Idiopathic central precocious puberty in girls: presentation factors.
BACKGROUND
It is sometimes difficult to distinguish between premature thelarche and precocious puberty in girls who develop breasts before the age of 8 years. We evaluated the frequencies of the signs associated with breast development and the factors influencing the presentation of girls with idiopathic central precocious puberty (CPP).


METHODS
353 girls monitored 0.9 +/- 0.7 year after the onset of CPP.


RESULTS
The age at CPP was < 3 years in 2%, 3-7 years in 38% and 7-8 years in 60% of cases. Pubic hair was present in 67%, growth rate greater than 2 SDS in 46% and bone age advance greater than 2 years in 33% of cases. Breast development was clinically isolated in 70 (20%) cases. However, only 31 of these (8.8% of the population) had a prepubertal length uterus and gonadotropin responses to gonadotropin releasing hormone and plasma estradiol. The clinical picture of CPP became complete during the year following the initial evaluation.25% of cases were obese. The increase in weight during the previous year (3.7 +/- 1.4 kg) and body mass index were positively correlated with the statural growth and bone age advance (P < 0.0001). There was no relationship between the clinical-biological presentation and the age at puberty, the interval between the onset of puberty and evaluation, or the presence of familial CPP.


CONCLUSIONS
The variation in presentation of girls with CPP does not depend on their age, interval between the onset and evaluation, or familial factors. This suggests that there are degrees of hypothalamic-pituitary-ovarian activation that are not explained by these factors.
Prété
Géraldine
G
Université Paris Descartes and Assistance Publique Hôpitaux de Paris, Hôpital Bicêtre, Unité d'Endocrinologie Pédiatrique, 94270 Le Kremlin Bicêtre, France. geraldineprete@yahoo.fr
Couto-Silva
Ana-Claudia
AC
Trivin
Christine
C
Brauner
Raja
R
D000365:Age Determination by Skeleton; D017668:Age of Onset; D001827:Body Height / Q000502:physiology; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D001940:Breast / Q000254:growth & development*; D002648:Child; D002675:Child, Preschool; D004958:Estradiol / Q000097:blood / Q000502:physiology; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood / Q000502:physiology; D007987:Gonadotropin-Releasing Hormone / Q000097:blood / Q000502:physiology; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood / Q000502:physiology; D011629:Puberty, Precocious / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D012189:Retrospective Studies; D014599:Uterus / Q000254:growth & development
D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone