الفهرس | Only 14 pages are availabe for public view |
Abstract Background Premature thelarche is one of the common variants of early puberty. It may present as a benign pubertal event or on the contrary as an early manifestation of precocious puberty compromising the final adult height and affecting psychosocial wellbeing for maturing girls. Predictors of precious puberty and early recognition of premature thelarche (PT) cases: that may turn into a pathological condition rather than an isolated phenomenon; are the subject of extensive research around the globe. Patients and methods Seventy two girls who visited Diabetes Endocrine and Metabolism Pediatric Unit (DEMPU) clinics in Cairo University during the year 2020 with a complaint of early breast development were enrolled in the study. A detailed history and full examination for participants including anthropometric measurements and Tanner staging was done. Bone age was estimated using Greulish and Pyle atlas. Hormonal profile including basal and stimulated luteinizng hormone (LH) and Follicle stimulating hormone (FSH) besides estradiol 2 (E2) and prolactin was measured for all girls along with breast and pelvic ultrasonography for most of cases with limited number of MRI scans. Results Age of presentation lies below 3 years in most of PT and central precocious puberty (CPP) cases. Height and weight standard deviation score (SDS) are the most consistent among other anthropometric variables in most of comparisons. Stimulated LH values are the only hormonal variable of significance between CPP and PT groups. Pelvic ultrasonography parameters are higher in CPP groups despite statistical no significance. Cutoff points for basal and stimulated LH/FSH ratio, bone age advancement and uterine volume were suggested with Stimulated LH/FSH ratio having the best sensitivity and specificity. Conclusion Stimulated LH/FSH ratio can be used as a marker for early puberty. Age of presentation lies below 3 years in both PT and CPP cases. Despite that Stimulated LH is the most consistent hormonal variable; interpreting its value in this age category should be approached cautiously |