Ann Pediatr Endocrinol Metab.  2022 Jun;27(2):105-112. 10.6065/apem.2142146.073.

Pathological brain lesions in girls with central precocious puberty at initial diagnosis in Southern Vietnam

• Huynh QTV
• Ho BT
• Le NQK
• Trinh TH
• Lam LHT
• Nguyen NTK
• Huang SY

• KMID: 2531274
• DOI: http://doi.org/10.6065/apem.2142146.073

Abstract

Purpose
Cranial magnetic resonance imaging (MRI) is recommended to identify intracranial lesions in girls with central precocious puberty (CPP). Yet, the use of routine MRI scans in girls with CPP is still debatable, as pathological findings in girls 6 years of age or older with CPP are limited. Therefore, we aimed to identify the prevalence of brain lessons in CPP patients stratified by age group (0–2, 2–6, and 6–8 years).
Methods
This retrospective cross-sectional study recruited 257 girls diagnosed with CPP for 6 years (2010–2016). MRI was used to detect brain abnormalities. Levels of luteinizing hormone, follicle-stimulating hormone, and sex hormones in blood samples were measured.
Results
Most girls had no brain lesions (82.9%, n=213), and of the minor proportion of girls with CPP that exhibited brain lesions (17.1%, n=44), 32 girls had organic CPP. Pathological findings were detected in 33.3% (2 of 6) of girls aged 0–2 years, 15.6% (5 of 32) of girls aged 2–6 years, and 3.6% (8 of 219) of girls aged 6–8 years. Hypothalamic hamartoma and tumors in the pituitary stalk were the most common pathological findings. The likelihood of brain lesions decreased with age. Girls with organic CPP were more likely to be younger (6.1±2.4 vs. 7.3±1.3 years, p<0.01) than girls with idiopathic CPP.
Conclusion
Older girls appeared to have a lower prevalence of organic CPP. Clinicians should cautiously use cranial MRI for girls aged 6–8 years with CPP.

Keyword

Central precocious puberty; Magnetic resonance imaging; Central nervous system; Prevalence; Girls

Figure

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  Fig. 1. The flowchart of the study. CPP, central precocious puberty; LH, luteinizing hormone; FSH, follicle-stimulating hormone; GnRHa, gonadotropin-releasing hormone analogue; MRI, magnetic resonance imaging.

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  Fig. 2. According to cranial magnetic resonance imaging scan, the prevalence of normal, pathological, questionable, and incidental findings in girls aged 0–2 years, 2–6 years, and 6–8 years. The P-value was derived from the Fisher exact test.

Reference

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