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Published on: November 21, 2013
[Central precocious puberty is associated with a high prevalence of organic disease]
M J Martín Díaz1, L Soriano Guillén, M T Muñoz Calvo
1Servicio de Endocrinología, Departamento de Pediatría, Hospital Infantil Universitario Niño Jesús, Universidad Autónoma de Madrid, España.
Introduction:
The incidence of central precocious puberty (CPP) is lower in boys than in girls; however, the presence of organic disease is more common in boys.
Objectives:
To investigate the percentage of CPP secondary to organic disease in boys and to analyze their clinical and biological characteristics at diagnosis, during follow-up, and at the end of therapy.
Patients And Methods:
Eight boys with a diagnosis of CPP treated with triptorelin every 28 days were included. Age, height in standard deviation (SD), body mass index (BMI) in SD, growth velocity in SD, bone age (Greulich and Pyle), predicted height (Bayle-Pinneau), and target height were analyzed. Testicular volume was measured (according to Prader standards) and peak lutein hormone (LH) values and testosterone levels were determined after gonadotropin-releasing hormone (GnRH) stimulus.
Results:
Seventy-five percent of the patients with CPP had organic disease. After treatment with triptorelin, growth reduction significantly decreased. In contrast, no changes were seen in the difference between bone age and chronological age, due to the slight difference found at diagnosis. Likewise, during treatment, there was no LH peak and testosterone levels were lower than 0.5 ng/ml in response to GnRH stimulus. No changes were observed in weight or BMI. Three patients reached an adult height similar to their genetic height and their predicted height, as estimated by the Bayle-Pinneau method.
Conclusions:
1. Among boys with CPP we found a substantial number of patients with organic disease. 2. Adult height after treatment with triptorelin can reach the normal range. 3. Determination of testosterone levels can be useful in the follow-up of these children during treatment.
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