Etiology and age incidence of precocious puberty in girls: a multicentric study.
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.
Cisternino
M
M
Department of Pediatrics, IRCCS Policlinico S. Matteo, University of Pavia, Italy. m.cisternino@smatteo.pv.it
Arrigo
T
T
Pasquino
A M
AM
Tinelli
C
C
Antoniazzi
F
F
Beduschi
L
L
Bindi
G
G
Borrelli
P
P
De Sanctis
V
V
Farello
G
G
Galluzzi
F
F
Gargantini
L
L
Lo Presti
D
D
Sposito
M
M
Tatò
L
L
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