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Endocrinology
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Mehul Dattani, Catherine Peters
In premature thelarche, girls usually present with isolated early breast development (Fig. 13.30). Over 80% of girls have cyclical breast development that waxes and wanes at intervals of 4–6 weeks. The age of onset is usually below 2 years and frequently continues as an extension of the neonatal breast enlargement, due to placental transmission of maternal oestrogens. Such development is usually associated with isolated ovarian cyst development, which is due to premature but isolated pulsatile FSH secretion. The uterus is of an appropriate size and shape for age, with no endometrial echo and only exceptionally is there a vaginal bleed. Growth is at a normal rate, and the bone age is not advanced. There are no other signs of puberty.
Breast disorders in children and adolescents
Published in Joseph S. Sanfilippo, Eduardo Lara-Torre, Veronica Gomez-Lobo, Sanfilippo's Textbook of Pediatric and Adolescent GynecologySecond Edition, 2019
Nirupama K. De Silva, Monica Henning
Unless there are associated signs of precocious puberty, the parents should be reassured and the child followed expectantly.11 Ninety percent of patients with isolated premature thelarche will have resolution of breast enlargement 6 months to 6 years after diagnosis.21 Long-term follow-up has shown that patients with isolated premature thelarche develop normal breasts at puberty and are at no increased risk for disorders or tumors of the breast.21
The Child With A Pubertal Development Disorder
Published in Michael B O’Neill, Michelle Mary Mcevoy, Alf J Nicholson, Terence Stephenson, Stephanie Ryan, Diagnosing and Treating Common Problems in Paediatrics, 2017
Michael B O’Neill, Michelle Mary Mcevoy, Alf J Nicholson, Terence Stephenson, Stephanie Ryan
Premature thelarche: premature breast development in the absence of other signs of sexual development. It may be unilateral or bilateral, and breast size may wax and wane although never more than stage 3 breast development. Premature thelarche is usually noted between 6 months and 4 years of age. Growth velocity and bone age are normal for age. Pelvic ultrasound shows prepubertal findings. Gonadotropin levels are prepubertal and resolve spontaneously or progress to puberty at a normal age. No treatment is required.
Nesfatin-1 as a potential marker for functional hypothalamic amenorrhea
Published in Gynecological Endocrinology, 2022
Anna Szeliga, Agnieszka Podfigurna, Blazej Meczekalski
In the literature so far, studies have demonstrated that in cases of premature thelarche, the concentration of nesfatin-1 does not correlate with the concentration of serum LH or FSH [25]. A similar lack of correlation was noted by Cathak et al. in patients with PCOS (no correlation between nesfatin-1 and LH concentrations), and by Altincik et al. in central precocious puberty. No relationship has been demonstrated between nesfatin-1 and estradiol concentrations [22, 26]. Nevertheless, observations such as those documented in patients with precocious puberty or PCOS are difficult to compare with the correlations observed in FHA. This is due to fundamental differences in etiopathogenesis, comorbidities, and risk factors. Moreover, the study authors themselves emphasize that in each case results were difficult to interpret, mostly due to small sample sizes (20 patients with PCOS or 22 patients with precocious puberty) [25, 26].
The effects of prenatal and lactational bisphenol A and/or di(2-ethylhexyl) phthalate exposure on female reproductive system
Published in Toxicology Mechanisms and Methods, 2022
Gizem Ozkemahli, Aylin Balci Ozyurt, Pinar Erkekoglu, Naciye Dilara Zeybek, Nilgun Yersal, Belma Kocer-Gumusel
Although male offspring appear to be more susceptible to the programming effects of phthalates and bisphenols, females could also be affected to a lesser extent (Cavanagh et al. 2018; Mankidy et al. 2013). Different studies suggested a link between exposure to phthalate derivatives and fertility and/or pregnancy loss, precocious puberty, premature thelarche, anovulation, endometriosis, leiomyomas and breast cancer (Durmaz et al. 2018; Hashemipour et al. 2018; Ahern et al 2019; Kahn et al. 2020; Pallotti et al. 2020; Rattan et al. 2018). On the other hand, BPA exposure at some doses and time points affects ovarian follicle numbers and sex steroid levels, adverse morphological and histopathological alterations in ovaries, a decrease in female fertility rate and weight of reproductive organs (ovary and uterus) and causes histopathological lesions (Patel et al. 2017; NTP 2018; Srivastava and Dhagga 2019; Ijaz et al. 2020).
Mammary Fibrocystic Change in a Pre-Pubertal child- A Case Report with a Histopathological Perspective
Published in Fetal and Pediatric Pathology, 2021
Smita Singh, Kavita Gaur, Archana Puri
Fibrocystic disease in a two year old child is novel. In a study done by Bock et al on breast lesions in children, 18% showed cystic changes with all cases being described in an age group of 14 to 17 years [9]. An extensive literature search revealed that this has hitherto not been described in a prepubertal child. More importantly, as fibrocystic change is usually synonymous with the “lumpy and bumpy” breast and not a discrete large breast mass, it is usually managed conservatively. In the absence of any obvious systemic hormonal abnormality or any histopathological evidence of inflammatory cells, endocrinal or infectious etiologies seemed unlikely in our case. Premature thelarche was also ruled out as the contralateral breast was clinically normal. The hormonal profile also did not suggest the same.