scholarly journals For Premature Thelarche and Premature Adrenarche, the Case for Waiting before Testing

2020 ◽  
pp. 1-4
Author(s):  
Paul B. Kaplowitz
Keyword(s):  
Premature Thelarche ◽  
Premature Adrenarche

scholarly journals Evaluation of puberty by verifying spontaneous and stimulated gonadotropin values in girls

2014 ◽  
Vol 0 (0) ◽  
Author(s):  
Vivian L. Chin ◽  
Ziyong Cai ◽  
Leslie Lam ◽  
Bina Shah ◽  
Ping Zhou
Keyword(s):  
Predictive Power ◽  
Clinical Information ◽  
Central Precocious Puberty ◽  
Bone Age ◽  
Change Model ◽  
Pharmacological Agents ◽  
Premature Thelarche ◽  
Premature Adrenarche ◽  
Hormone Analog ◽  
Lowered Sensitivity

AbstractChanges in pharmacological agents and advancements in laboratory assays have changed the gonadotropin-releasing hormone analog stimulation test.To determine the best predictive model for detecting puberty in girls.Thirty-five girls, aged 2 years 7 months to 9 years 3 months, with central precocious puberty (CPP) (n=20) or premature thelarche/premature adrenarche (n=15).Diagnoses were based on clinical information, baseline hormones, bone age, and pelvic sonogram. Gonadotropins and E2 were analyzed using immunochemiluminometric assay. Logistic regression for CPP was performed.The best predictor of CPP is the E2-change model based on 3- to 24-h values, providing 80% sensitivity and 87% specificity. Three-hour luteinizing hormone (LH) provided 75% sensitivity and 87% specificity. Basal LH lowered sensitivity to 65% and specificity to 53%.The E2-change model provided the best predictive power; however, 3-h LH was more practical and convenient when evaluating puberty in girls.

Plasma kisspeptin and ghrelin levels in puberty variant cases

2017 ◽  
Vol 30 (5) ◽  
Author(s):  
Erdal Kurnaz ◽  
Yaşar Şen ◽  
Süleyman Aydın
Keyword(s):  
Serum Levels ◽  
Control Group ◽  
Control Groups ◽  
Premature Thelarche ◽  
Premature Adrenarche ◽  
Significant Difference ◽  
And Gender ◽  
And Control ◽  
Relationship Of ◽  
The Relationship

AbstractBackground:The aim of this study was to determine the serum levels of kisspeptin and ghrelin (GAH), as well as the relationship of these two peptides with each other in premature thelarche (PT) and premature adrenarche (PA) cases and to investigate the possibility of using these peptides as markers in the differentiation of puberty disorders.Methods:A PT group aged 1–8 years (n = 40), a PA group aged 1–9 years (n = 23, female/male = 20/3) and control groups consistent with each of the previous groups in terms of age and gender were created for the study. Kisspeptin and ghrelin levels were measured with ELISA methods from blood samples drawn while fasting in the morning.Results:When the PT group was compared with the controls, the plasma kisspeptin levels of the cases were significantly higher than the control group (165.47 ± 15.45 pmol/L, 96.82 ± 12.33 pmol/L, p = 0.005, respectively). Kisspeptin levels in the PA group did not show a difference with the control group (121.36 ± 17.99 pmol/L, 95.52 ± 11.54 pmol/L, p = 0.249, respectively). No significant difference could be found when GAH levels in the PT and PA groups were compared with controls. No significant correlation was found between kisspeptin and GAH levels in the PT and PA groups.Conclusions:Our results indicate that kisspeptin plays an important role in the PT, but GAH is not associated with puberty disorders.

scholarly journals High DHEAS Is Associated With Earlier Pubertal Events in Girls But Not in Boys

2017 ◽  
Vol 1 (7) ◽  
pp. 800-808 ◽  
Author(s):  
Ana Pereira ◽  
German Iñiguez ◽  
Camila Corvalan ◽  
Verónica Mericq
Keyword(s):  
Ovarian Function ◽  
Pubertal Development ◽  
Sex Characteristics ◽  
Premature Thelarche ◽  
Logistic Regression Models ◽  
Tanner Staging ◽  
Secondary Sex Characteristics ◽  
Premature Adrenarche ◽  
The Relationship

Context: Premature adrenarche (PA) has been associated with increased metabolic risk. Objective: To describe the risk of precocious thelarche (PT; <8 years), pubarche (PP; girls <8 years, boys <9 years), and gonadarche (PG; <9 years) in children with high dehydroepiandrosterone sulphate (DHEAS [HD]) vs those with normal DHEAS (ND). Setting and Intervention: Longitudinal Chilean cohort (n = 1052, 49.9% girls). Annual clinical examination including secondary sex characteristics by Tanner staging. Logistic regression models were adjusted by age and BMI. Main Outcome: Assess the relationship between DHEAS and premature thelarche, gonadarche, and pubarche in both sexes. Results: At age of DHEAS determination, overweight/obesity was present in 44.3% of boys and 42.9% of girls. Incidences of any precocious event were observed in 17.2% of boys and in 25.4% of girls, presented as 8.7% of PG and 8.5% of PP in boys and as 21.3% of PT and 4.1% of PP in girls. In crude and adjusted models in boys, HD did not increase the risk of earlier pubertal events. Conversely, girls with HD had a 2.6 times greater risk of early thelarche and a three times greater risk of early pubarche compared with girls with ND concentrations. Conclusion: In Chilean adolescents, precocious events of pubertal development were in line with the worldwide secular trend of earlier sexual maturation. HD was only associated with PT and PP in girls. Continuous follow-up of this cohort is a unique opportunity to prospectively address and analyze the interrelationships among HD, early growth, and adiposity as determinants of gonadarche, pubertal rate/sequence progression, and ovarian function.

GROWTH DISTURBANCES AND VALUES FOR HORMONE EXCRETION IN VARIOUS FORMS OF PRECOCIOUS SEXUAL DEVELOPMENT

PEDIATRICS ◽  
1961 ◽  
Vol 28 (2) ◽  
pp. 258-275
Author(s):  
Pierre Ferrier ◽  
Thomas H. Shepard ◽  
Elizabeth Knapp Smith
Keyword(s):  
Precocious Puberty ◽  
Sexual Development ◽  
Laboratory Finding ◽  
Vaginal Smear ◽  
Bone Maturation ◽  
Premature Thelarche ◽  
Sexual Precocity ◽  
Premature Adrenarche ◽  
Primordial Dwarfism ◽  
Hormone Excretion

Forty-two children with precocious sexual development have been classified according to: a) constitutional sexual precocity, b) premature adrenarche, and c) premature thelarche. Constitutional sexual precocity and premature adrenarche are associated with excessive growth, advance in bone maturation, and elevation of the urinary 17-ketosteroids. In contrast, in premature thelarche growth, bone maturation and 17-ketosteroids were normal. The presence of estrogenization of the vaginal smear was the most helpful laboratory finding in differentiating constitutional sexual precocity from the other two conditions. The presence of detectable urinary gonadotropins in precocious puberty is of limited help. Two patients with primordial dwarfism and associated precocious puberty are reported. The occurrence of constitutional precocious puberty in a brother and a sister is described. This is apparently the first reported instance in which familial precocious puberty occurs in either sex.

scholarly journals Aetiology of Percociuos Puberty in Patients Presenting to A Tertiary Care Hospital

2018 ◽  
Vol 41 (3) ◽  
pp. 143-146
Author(s):  
Tasnima Ahmed ◽  
Fauzia Mohsin ◽  
Nasreen Islam ◽  
Juben Nahar ◽  
Shahida Akhter ◽  
...  
Keyword(s):  
Precocious Puberty ◽  
Adrenal Adenoma ◽  
Tertiary Care ◽  
Central Precocious Puberty ◽  
Hypothalamic Hamartoma ◽  
Care Hospital ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
Premature Thelarche ◽  
Premature Adrenarche

Background: Precocious puberty is a common paediatric endocrine disorder seen in clinical practice. This study was carried out to find out the aetiology of precocious puberty in children presenting in a tertiary care hospital.Methodology: This cross sectional study was done at paediatric endocrine outpatient department at BIRDEM General Hospital from July 2005 to June 2015. The clinical data as well as laboratory findings were collected from consecutive patients who presented for evaluation of precocious puberty.Result: Seventy one patients presented with precocious puberty during this study period. There was female preponderance (71.8%). The mean age at presentation of girls and boys were 4.8±2.1 years and 6.63±1.4 years respectively. Among the 51 girls who presented with precocious puberty 22(43.1%) had central precocious puberty (CPP), 5(9.8%) had peripheral precocious puberty (PPP) and 24(47%) had incomplete precocious puberty (IPP). Among the 22 girls with CPP 19(86.3%) were idiopathic & 3(13.6%) girls were hypothyroid. Among the 5 girls with PPP, 3(60%) had congenital adrenal hyperplasia (CAH) & 2(40%) had adrenal adenoma. In case of incomplete precious puberty among 24 girls, 20 (83.3%) had premature thelarche, 1(4.1%) had premature menarche & 3 (12.5%) had premature adrenarche. In 20 boys with precocious puberty, 7(35%) had CPP. Among them 3(42.8%) boys had hypothalamic hamartoma, 1(14.2%) boy had craniopharyngioma and other 3(42.8%) boys had idiopathic CPP. PPP was present in 11(55%) boys. Among them 8(72.7%) patient had CAH, 2(18.1%) had adrenal adenoma and 1(9.0%) had hepatoblastoma. Premature adrenarche was present in 2(10%) boys.Conclusions: Precocious puberty was more commonly found among girls as compared to boys. Central precocious puberty was more common among girls and majority were idiopathic. Among boy precocious pseudopuberty was more common and CAH was the commonest cause. Majority of boy with central precocious puberty had organic brain lesion.Bangladesh J Child Health 2017; VOL 41 (3) :143-146

The pattern of gonadotropin and estradiol secretion in exaggerated thelarche

1993 ◽  
Vol 128 (4) ◽  
pp. 345-350 ◽  
Author(s):  
Luigi R Garibaldi ◽  
Thomas Aceto ◽  
Colleen Weber
Keyword(s):  
Precocious Puberty ◽  
Central Precocious Puberty ◽  
Bone Age ◽  
Premature Thelarche ◽  
Premature Adrenarche ◽  
Estradiol Secretion ◽  
Secretory Potential ◽  
Estrogen Effects ◽  
Estrogen Effect ◽  
Similar Peak

Purpose: To assess the dynamics of the pituitary-ovarian axis in exaggerated thelarche, defined as premature thelarche associated with signs of systemic estrogen effects (advanced bone age and/or growth acceleration) without progression to complete puberty. Subjects and methods: Seven girls (age <2.5 years) with exaggerated thelarche, 6 girls with inactive pituitary-ovarian axis (premature adrenarche) and 21 girls with activated axis (central precocious puberty) had serum FSH, LH and E2 measured serially before and 1 to 24 h after gonadotropin-releasing hormone agonist (GnRHa) administration (leuprolide, 20 μg/kg sc), used as a test of combined pituitary-ovarian stimulation. Results: Although girls in the exaggerated thelarche and adrenarche group had similar [mean (SEM)] baseline FSH [3.2 (0.9) vs 1.4 (0.3) IU/I], LH [0.36(0.1) vs 0.27 (0.02) IU/I] and E2 [20 (1.2) vs 21 (2) pmol/l] concentrations, and similar peak post-GnRHa LH concentrations [5.5 (1.1) vs 2.4 (0.5) IU/I], girls with exaggerated thelarche achieved higher peak FSH [41(9) vs 14 (3) IU/I, p< 0.01] and E2 [243 (40) vs 37 (6) pmol/l, p<0.001] concentrations after GnRHa. In comparison to patients with exaggerated thelarche, girls with precocious puberty had higher (p<0.01-0.001) baseline LH [3.6 (0.8) IU/I], baseline E2 [69 (11) pmol/l], GnRHa-stimulated peak LH [68 (1 7) IU/I] and peak E2 [648 (58) pmol/l] concentrations, but similar FSH parameters. Conclusions: Girls with exaggerated thelarche exhibit substantial E2 secretory potential that can be demonstrated by GnRHa stimulation, is predominantly FSH-driven, and probably accounts for the manifestations of estrogen effect seen in these girls.

Premature Adrenarche and its Association with Cardiovascular Risk in Females

2020 ◽  
Vol 26 (43) ◽  
pp. 5609-5616
Author(s):  
Sarantis Livadas ◽  
Christina Bothou ◽  
Djuro Macut
Keyword(s):  
Polycystic Ovary ◽  
Dehydroepiandrosterone Sulfate ◽  
Adrenal Androgen ◽  
Premature Adrenarche ◽  
Adrenal Hyperandrogenism ◽  
Long Term Follow Up ◽  
History Of ◽  
Hormonal Milieu ◽  
The Impact

Early activation of the adrenal zona reticularis, leading to adrenal androgen secretion, mainly dehydroepiandrosterone sulfate (DHEAS), is called premature adrenarche (PA). The fact that adrenal hyperandrogenism in females has been linked to a cluster of cardiovascular (CV) risk factors, even in prepubertal children, warrants investigation. Controversial results have been obtained in this field, probably due to genetic, constitutional, and environmental factors or differences in the characteristics of participants. In an attempt to understand, in depth, the impact of PA as a potential activator of CV risk, we critically present available data stratified according to pubertal status. It seems that prepubertally, CV risk is increased in these girls, but is somewhat attenuated during their second decade of life. Furthermore, different entities associated with PA, such as polycystic ovary syndrome, non-classical congenital adrenal hyperplasia, heterozygosity of CYP21A2 mutations, and the impact of DHEAS on CV risk, are reviewed. At present, firm and definitive conclusions cannot be drawn. However, it may be speculated that girls with a history of PA display a hyperandrogenic hormonal milieu that may lead to increased CV risk. Accordingly, appropriate long-term follow-up and early intervention employing a patient-oriented approach are recommended.

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