Assessment of Normal, Normal Variants, and Precocious Puberty in Children Referred With Signs of Early Pubertal Development to a Pediatric Endocrine Unit

Özet

Introduction: The aim of this study was to evaluate the etiologic distribution and clinical features of children referred to a pediatric endocrinology clinic with signs of early puberty, and to compare clinical, biochemical, and anthropometric properties of the patients followed-up with the diagnosis of precocious puberty and normal variants puberty. Methods: In this single-center study, we included children referred with signs of early puberty between July 2015 and July 2017. We retrospectively evaluated the anthropometric measurements and pubertal status of the patients. In the evaluation of patients with suspected early puberty, biochemical tests, bone age, and pelvic ultrasound were used. If indicated, a standard gonadotropin-releasing hormone stimulation test and brain magnetic resonance imaging were performed. Results: A total of 476 children were referred for evaluation of early puberty. There were 454 (95.3%) females. The mean age of the patients at the time of referral was 8.97±2.5 years for girls and 9.56±0.74 years for boys. Out of 476 children, only 139 (29.2%) had early pubertal development, and the remaining 337 (70.8%) had normal puberty or no puberty. Out of 139 patients, 45 (9.4%) had precocious puberty, 59 (12.3%) had premature thelarche, and 35 (7.3%) had premature adrenarche. Discussion and Conclusion: Most of children referred for the evaluation of early pubertal development showed normal puberty or puberty variants. This study emphasizes the importance of a good diagnostic evaluation of these patients.