SavedAdd your journal

Journals / New Trends in Medicine Sciences / 2026 / Volume: 7 Issue: 3

Clinical and Diagnostic Spectrum of Girls Evaluated for Suspected Precocious Puberty: A Single-Center Study

Semra Bahar Akın(derince eğitim araştırma hastanesi)0000-0002-7113-9646
Pages
—
Publication Date
2026-10-29
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Our findings further support the selective use of neuroimaging and the need for individualized treatment.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objective: To evaluate the clinical, anthropometric, biochemical, and imaging characteristics of girls presenting with suspected precocious puberty and identify the key parameters that distinguish central precocious puberty (CPP) from benign pubertal variants.
📊
Key Findings & Data:Methods: Between 2024 and 2025, 231 girls were retrospectively assessed at a single center and categorized into six diagnostic groups: central precocious puberty (CPP), rapidly progressing early puberty (R-EP), slowly progressing early puberty, premature thelarche, premature adrenarche, and normal.
💡
Conclusion & Impact:Our findings further support the selective use of neuroimaging and the need for individualized treatment.
🔬Design:Research Article
📍Scope:2024 Verileri
⚙️Variables:Puberty · Precocious · lipomastia

Abstract

Objective: To evaluate the clinical, anthropometric, biochemical, and imaging characteristics of girls presenting with suspected precocious puberty and identify the key parameters that distinguish central precocious puberty (CPP) from benign pubertal variants. Methods: Between 2024 and 2025, 231 girls were retrospectively assessed at a single center and categorized into six diagnostic groups: central precocious puberty (CPP), rapidly progressing early puberty (R-EP), slowly progressing early puberty, premature thelarche, premature adrenarche, and normal. Clinical, anthropometric, laboratory, imaging, and treatment data were compared between the groups. Results: Age at presentation was significantly lower in the CPP and premature thelarche groups (p<0.001). Breast development was the most common presenting symptom. Advanced breast/pubic hair stages and more frequent axillary hair were observed in the CPP group, whereas early stages predominated in the benign variants (p<0.001). Basal LH and estradiol levels were significantly higher in the R-EP group (p<0.001). Pelvic ultrasonography revealed significantly larger uterine lengths and ovarian volumes in the CPP group (p<0.001). All pituitary MRIs were normal, except in three cases with clinically insignificant microadenomas. GnRH analog therapy was initiated in all patients with CPP and in 63.6% of those with rapidly progressing early puberty. Conclusion: Most referrals for suspected early puberty were benign variants. A multidimensional diagnostic approach is critical to avoid unnecessary intervention. In contrast, timely diagnosis and treatment of CPP are essential to preserve long-term growth and improve psychosocial outcomes. Our findings further support the selective use of neuroimaging and the need for individualized treatment.

🔖

Cite This Article

Akın, S. B. (2026). Clinical and Diagnostic Spectrum of Girls Evaluated for Suspected Precocious Puberty: A Single-Center Study. New Trends in Medicine Sciences, Volume: 7 Issue: 3. https://doi.org/10.56766/ntms.1955497

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (36)

  1. Plant TM. Neuroendocrine control of puberty. J Neuroendocrinol. 2015;27(7):594-602.
  2. Farello G, Altieri C, Cutini M, Pozzobon G, Verrotti A. Review of the literature on current changes in the timing of pubertal development and the incomplete forms of early puberty. Front Pediatr. 2019;7:147.
  3. Kaplowitz P, Bloch C. Evaluation and referral of children with signs of early puberty. Pediatrics. 2016;137(1):e20153732.
  4. Mogensen SS, Aksglaede L, Mouritsen A, et al. Diagnostic work-up of 449 consecutive girls who were referred to be evaluated for precocious puberty. J Clin Endocrinol Metab. 2011;96(5):1393-1401.
  5. Kaplowitz P. Clinical characteristics of 104 children referred for evaluation of precocious puberty. J Clin Endocrinol Metab. 2004;89(8):3644-650.
  6. Kılınç S. Assessment of normal, normal variants, and precocious puberty in children referred with signs of early pubertal development to a pediatric endocrine unit. Haydarpasa Numune Med J. 2019;59(1):71-77.
  7. Eklioğlu BS, Atabek ME, Akyürek N, Sarıkaya E. The etiologic distribution and clinical features of cases presenting with the findings of puberty to the pediatric endocrinology clinic. Turkish J Pediatr Dis. 2016;10(4):233-36.
  8. Sarıkaya E, Kilci F. Differentiating true precocious puberty and puberty variants in consecutive 275 girls: a single center experience. J Pediatr Endocrinol Metab. 2025;38(4):367-73.
  9. Chioma L, Chiarito M, Bottaro G, et al. COVID-19 pandemic phases and female precocious puberty: the experience of the past 4 years (2019 through 2022) in an Italian tertiary center. Front Endocrinol (Lausanne). 2023;14:1132769.
  10. Yesiltepe Mutlu G, Eviz E, Haliloglu B, et al. The effects of the COVID-19 pandemic on puberty: a cross-sectional, multicenter study from Turkey. Ital J Pediatr. 2022;48(1):144.
  11. Yüksek Acinikli K, Erbaş İM, Besci Ö, et al. Has the frequency of precocious puberty and rapidly progressive early puberty increased in girls during the COVID-19 pandemic? J Clin Res Pediatr Endocrinol. 2022;14(3):302-307.
  12. Vurallı D, Gönç EN, Özön ZA, Alikaşifoğlu A. Adequacy of basal luteinizing hormone levels in the diagnosis of central precocious puberty. Turk Pediatri Ars. 2020;55(2):131-38.
  13. Cheuiche AV, da Silveira LG, de Paula LCP, Lucena IRS, Silveiro SP. Diagnosis and management of precocious sexual maturation: an updated review. Eur J Pediatr. 2021;180:3073-87.
  14. Bereket A. A critical appraisal of the effect of gonadotropin-releasing hormone analog treatment on adult height of girls with central precocious puberty. J Clin Res Pediatr Endocrinol. 2017;9(Suppl 2):33-48.
  15. Berberoğlu M. Precocious puberty and normal variant puberty: definition, etiology, diagnosis and current management. J Clin Res Pediatr Endocrinol. 2009;1(4):164-74.
  16. Utriainen P, Laakso S, Liimatta J, Jääskeläinen J, Voutilainen R. Premature adrenarche—a common condition with variable presentation. Horm Res Paediatr. 2015;83(4):221-31.
  17. Neyzi O, Bundak R, Gökçay G, et al. Reference values for weight, height, head circumference, and body mass index in Turkish children. J Clin Res Pediatr Endocrinol. 2015;7(4):280-93.
  18. Tanner JM. Growth at Adolescence. 2nd ed. Blackwell Scientific; 1962.
  19. Marshall WA, Tanner JM. Variations in pattern of pubertal changes in girls. Arch Dis Child. 1969;44(235):291-303.
  20. Greulich WW, Pyle SI. Radiographic Atlas of Skeletal Development of the Hand and Wrist. 2nd ed. Stanford University Press; 1959.
  21. Bayley N, Pinneau SR. Tables for predicting adult height from skeletal age. J Pediatr. 1952;40(4):423-41.
  22. Sessa L, Rotunno G, Sodero G, Pane LC, Rendeli C, Maresca G, Rigante D, Cipolla C. Predictive value of transabdominal pelvic ultrasonography for the diagnosis of central precocious puberty: A single-center observational retrospective study. Clin Pediatr Endocrinol. 2024 Oct;33(4):199-206.
  23. Vuralli D, Gonc EN, Alikasifoglu A, Kandemir N, Ozon ZA. Central nervous system imaging in girls with central precocious puberty: when is necessary? Arch Endocrinol Metab. 2020;64(5):591-96.
  24. Stagi S, De Masi S, Bencini E, et al. Increased incidence of precocious and accelerated puberty in females during and after the Italian lockdown for the coronavirus 2019 (COVID-19) pandemic. Ital J Pediatr. 2020;46(1):165.
  25. Giabicani É, Allali S, Durand A, et al. Presentation of 493 consecutive girls with idiopathic central precocious puberty: a single-center study. PLoS One. 2013;8(7):e70931.
  26. Carvalho R, Pereira M, Da Silva R, et al. Clinical and analytical presentation of central precocious puberty: a 20-year cross-sectional study. Cent Eur J Paediatr. 2024.
  27. Prété G, Couto-Silva AC, Trivin C, Brauner R. Idiopathic central precocious puberty in girls: presentation factors. BMC Pediatr. 2008;8:27.
  28. Li W, Liu Q, Deng X, Chen Y, Liu S, Story M. Association between obesity and puberty timing: a systematic review and meta-analysis. Int J Environ Res Public Health. 2017;14(10):1266.
  29. Hosseini Z, Arani K, Moraveji A, Talari H. Ultrasonic evaluation of thelarche grading in 2-8-year-old obese girls suspected of precocious puberty. Pediatr Endocrinol Diabetes Metab. 2022;28(1):23-29.
  30. Yüce Ö, Sevinc D. Ultrasonographic assessment of pubertal breast development in obese children: compliance with the clinic. J Pediatr Endocrinol Metab. 2018;31(2):137-41.
  31. Song X, Zhou J, Han T, Lin Z, Chen X, Li Y. Early warning value of multiple serum indicators combined with ultrasound detection in girls with central precocious puberty. Front Endocrinol (Lausanne). 2025;16:1518764.
  32. Peltek Kendirci HN, Kaba İ. Evaluation of clinical, laboratory and radiological findings in the differential diagnosis of premature thelarche and central precocious puberty. J Acad Res Med. 2022;12(1):10-14.
  33. Yu H, Liu X, Chen J, Wang S, Quan X. Pelvic ultrasound in diagnosing and evaluating the efficacy of gonadotropin-releasing hormone agonist therapy in girls with idiopathic central precocious puberty. Front Pharmacol. 2019;10:104.
  34. Kan L, He D, Yue W. The combined diagnostic and therapeutic value of ultrasound and X-ray bone age index in girls with idiopathic central precocious puberty. Endocr Connect. Published online September 23, 2025.
  35. Mogensen SS, Aksglaede L, Mouritsen A, et al. Pathological and incidental findings on brain MRI in a single-center study of 229 consecutive girls with early or precocious puberty. PLoS One. 2012;7(1):e29829.
  36. Kaplowitz P, Backeljauw P, Allen D. Toward more targeted and cost-effective gonadotropin-releasing hormone analog treatment in girls with central precocious puberty. Horm Res Paediatr. 2018;90(1):1-7.