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

Affiliations
  • 1Department of Pediatrics, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh city, Ho Chi Minh City, Vietnam
  • 2Department of Nephrology and Endocrinology, Children’s Hospital 2, Ho Chi Minh City, Vietnam
  • 3Department of Peadiatric Surgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh city, Ho Chi Minh City, Vietnam
  • 4Children’s Hospital 2, Ho Chi Minh City, Vietnam
  • 5International Master/PhD Program in Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
  • 6Professional Master Program in Artificial Intelligence in Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
  • 7Research Center for Artificial Intelligence in Medicine, Taipei Medical University, Taipei City, Taiwan
  • 8School of Nutrition and Health Sciences, Taipei Medical University, Taipei City, Taiwan
  • 9Graduate Institute of Metabolism and Obesity Sciences, Taipei Medical University, Taipei City, Taiwan
  • 10Nutrition Research Center, Taipei Medical University Hospital, Taipei City, Taiwan

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

  • 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.

  • 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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