title: Premature pubarche before one year of age: distinguishing between mini-puberty variants and precocious puberty.
abstract: BACKGROUND
  The aim of this study was to facilitate the distinction between the benign "mini-puberty of early infancy" and precocious puberty (PP).
  
  
  METHODS
  We compared 59 patients (21 boys and 38 girls) seen for pubic hair development before one year of age diagnosed as mini-puberty to 13 patients (2 boys) in whom pubertal development before one year revealed a PP.
  
  
  RESULTS
  The boys with mini-puberty presented with pubic hair development and prepubertal testicular volume, with low plasma testosterone concentrations. Their gonadotropin responses to gonadotropin releasing hormone (GnRH) test showed predominant luteinising hormone increase in 9/13. The girls presented with pubic hair development that was accompanied by breast development in 47% of cases, with low plasma estradiol concentrations. Their gonadotropin responses showed predominant follicle-stimulating hormone increase in the 17 evaluated. The patients with PP had organic central PP (5 hypothalamic hamartoma) or idiopathic central PP (n=6), or peripheral PP (one ovarian tumor and one congenital adrenal hyperplasia). The diagnosis was challenging only in 3 girls with idiopathic central PP presenting with prepubertal plasma estradiol concentrations and responses to GnRH test.
  
  
  CONCLUSIONS
  The diagnosis of PP was easily determined based on the clinical presentation and the pubertal concentrations of testosterone in boys or of estradiol in girls, as was the diagnosis of central or peripheral origin of PP based on gonadotropin response to the GnRH test. Once PP is excluded, these patients need careful follow-up and physician consultation is needed if clinical pubertal signs progress.
authors.affiliation: Pediatric Endocrinology Unit, Fondation Ophtalmologique Adolphe de Rothschild and Université Paris Descartes, Paris, France.
authors.forename: Rafik
authors.initials: R
authors.lastname: Bourayou
authors.affiliation: Pediatric Endocrinology Unit, Fondation Ophtalmologique Adolphe de Rothschild and Université Paris Descartes, Paris, France.
authors.forename: Eloïse
authors.initials: E
authors.lastname: Giabicani
authors.affiliation: Pediatric Endocrinology Unit, Fondation Ophtalmologique Adolphe de Rothschild and Université Paris Descartes, Paris, France.
authors.forename: Monique
authors.initials: M
authors.lastname: Pouillot
authors.affiliation: Department of Molecular Genetics, Pharmacogenetics, Hormonology, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, and Université Paris Sud, Le Kremlin Bicêtre, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Brailly-Tabard
authors.affiliation: Pediatric Endocrinology Unit, Fondation Ophtalmologique Adolphe de Rothschild and Université Paris Descartes, Paris, France.
authors.forename: Raja
authors.initials: R
authors.lastname: Brauner
mesh_terms: D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011627:Puberty / Q000502:physiology*; D011629:Puberty, Precocious / Q000175:diagnosis*
references.citation: Clin Endocrinol (Oxf). 2001 Mar;54(3):289-94
references.pmid: 11298079
references.citation: J Clin Endocrinol Metab. 2014 Feb;99(2):433-9
references.pmid: 24297793
references.citation: J Clin Endocrinol Metab. 2003 Jun;88(6):2624-33
references.pmid: 12788866
references.citation: Eur J Pediatr. 2004 Feb;163(2):89-93
references.pmid: 14689304
references.citation: J Clin Endocrinol Metab. 2004 May;89(5):2107-13
references.pmid: 15126527
references.citation: Arch Dis Child. 1969 Jun;44(235):291-303
references.pmid: 5785179
references.citation: Arch Dis Child. 1970 Feb;45(239):13-23
references.pmid: 5440182
references.citation: Rev Fr Gynecol Obstet. 1971 Jun-Jul;66(6):391-6
references.pmid: 5112836
references.citation: Clin Endocrinol (Oxf). 1978 Jun;8(6):437-44
references.pmid: 352578
references.citation: Arch Dis Child. 1979 Jun;54(6):472-5
references.pmid: 475434
references.citation: J Steroid Biochem. 1979 Jul;11(1B):543-8
references.pmid: 491626
references.citation: J Pediatr. 1980 Oct;97(4):600-2
references.pmid: 7420225
references.citation: Am J Dis Child. 1983 Feb;137(2):127-33
references.pmid: 6336889
references.citation: J Clin Endocrinol Metab. 1988 Sep;67(3):474-9
references.pmid: 3137242
references.citation: J Clin Endocrinol Metab. 1990 Nov;71(5):1251-8
references.pmid: 2121771
references.citation: Arch Dis Child. 1990 Nov;65(11):1199-202
references.pmid: 2248527
references.citation: Eur J Clin Nutr. 1991 Jan;45(1):13-21
references.pmid: 1855495
references.citation: J Clin Endocrinol Metab. 1991 Sep;73(3):674-86
references.pmid: 1651957
references.citation: J Pediatr. 1995 Jan;126(1):11-4
references.pmid: 7815198
references.citation: Arch Dis Child. 1995 May;72(5):466
references.pmid: 7618922
references.citation: Acta Paediatr. 1997 Sep;86(9):1016-8
references.pmid: 9343289
references.citation: J Endocrinol Invest. 1998 Mar;21(3):180-3
references.pmid: 9591214
references.citation: J Pediatr Endocrinol Metab. 2005 Jan;18(1):25-31
references.pmid: 15679066
references.citation: Pediatrics. 2006 Mar;117(3):951-4
references.pmid: 16510682
references.citation: Clin Endocrinol (Oxf). 2006 Aug;65(2):239-45
references.pmid: 16886967
references.citation: Pediatrics. 2009 Apr;123(4):e752-62
references.pmid: 19332438
references.citation: J Clin Endocrinol Metab. 2009 Aug;94(8):2835-40
references.pmid: 19454583
references.citation: J Pediatr. 2010 Mar;156(3):466-71
references.pmid: 19914634
references.citation: Horm Res Paediatr. 2014;82(2):73-80
references.pmid: 25012863
references.citation: J Pediatr. 2012 Nov;161(5):855-63
references.pmid: 22727865
references.citation: PLoS One. 2013;8(7):e70931
references.pmid: 23936254
references.citation: Acta Paediatr. 2001 Jul;90(7):751-6
references.pmid: 11519977