Pathological brain lesions in girls with central precocious puberty at initial diagnosis in Southern Vietnam

Area of Science:

• Pediatric Endocrinology
• Neuroimaging
• Reproductive Medicine

Background:

• Cranial magnetic resonance imaging (MRI) is often recommended for diagnosing central precocious puberty (CPP) to identify intracranial lesions.
• However, the utility of routine MRI in girls with CPP, particularly those aged 6 years and older, remains debated due to limited pathological findings in this demographic.

Purpose of the Study:

• To determine the prevalence of brain lesions in girls with CPP, stratified by age groups: 0-2 years, 2-6 years, and 6-8 years.
• To evaluate the association between age and the likelihood of detecting intracranial abnormalities in girls with CPP.

Main Methods:

• A retrospective cross-sectional study was conducted involving 257 girls diagnosed with CPP between 2010 and 2016.
• Brain abnormalities were detected using cranial MRI, and hormonal levels (luteinizing hormone, follicle-stimulating hormone, sex hormones) were measured from blood samples.

Main Results:

• Overall, 82.9% of girls had no brain lesions; 17.1% exhibited abnormalities, with 32 cases of organic CPP.
• Pathological findings were most prevalent in the youngest group (33.3% in 0-2 years), decreasing with age (15.6% in 2-6 years, 3.6% in 6-8 years).
• Hypothalamic hamartoma and pituitary stalk tumors were the most common lesions. Younger age correlated with organic CPP.

Conclusions:

• The prevalence of brain lesions, particularly organic CPP, significantly decreases with age in girls diagnosed with central precocious puberty.
• Clinicians should exercise careful consideration regarding the necessity of cranial MRI for girls aged 6-8 years presenting with CPP due to the low prevalence of pathological findings.