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Central precocious puberty in boys; diagnosis, treatment and follow-up: a nation-wide study
Sevinc Odabasi Gunes1, Merve Sakar2, Nursel Muratoglu Sahin2
1UHS Gulhane Training and Research Hospital, Department of Pediatric Endocrinology, Ankara, Türkiye. sevinc.odabasigunes@sbu.edu.tr.
Insights
Central precocious puberty (CPP) in boys was evaluated, finding organic CPP (oCPP) less prevalent than previously reported. Early evaluation is crucial for boys under 3 to identify potential organic causes.
Area of Science:
- Pediatric Endocrinology
- Reproductive Health
- Child Development
Background:
- Central precocious puberty (CPP) is a condition characterized by early onset of puberty.
- Understanding the subtypes, idiopathic CPP (iCPP) and organic CPP (oCPP), is crucial for effective management.
- Demographic, clinical, and laboratory features influence treatment outcomes.
Purpose of the Study:
- To analyze demographic, clinical, laboratory, and imaging characteristics of boys with CPP.
- To assess treatment responses in patients diagnosed with CPP.
- To differentiate between idiopathic and organic CPP based on MRI findings.
Main Methods:
- Retrospective data collection from pediatric endocrinology clinics in Türkiye.
- Classification of patients into iCPP and oCPP groups based on MRI.
- Further categorization of oCPP into confirmed, unrelated, and uncertain subgroups.
Main Results:
- 62.9% of 232 patients had iCPP; oCPP prevalence was lower than expected.
- Higher basal LH and testosterone levels were observed in the oCPP group.
- Boys under 3 years old consistently presented with oCPP-confirmed lesions.
- Final height was significantly impacted by treatment initiation height, paternal height, and target height.
Conclusions:
- oCPP prevalence appears lower than previously documented.
- No definitive marker exists to rule out oCPP without MRI in iCPP cases.
- Vigilant evaluation for organic causes is essential in boys under 3 with CPP.
Purpose:
To evaluate demographic characteristics, clinical, laboratory, imaging features, and treatment responses of boys who were diagnosed and treated for central precocious puberty (CPP).
Methods:
The data were collected from pediatric endocrinology clinics in Türkiye. Patients were classified into two groups based on magnetic resonance imaging (MRI) findings, idiopathic CPP (iCPP) and organic CPP (oCPP). The oCPP group was further cathegorized into three subgroups: oCPP-confirmed, oCPP-unrelated, and oCPP-uncertain lesions.
Results:
Among 232 patients, 62.9% were diagnosed with iCPP. All patients aged <3 years had oCPP-confirmed lesions. Basal luteinizing hormone (LH) and total testosterone (T) levels were higher in oCPP group than in iCPP group (p = 0.004 and p = 0.02, respectively). Basal LH, basal follicle-stimulating hormone (FSH), T, and peak LH/FSH were lower in the iCPP-obese group (p < 0.05). T differed significantly among the oCPP-confirmed, oCPP-unrelated, and oCPP-uncertain subgroups (p = 0.032). Among patients that reached final height (FH), the difference between target height (TH) standard deviation score (SDS) and FH SDS was higher in oCPP group than in iCPP group (p < 0.05). A positive correlation was found between predicted adult height at the treatment initiation and FH (r = 0.463 p = 0.020). Factors affecting FH were height SDS at the beginning of treatment, paternal height SDS, and TH SDS.
Conclusions:
The prevelance of oCPP was found lower compared with previous literature data. Currently, there is no reliable marker to predict oCPP that would allow clinicians to safely omit MRI in iCPP cases. However, boys under 3 years of age should be carefully evaluated for potential organic causes of CPP.
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