:Humans; D015994:Incidence; D007558:Italy; D008279:Magnetic Resonance Imaging; D008499:Medical Records; D011629:Puberty, Precocious / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000235:genetics; D014057:Tomography, X-Ray Computed