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[Precocious puberty in boys. Study of a series of 34 cases]
Insights
True precocious puberty in boys is often linked to intracranial issues or tumors. Cyproterone treatment showed greater effectiveness than medroxyprogesterone in managing sexual development and predicting adult height.
Area of Science:
- Pediatric Endocrinology
- Neuroendocrinology
- Oncology
Context:
- True precocious puberty (TPP) involves early onset of secondary sexual characteristics.
- Causes of TPP in boys include intracranial lesions, extrapituitary tumors, and idiopathic factors.
- Evaluating TPP requires assessing clinical signs, bone age, and hormonal profiles.
Purpose:
- To investigate the causes and clinical presentation of true precocious puberty in a cohort of boys.
- To compare the efficacy of cyproterone and medroxyprogesterone treatments for TPP.
- To analyze the relationship between bone age, height age, and predicted adult height in treated patients.
Summary:
- Thirty-four boys with TPP were studied; 28 had intracranial causes (tumors/lesions), 3 had extrapituitary tumors, and 3 were idiopathic.
- Sexual development lagged behind bone age advancement and hormone level increases (testosterone, gonadotropin reserve).
- Cyproterone treatment demonstrated superior outcomes compared to medroxyprogesterone regarding sexual development and predicted adult height.
Impact:
- Findings highlight the importance of neuroimaging in diagnosing TPP.
- Cyproterone emerges as a potentially more effective therapeutic option for managing TPP in boys.
- This study contributes to optimizing treatment strategies for TPP, improving long-term growth and development outcomes.
Abstract:
Thirty-four boys with true precocious puberty were observed: In 28, precocious puberty was related to intracranial causes (17 tumors, 11 other lesions), in 3, it was due to extrapituitary gonadotropin-secreting tumors and in 3 it appeared idiopathic. The clinical development of sex characteristics was slower than the advance of bone age and the increase in hormone levels (plasma testosterone and pituitary gonadotropin reserve as measured by the LH-RH test). Cyproterone treatment seemed more effective than medroxyprogesterone, with respect to both sexual development and evolution of the bone age/height age ratio or the predictable adult height.