1
|
Kılınç Uğurlu A, Özdemir Gökce A, Çakır Gündoğan S, Ekşioğlu AS, Boyraz M. MRI evaluation of cranial pathologies in rapidly progressive early puberty cases aged 8-9. Front Endocrinol (Lausanne) 2024; 14:1316333. [PMID: 38229738 PMCID: PMC10789853 DOI: 10.3389/fendo.2023.1316333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/05/2023] [Indexed: 01/18/2024] Open
Abstract
Purpose The aim of this study was to investigate the frequency and distribution of intracranial pathologies in female patients between 8 and 9 years of age who were diagnosed with early puberty (rapidly progressive) through the evaluation of MRI images. Materials and methods A total of 74 female patients diagnosed with central precocious puberty (CPP) (6-8 years) and rapidly progressive early puberty (RPEP) (8-9 years) were included in the study. The patients were categorized into two groups, normal and abnormal, based on the findings from their MRI scans. Recent literature has classified abnormal MRI findings into three groups: pathological findings, findings with a questionable relationship to CPP, and incidental findings. Furthermore, the patients were divided into four groups based on their MRI findings and whether they had CPP or RPEP : CPP (6-8 years) +Normal MRI, RPEP (8-9 years) + Normal MRI, CPP (6-8 years) +Abnormal MRI, RPEP (8-9 years) +Abnormal MRI. Results Out of the 74 girls included in the study, 54% (n=40) showed normal MRI results, while abnormal MRI findings were detected in 46% (n = 34) of the cases. No malignant lesions were identified among cases with abnormal MRI findings. The occurrence of abnormal MRI findings was observed in 46% of the PP group and 45% of the RPEP group. Incidental findings were the most common MRI findings in both groups. The proportion of cases with pathological findings and findings with a questionable relationship to CPP was similar in both groups (p = 0.06). Basal luteinizing hormone (LH) concentration was found to be higher in the RPEP (8-9 years) +Abnormal MRI group compared to the CPP (6-8 years) +Normal MRI group (p = 0.01). Conclusion Our study is the first to investigate MRI findings in cases of rapidly progressive early puberty in the age range of 8-9 years. Our study demonstrates that there is no difference in terms of intracranial findings between cases of precocious puberty at the age of 6-8 years and cases of rapidly progressive early puberty aged 8-9.
Collapse
Affiliation(s)
- Aylin Kılınç Uğurlu
- Ankara Bilkent City Hospital, Pediatric Endocrinology Clinic, Ankara, Türkiye
| | - Ayse Özdemir Gökce
- Ankara Bilkent City Hospital, Pediatric Radiology Clinic, Ankara, Türkiye
| | | | | | - Mehmet Boyraz
- Ankara Bilkent City Hospital, Pediatric Endocrinology Clinic, Ankara, Türkiye
| |
Collapse
|
2
|
Jang S, Kim SJ, Lee M, Lee HI, Kwon A, Suh J, Song K, Chae HW, Kim HS. Comparison of the effect of gonadotropin-releasing hormone agonist dosage in girls with central precocious puberty. Ann Pediatr Endocrinol Metab 2023; 28:283-288. [PMID: 36758971 PMCID: PMC10765025 DOI: 10.6065/apem.2244210.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/18/2022] [Accepted: 10/27/2022] [Indexed: 02/05/2023] Open
Abstract
PURPOSE There are no definite guidelines on the optimal dosage of gonadotropin-releasing hormone (GnRH) agonist for treatment of central precocious puberty (CPP). We compared growth outcomes of GnRH agonist at different dosages in girls with idiopathic CPP to assess the optimal dosage. METHODS This retrospective study included 86 girls with idiopathic CPP who had been treated with GnRH agonist for at least one year and had attained their final adult height. Leuprolide was given as fixed dosage (3.75 mg every 4 weeks in body weight >20 kg, n=72) or weight-based dosage (60-85 μg/kg every 4 weeks, n=14). We compared suppression of advanced puberty and treatment response between the 2 groups. RESULTS Peak estradiol and luteinizing hormone and bone age (BA)/chronological age after injection of GnRH agonist were effectively suppressed in both groups. In both groups, the height standard deviation score (SDS) for BA increased after treatment. Final adult height (FAH) (fixed dosage group,160.8±4.1 cm and weight-based dosage group, 161.2±4.4 cm) was significantly higher than the initial predicted adult height (PAH) (155.5±3.3 and 156.1±3.6 cm, respectively) (both P<0.001) and similar to midparental height (159.8±3.3 and 160.6±3.7 cm, respectively). There were no differences in gain in height SDS for BA and gain in height (FAH-PAH at the start) between the 2 groups. CONCLUSION There were no differences in treatment outcome between fixed dosage (3.75 mg/4 wk) and weight-based dosage (60-85 μg/kg/4wk) of GnRH agonist. Therefore, a fixed dosage of GnRH agonist can be used more conveniently for CPP treatment without growth oversuppression.
Collapse
Affiliation(s)
- Shinyoung Jang
- Division of Pediatric Endocrinology, Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Su Jin Kim
- Division of Pediatric Endocrinology, Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Myeongseob Lee
- Division of Pediatric Endocrinology, Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Hae In Lee
- Department of Pediatrics, CHA Gang-nam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Ahreum Kwon
- Division of Pediatric Endocrinology, Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Junghwan Suh
- Division of Pediatric Endocrinology, Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Kyungchul Song
- Division of Pediatric Endocrinology, Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Wook Chae
- Division of Pediatric Endocrinology, Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Ho-Seong Kim
- Division of Pediatric Endocrinology, Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
3
|
Lee HS. Central precocious puberty: is routine brain MRI screening necessary for girls?: Commentary on "Brain magnetic resonance imaging (MRI) findings in central precocious puberty patients: is routine MRI necessary for newly diagnosed patients?". Ann Pediatr Endocrinol Metab 2023; 28:155-156. [PMID: 37798890 PMCID: PMC10556437 DOI: 10.6065/apem.2322096edi07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Affiliation(s)
- Hae Sang Lee
- Department of Pediatrics, Ajou University Hospital, Ajou Unviersity School of Medicine, Suwon, Korea
| |
Collapse
|
4
|
Park J, Jeon M, Maeng S, Kwon DK, Kim S, Lee JE. Central precocious puberty with hypothalamic hamartoma: the first case reports of 2 siblings with different phenotypes of Seckel syndrome 5. Ann Pediatr Endocrinol Metab 2023; 28:225-230. [PMID: 35798296 PMCID: PMC10556446 DOI: 10.6065/apem.2244066.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/01/2022] [Accepted: 05/11/2022] [Indexed: 11/20/2022] Open
Abstract
Hypothalamic hamartomas (HHs) are nonneoplastic mass lesions located in the hypothalamus that can cause central precocious puberty (CPP) and/or gelastic seizures. Seckel syndrome 5 (OMIM210600, SCKL5) is a rare autosomal recessive genetic spectrum disorder characterized by intrauterine growth retardation, proportionate osteodysplastic primordial dwarfism, a wide range of intellectual disability, "bird-headed" facial features, and microcephaly with various structural brain abnormalities. Two siblings presented with short stature and small head circumference and were diagnosed with SCKL 5. The younger sister had HH with CPP and experienced a slipped capital femoral epiphysis during treatment. The 2 siblings had the same genetic variant but showed different phenotypes, which has not been reported previously; this study also as presents the first cases of SCKL5 diagnosed by genetic confirmation in Korea.
Collapse
Affiliation(s)
- Jisun Park
- Department of Pediatrics, Inha University Hospital, Incheon, Korea
| | - Minjun Jeon
- Department of Pediatrics, Inha University Hospital, Incheon, Korea
| | - Seri Maeng
- Department of Psychiatry, Inha University Hospital, Incheon, Korea
| | - Dae Kyu Kwon
- Department of Orthopedics, Inha University Hospital, Incheon, Korea
| | - Sujin Kim
- Department of Pediatrics, Inha University Hospital, Incheon, Korea
| | - Ji Eun Lee
- Department of Pediatrics, Inha University Hospital, Incheon, Korea
| |
Collapse
|
5
|
Kim JH. Commentary on "Pathological brain lesions in girls with central precocious puberty at initial diagnosis in Southern Vietnam". Ann Pediatr Endocrinol Metab 2022; 27:79-80. [PMID: 35793996 PMCID: PMC9260371 DOI: 10.6065/apem.2221073edi01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Ji Hyun Kim
- Department of Pediatrics, Dongguk University Ilsan Hospital, Goyang, Korea,Address for correspondence: Ji Hyun Kim Department of Pediatrics, Dongguk University Ilsan Hospital, 27 Dongguk-ro, Ilsandong-gu, Goyang 10326, Korea
| |
Collapse
|