scholarly journals Premature Thelarche in Later Childhood Demonstrates a Pubertal Response to GnRH Stimulation Test at One Year after Breast Development

2011 ◽  
Vol 20 (4) ◽  
pp. 81-87 ◽  
Author(s):  
Satoshi Takakuwa
Keyword(s):  
Stimulation Test ◽  
Breast Development ◽  
Premature Thelarche ◽  
One Year

scholarly journals Natural history of premature thelarche: review of 60 girls

2001 ◽  
Vol 41 (6) ◽  
pp. 279 ◽  
Author(s):  
Jose R. L. Batubara ◽  
Adji Suranto ◽  
Sudigdo Sastroasmoro ◽  
Bambang Tridjaja ◽  
Aman B. Pulungan
Keyword(s):  
Natural History ◽  
Practical Knowledge ◽  
Central Precocious Puberty ◽  
Daily Practice ◽  
Bone Age ◽  
Breast Development ◽  
First Year ◽  
Premature Thelarche ◽  
History Of ◽  
One Year

In Indonesia report on the natural history of premature thelarche is very limited. Daily practice requires physicians to have some basic practical knowledge, among others the natural history of premature thelarche, in order to manage these patients properly. We reviewed data of 85 premature thelarche patients who visited our department from January 1989 until December 1998. Only 60 patients met the study criteria. The mean chronological age of the patients at diagnosis was 43.4 months. About half of these patients (31/60) were diagnosed before they were 2 years old. Half of the patients had bilateral breast involvement. The hormonal pattern showed 24/48 follicle stimulating hormone predominant-response. Most patients (33/47) showed normal plasma estradiol level. Bone age analysis was normal in 46/57 patients, and only 9 showed accelerated bone age. Pelvic ultrasonography showed prepubertal reproduction organs in 26/35. Vaginal smears showed signs of estrogenization with various degree of stimulation in 13 patients. At the end of observation the outcome of premature thelarche were: 31 regressed, 19 persisted, 6 had progressive breast development and 4 progressed to central precocious puberty. The initial clinical and laboratory characteristics of those who developed CPP varied. Among 31 premature thelarche patients who regressed, 21 had onset of breast enlargement before age of 2 years. In most of the regressed patients (20/31), regression occurred completely within the first year. Most premature thelarche patients with onset before 2 years will regress within one year after diagnosis. 

Breast development in male-to-female transgender patients after one year cross-sex hormonal treatment

2016 ◽  
Author(s):  
Blok Christel de ◽  
Maartje Klaver ◽  
Nienke Nota ◽  
Marieke Dekker ◽  
Heijer Martin den
Keyword(s):  
Hormonal Treatment ◽  
Breast Development ◽  
One Year ◽  
Male To Female

AMH levels at central precocious puberty and premature thelarche: is it a parameter?

2015 ◽  
Vol 28 (11-12) ◽  
Author(s):  
Nursel Muratoglu Sahin ◽  
Sibel Tulgar Kinik ◽  
Mustafa Agah Tekindal ◽  
Nilufer Bayraktar
Keyword(s):  
Precocious Puberty ◽  
Central Precocious Puberty ◽  
Breast Development ◽  
Premature Thelarche ◽  
Pubertal Onset ◽  
Antimullerian Hormone ◽  
The Mean ◽  
Antimüllerian Hormone

AbstractThe possible difference of antimüllerian hormone (AMH) levels at central precocious puberty (CPP) and premature thelarche (PT) has not been properly evaluated.By evaluating AMH levels in girls with diagnosed CPP and PT, we aim to show the change of AMH levels at the pubertal onset.Sixty-five girls who have breast development before the age of 8 years and 25 healthy girls were enrolled in the study.The subjects were divided into two groups as CPP and PT, according to results of GnRH test. AMH levels were determined in the two groups.The mean AMH levels of the CPP group were significantly lower than those in the PT group (13.57±9.85 pmol/L and 58.42±12.78 pmol/L, respectively, p=0.022).These results suggest that the AMH levels decrease in the duration of the hypothalamus-pituitary-ovarian axis activation. We thought that AMH might/may be a marker for distinguishing between CPP and PT.

scholarly journals Ultrasonographic and clinical parameters for early differentiation between precocious puberty and premature thelarche

2006 ◽  
Vol 154 (6) ◽  
pp. 891-898 ◽  
Author(s):  
Liat de Vries ◽  
Gadi Horev ◽  
Michael Schwartz ◽  
Moshe Phillip
Keyword(s):  
Precocious Puberty ◽  
Clinical Laboratory ◽  
Early Stage ◽  
Standard Deviation Score ◽  
Bone Age ◽  
Stimulation Test ◽  
Transverse Diameter ◽  
Pelvic Ultrasound ◽  
Premature Thelarche ◽  
Uterine Volume

Objective: To determine if uterine and ovarian measurements can significantly distinguish between precocious puberty (PP) and premature thelarche (PT) and whether ultrasound has any advantage over the gonadotropin-releasing hormone (GnRH) stimulation test. Design: Prospective. Methods: One hundred and three girls referred consecutively for evaluation of breast budding before age 8 years underwent physical examination, GnRH stimulation test, bone age assessment, and transabdominal pelvic ultrasound. The diagnosis of PP or PT was based on clinical judgment. The clinical, laboratory, and ultrasound data of the PP and PT groups were compared. Results: Eighty-one girls were diagnosed with PP and 22 with PT. Significant differences in most of the uterine and ovarian measurements were found between the groups. On logistic regression analysis, bone age standard deviation score, uterine transverse diameter, and uterine volume were the most significant variables predicting PP. Comparison of 30 girls with PP and 21 with PT in whom peak luteinizing hormone was <5 mIU/ml on the GnRH stimulation test, using analysis of variance, yielded significant differences in uterine width (P<0.001), fundus diameter (P <0.04), uterine volume (P= 0.006), and ovarian circumference (P <0.02). Conclusions: Increased uterine and ovarian measurements may be an early and sensitive sign of PP. Pelvic ultrasound, a noninvasive, inexpensive, and reliable tool, may give the clinician a complementary indication to the GnRH test in distinguishing isolated PT from early-stage PP in girls with early breast budding.

scholarly journals The utility of basal serum LH in prediction of central precocious puberty in girls

2012 ◽  
Vol 166 (2) ◽  
pp. 295-299 ◽  
Author(s):  
Yehonatan Pasternak ◽  
Michael Friger ◽  
Neta Loewenthal ◽  
Alon Haim ◽  
Eli Hershkovitz
Keyword(s):  
Precocious Puberty ◽  
Predictive Value ◽  
Central Precocious Puberty ◽  
Stimulation Test ◽  
Breast Development ◽  
Basal Serum ◽  
Serum Lh ◽  
Before And After ◽  
Design And Methods ◽  
Prepubertal Girls

ObjectiveThe mainstay of distinction between prepubertal girls and girls who are suspected of having central precocious puberty (CPP) is based on gonadotropin measurements after a GnRH stimulation test to evaluate hypothalamic–pituitary–gonadal axis maturity. The objective of this study was to determine whether a single basal gonadotropin measurement carries a useful predictive value in verifying or refuting the diagnosis of CPP.Design and methodsBasal serum LH and FSH were measured by a chemiluminescent immunometric assay in a cohort of girls who had been evaluated for CPP before and after GnRH stimulation test. Peak LH levels higher than 5 IU/l were considered a pubertal response.ResultsEighty girls with suspected breast development before 8 years of age were enrolled to the study, out of whom 42 had CPP.Low basal serum LH (≤0.1 IU/l) was sufficient to rule out the diagnosis of CPP in 94.7% of the 38 prepubertal girls; the sensitivity of basal LH levels for this purpose was only 64%. The basal FSH and the basal LH to FSH ratio achieved less efficient predictive value with 76 and 71% sensitivity and 73 and 86% specificity respectively.ConclusionA single basal LH measurement may be adequate to confirm but not to refute the presence of CPP in most of the girls who are evaluated for early pubertal signs.

scholarly journals Diagnostic Accuracy of Female Pelvic Ultrasonography in Differentiating Precocious Puberty From Premature Thelarche: A Systematic Review and Meta-analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Nam Nhat Nguyen ◽  
Linh Ba Phuong Huynh ◽  
Minh Duc Do ◽  
Tien Yun Yang ◽  
Meng-Che Tsai ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Precocious Puberty ◽  
Stimulation Test ◽  
Cochrane Library ◽  
Operating Characteristics ◽  
Premature Thelarche ◽  
Pelvic Ultrasonography ◽  
Uterine Length

BackgroundThe gonadotropin-releasing hormone (GnRH) stimulation test is the benchmark for diagnosing precocious puberty (PP). However, it is invasive, time-consuming, costly, and may create an unpleasant experience for participants. Moreover, some overlaps may occur between PP and premature thelarche (PT) in the early stage of PP. Female pelvic ultrasonography may provide additional information to help differentiate PP from PT and subsequently initiate early treatment. In this study, we aimed to first directly compare pelvic ultrasonography parameters between PP and PT groups and secondly, investigate their diagnostic accuracy compared with the GnRH stimulation test.MethodsA systematic search of the PubMed/MEDLINE, EMBASE, Scopus, and Cochrane Library databases was performed up to March 31, 2021. All types of studies, except for case reports and review articles, were included. The GnRH stimulation test was used to confirm PP diagnosis. Those whose organic conditions might cause PP were excluded. The mean, standard deviation, sensitivity, and specificity of each parameter were documented. Forest plots were constructed to display the estimated standardized mean differences (SMDs) from each included study and the overall calculations. A bivariate model was used to calculate the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR).ResultsA total of 13 studies were included for analysis. The SMDs (95% confidence interval – CI) in ovarian volume, fundal-cervical ratio, uterine length, uterine cross-sectional area, and uterine volume between PP and PT groups were 1.12 (0.78–1.45; p &lt; 0.01), 0.90 (0.07–1.73; p = 0.03), 1.38 (0.99–1.78; p &lt; 0.01), 1.06 (0.61–1.50; p &lt; 0.01), and 1.21 (0.84–1.58; p &lt;0.01), respectively. A uterine length of 3.20 cm yielded a pooled sensitivity of 81.8% (95% CI 78.3%–84.9%), specificity of 82.0% (95% CI 61.0%–93.0%), PLR of 4.56 (95% CI 2.15–9.69), NLR of 0.26 (95% CI 0.17–0.39), and DOR of 19.62 (95% CI 6.45–59.68). The area under the summary receiver operating characteristics curve was 0.82.ConclusionFemale pelvic ultrasonography may serve as a complementary tool to the GnRH stimulation test in differentiating PP from PT.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021232427, ID: CRD42021232427.

scholarly journals Factors affecting bone maturation in Chinese girls aged 4-8 years with isolated premature thelarche

2020 ◽  
Author(s):  
Huiping Su ◽  
Zhe Su ◽  
Lili Pan ◽  
Li Wang ◽  
Zhongwei Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Standard Deviation Score ◽  
Multiple Linear Regression Model ◽  
Normal Weight ◽  
Stimulation Test ◽  
Sex Hormone Binding Globulin ◽  
Control Group ◽  
Premature Thelarche ◽  
Independent Risk Factors ◽  
Isolated Premature Thelarche

Abstract Background: In isolated premature thelarche (IPT) girls, bone age (BA) is considered consistent with chronological age. However, some IPT girls confirmed by gonadotropin-releasing hormone (GnRH) stimulation test could show another trend. We analysed BA and possible potentiating factors in a selected group of girls aged 4-8 years with IPT. Methods: IPT girls confirmed by GnRH stimulation test aged 4-8 years hospitalized from January 2015 to April 2018 at Shenzhen Children's Hospital were included in this retrospective study. They were divided into two groups with advanced BA of 2 years as the cut-off. Body mass index (BMI) and hormone levels were the main outcome measures, and regression analysis was used to identify independent risk factors. IPT girls were divided into subgroups according to the levels of BMI standard deviation score (SDS), insulin-like growth factor-1 (IGF-1) SDS and dehydroepiandrosterone sulfate (DHEAS) SDS for comparisons of advanced BA. Results: Overall, 423 subjects were included and classified into the advanced BA group (48.7%, n=206) and control group (51.3%, n=217). The advanced BA group had significantly higher BMI SDS, serum DHEAS SDS, IGF-1 SDS, androstenedione and fasting insulin and significantly lower sex hormone binding globulin (all p<0.001). Serum IGF-1 SDS (OR=1.926, p＜0.001), BMI SDS (OR=1.427, p=0.001) and DHEAS SDS (OR=1.131, p=0.005) were independent risk factors for significantly advanced BA. In the multiple linear regression model, serum IGF-1 SDS, BMI SDS and DHEAS SDS were the strongest predictors of advanced BA, accounting for 19.3% of the variance. According to BMI, 423 patients were classified into three groups: normal weight (56.03%, n=237), overweight (19.15%, n=81) and obesity (24.82%, n=105). The proportion of advanced BA in obesity group was significantly higher than those of normal weight and overweight groups (χ2=18.088, p＜0.001). In the subgroup with normal weight, higher serum IGF-1 SDS (p=0.009) and DHEAS SDS (p=0.003) affected BA advancement independent of BMI SDS. Conclusions: Girls with IPT confirmed by GnRH stimulation test aged 4-8 years might have significantly advanced BA. Obesity was highly associated with advanced BA. Age-specific serum IGF-1 SDS and DHEAS SDS were risk factors for BA advancement independent of BMI.

Thyrotoxic atrial fibrillation: an underdiagnosed or overdiagnosed condition?

1990 ◽  
Vol 36 (4) ◽  
pp. 620-627 ◽  
Author(s):  
B Fagerberg ◽  
G Lindstedt ◽  
S O Strömblad ◽  
B Darpö ◽  
E Nyström ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Diagnostic Methods ◽  
Stimulation Test ◽  
Ambulatory Patients ◽  
Reference Limits ◽  
Stimulation Tests ◽  
Pathogenetic Factor ◽  
One Year ◽  
Improved Methods

Abstract Hyperthyroidism has been considered to be underdiagnosed as a pathogenetic factor for atrial fibrillation, according to results of thyroliberin stimulation tests. We assessed, clinically and biochemically, thyroid function in 110 ambulatory patients with atrial fibrillation [mean age 64 (SD 11) years] from a group of consecutive cases referred to a specialist cardiology unit during one year. Patients finally categorized as euthyroid (n = 100) commonly presented with one or more symptoms or signs considered to be typical for thyrotoxic patients. Three patients (2.7%; 95% confidence interval, 0-7.5%) fulfilled criteria for hyperthyroidism, but only one was identified from clinical examination. The thyroliberin stimulation test (performed in all patients) identified another seven patients who might have been classified as hyperthyroid according to commonly used criteria for an abnormal thyrotropin response. However, none of these seven patients was judged as hyperthyroid after follow-up. Their thyrotropin concentrations were all above the detection limit for the immunoenzymometric assay. With few exceptions, they had thyroid hormone concentrations within reference limits calculated from the results for the 100 euthyroid subjects, and their concentration ratio for free 3,5,3'-triiodothyronine to free thyroxin, 0.31 (SD 0.05), was lower than that found in the euthyroid group [0.38 (SD 0.08), P less than 0.05]. We conclude that (a) criteria for evaluating results of the thyroliberin stimulation test should be revised, (b) this test is still useful in evaluating suspected cases of hyperthyroidism, for which results of current, improved methods for thyrotropin determination are equivocal, and (c) improved diagnostic methods should be used to characterize the relative importance of hyperthyroidism as a causal factor for atrial fibrillation.

Thelarche variant: A new syndrome of precocious sexual maturation?

1990 ◽  
Vol 123 (5) ◽  
pp. 481-486 ◽  
Author(s):  
Richard Stanhope ◽  
Charles C. D. Brook
Keyword(s):  
Precocious Puberty ◽  
Sexual Maturation ◽  
Central Precocious Puberty ◽  
Clinical Findings ◽  
Breast Development ◽  
Gnrh Analogue ◽  
Gonadotropin Secretion ◽  
Premature Thelarche ◽  
Isolated Premature Thelarche ◽  
Depot Injections

Abstract. We describe 10 girls (mean age 3.7 years, range 1.9-6.9) with precocious sexual maturation and clinical findings intermediate between those of premature thelarche and central precocious puberty. Studies of spontaneous gonadotropin secretion and ovarian ultrasound morphology also revealed findings intermediate between those of isolated premature thelarche and central precocious puberty. There was no response in 6 of the girls treated with GnRH analogue, whether administered intranasally, sc, or by monthly depot injections. We have called this condition thelarche variant because the gonadotropin independence and cyclical nature of breast development may well be due to a lesion of folliculogenesis.

Sign in / Sign up

Export Citation Format

Share Document