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Sexual precocity induced by ovarian follicular cysts. Is autoimmunity involved?
W H Stokvis-Brantsma1, M M van Weissenbruch, J M Wit
1University Hospital for Children and Youth, Het Wilhelmina Kinderziekenhuis, State University Utrecht, The Netherlands.
Abstract:
A 2-year-old girl presented with gonadotrophin-independent precocious puberty due to ovarian follicles. Central precocious puberty was excluded by several GnRH-tests and overnight LH sampling. There were no signs of McCune-Albright syndrome. An ovarian tumour was excluded by laparotomy and biopsies. Abdominal sonography demonstrated follicles occurring mostly in the left, sometimes in the right, ovary. Immunoglobulin G (IgG) purified from the patient's serum was capable of stimulating DNA synthesis in granulosa cells of rat ovarian segments kept in organ culture. Since FSH had a similar in-vitro action it is hypothesized that this patient's IgG mimics the action of FSH.