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Primary adrenal malignancy
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Ayshea Hameeduddin, Anju Sahdev, Rodney H Reznek
Some children may also present with precocious puberty. Elevated blood pressure is seen in >50% of childhood adrenal carcinomas, mostly associated with cortisol hypersecretion. The median age at diagnosis in children is 4.3 years with girls predominating over boys (5.3:1) below the age of 4 years (27–29).
McCune−Albright Syndrome
Published in Dongyou Liu, Handbook of Tumor Syndromes, 2020
Precocious puberty commonly occurs in girls. Testicular masses of Leydig/Sertoli cell hyperplasia are seen in boys with MAS, and ultrasound is used to detect the same. These testicular masses cannot be detected by physical examination, and malignant transformation is rare.
Pubertal Development and Menarche
Published in Jane M. Ussher, Joan C. Chrisler, Janette Perz, Routledge International Handbook of Women’s Sexual and Reproductive Health, 2019
One outcome of these studies was renewed concern about precocious puberty. Kaplowitz and Bloch (2016) recommended that girls who experience breast bud development assessed by palpation before the age of 8 be referred for an evaluation of precocious puberty. Observable signs of adrenarche before age 8, especially the appearance of pubic hair, should also be referred to investigate a diagnosis of premature adrenarche (Kaplowitz & Bloch, 2016). Premature adrenarche has been studied in relation to the development of polycystic ovarian syndrome (PCOS) and other related health issues that might ensue (Dorn & Biro, 2011). Despite these concerns, Kaplowitz and Bloch (2016) defined central precocious puberty in girls as the full activation of the HPG axis, and further, that true precocious puberty entails increased development and growth of breasts, though pubic hair may not exist. Diagnosis usually includes bone age determination and hormonal assays. Studies of the incidence of precocious puberty have also occurred in other parts of the world, e.g., in Korea (Kim, Huh, Won, Lee, & Park, 2015), and Pakistan (Atta et al., 2014), albeit with various diagnostic indicators. It is important to note that precocious puberty is distinct from early puberty.
A single blood sample for stimulated LH assayed by ICMA is useful for monitoring the treatment efficacy of triptorelin depot in girls
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2022
Yuan Zhou, Ruofan Jia, Fan-Sheng Kong, Min Chen, Feng Ren, Zhuangjian Xu, Yaping Ma
The CPP is defined as follows. Precocious puberty is defined as the appearance of secondary sex characteristics before the age of 8 years in girls. The following indicators exist to indicate HPGA activation. There is evidence of gonadal development under B-ultrasound examination with unilateral ovarian volume > 1.2 mL [8] and multiple follicles > 4 mm in diameter [9]. Serum sex hormones are at the level of puberty. Serum PLH is > 5.00 IU/L during the triptorelin stimulation test [10]. If PLH is ≤ 5.00 IU/L, but other evidence suggests probable HPGA activation, the triptorelin stimulation test is repeated after 3 months. A spontaneous LH > 0.3 IU/L or spontaneous E2 > 10 pg/mL is also considered at the level of puberty [11]. Due to insufficient sensitivity of the instruments and pulsatile secretion of E2, the study was adjusted to use the lowest detectable level of E2 for 15 or 20 pg/mL. There is longitudinal growth. Bone age is beyond chronological age by 1 year.
Novel compound heterozygous mutations of PCNT gene in MOPD type II with central precocious puberty
Published in Gynecological Endocrinology, 2021
Yaping Ma, Zhuangjian Xu, Jinling Zhao, Handan Shen
This 6 years and 11 months old girl had left breast Tanner II and bone age of 8.4 years. The peak value of luteinizing hormone in the triptorelin stimulation test was 8.97 IU/l (>5IU/l). These together suggest that the activity of the hypothalamus pituitary-gonadal axis had been started before age of 8 years, which is the characteristics of CPP. In a study, precocious puberty has been reported in 6 of 21 MOPD II females elder than 8-years old [15]. Those cases were also accompanied by severe insulin resistance [14]. While insulin resistance was not present in our case. Most CPP cases are idiopathic, but some are caused by mutations in KISS1, KISS1R, MKRN3, or DLK1 gene [16]. However, our gene sequencing data did not reveal these reported gene mutations. In addition, the MRI scan did not show abnormal pituitary and cerebrovasculature in this case. Whether CCP in this MOPD II is related to the novel compound heterozygous mutation of PCNT needs further study.
Long-term effects of treatment of central precocious puberty with gonadotropin-releasing hormone analogs every three months
Published in Gynecological Endocrinology, 2020
Anastasia Vatopoulou, Evelien Roos, Angelos Daniilidis, Konstantinos Dinas
We prospectively studied all female patients who were diagnosed with CPP in the Pediatric and Adolescent Gynecology Outpatient Clinic of the Second Department of Obstetrics and Gynecology of the Medical School of the Aristotle University Thessaloniki, in the Hippokration Hospital, Thessaloniki, Greece, between January 2015 and December 2019. CPP was defined as breast staging ≥2 according to Tanner and random luteinizing hormone levels >0.3 mIU/ml in girls ≤8-years-old. Patients with other causes of precocious puberty or other chronic diseases were excluded. At baseline, physical examination including complete anthropometric measurements, laboratory investigation, and left wrist X-ray was performed. Bone age was determined according to the standards of Greulich and Pyle [11]. All patients were at Tanner stage 2 according to breast appearance and at Tanner stage 1 according to pubic hair growth. The Bayley–Pinneau tables were used to predict adult height [12]. All patients were treated with intramuscular leuprolide acetate 11.25 mg (Elityran, Takeda, Tokyo, Japan) every 3 months. Physical examination was performed every 3 months whereas laboratory investigation and left wrist X-ray were performed every 12 months during follow-up. The paired samples t-test was used to compare: (a) predicted height at baseline and actual height at the end of treatment and (b) the difference between chronological age and bone age at baseline and at the end of treatment. The study was performed according to the mandates of the Declaration of Helsinki.