Peripheral precocious puberty: a retrospective study for six years in Hangzhou, China

To evaluate the clinical and aetiopathogenesis of peripheral precocious puberty (PPP) in Chinese children.

A total of 91 PPP children were reviewed. Clinical features including age, gender, stage of pubertal development, presenting symptoms, features and aetiopathogenesis were investigated.

They were 65 girls (71.4%) and 26 boys (28.6%) with a median age of 3.6 years. The median age of girls and boys were 3.7 and 3.4 years, respectively, with a significant difference (P = 0.048). Congenital adrenal cortical hyperplasia (CAH) patients with a median age of 0.2 years were younger than other patients. The major complaint was the appearance of breast buds (56.6%), followed by menstruation (5.5%), vaginal discharge (5.5%) and vomiting (4.4%). Heterosexual PPP was common in CAH girls (10 cases) while exogenic sexual steroid exposure was common in boys (10 cases). Major cause of PPP was gonadal abnormalities (34.1%), including 24 girls with autonomous isolated ovarian cysts, one with Sertoli's cell ovarian tumour, five with testicular tumours and one with testotoxicosis. CAH was the most common cause of PPP in boys. Exogenous sexual steroid exposure was the third cause. MeCune-Albright syndrome was also found in three cases. It was noted that the causes of 24 cases (26.4%), including 20 girls and 4 boys, were still unknown.

The results imply that PPP is a common matter of children in the department of endocrinology. It is more frequently in girls. History, physical examination, clinical suspicion and imaging detection should be considered carefully to diagnose and investigate the aetiopathogenesis.