Precocious puberty at an endocrine centre in Jordan

Data from developed countries about precocious puberty are abundant; data from developing countries are limited. Causes are different, and diagnostic and treatment possibilities are very expensive. The present study aimed to display the spectrum of initial presentation and aetiology among children with precocious puberty and to assess any association between th e clinical features and the underlying cause of the condition.

Forty-three girls and seven boys with precocious puberty were diagnosed at the Endocrine Clinic of Jordan University Hospital and at The National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan, between the 1984 and 2003.

Mean age for the girls with precocious puberty was 4.1 years +/- 2.5 SD and for the boys was 2.4 years +/- 1.9 SD. Among the girls, 21% presented with breast development only, 9% with pubic hair appearance only and 70% with multiple signs. All the boys presented with pubic hair appearance and enlarged genitalia. Organic causes for precocious puberty were detected in 42% of the girls and in all the boys. Idiopathic precocious puberty was more common among the girls presenting with breast development only (89%) compared with those presenting with multiple presenting signs (50%), and also was more common among girls presenting between 6 and 8 years (82%) than among those presenting < 6 years of age (42%). Congenital adrenal hyperplasia was diagnosed in four boys and four girls, and hypothyroidism in three girls.

Precocious puberty in the girls was usually of idiopathic origin when it presented with breast development only and at age older than 6 years. Congenital adrenal hyperplasia and hypothyroidism could represent important causes for precocious puberty in our community.