Premature thelarche: a long-term follow-up

Area of Science:

• Pediatric Endocrinology
• Reproductive Health

Background:

• Differentiating premature thelarche from idiopathic central precocious puberty is crucial for prognosis and treatment.
• Limited data exists to predict the long-term outcomes for girls diagnosed with premature thelarche.

Purpose of the Study:

• To longitudinally assess the progression of premature thelarche in relation to the age of onset.
• To identify predictive factors for the development of central precocious puberty in girls with premature thelarche.

Main Methods:

• A longitudinal study of 46 girls with premature thelarche, divided into two groups based on onset before or after two years of age.
• Hormonal assessments including basal follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels, and response to gonadotropin-releasing hormone (GnRH) testing.
• Follow-up duration ranged from 5.1 to 7.8 years.

Main Results:

• Girls presenting with premature thelarche after age two showed a higher incidence of progressing to precocious puberty compared to those presenting before age two.
• Basal FSH levels were significantly higher in the study group than in controls, with an elevated FSH response to GnRH testing.
• A greater percentage of resolution was observed in the group with earlier onset (Group A).

Conclusions:

• The age of onset of premature thelarche is a significant clinical factor in distinguishing girls at risk for developing central precocious puberty.
• Early thelarche onset may indicate a lower risk of progression to precocious puberty.