Precocious Puberty and Its Treatment
Tóm tắt
Recent publications primarily relate to advances in central precocious puberty (CPP), with little new information concerning the diagnosis and treatment of peripheral precocious puberty (PPP). New information concerning CPP is centered on newer treatment options, all of which involve newer modes of delivering Gonadotropin-Releasing Hormone analog therapy. Recent publications about CPP and the association with CNS lesions, malnutrition and catch-up growth and more efficient ways to predict and document pubertal luteinizing hormone secretion will be discussed. In this article, we will review these newer developments as well as psychological issues, sexual behavior, bone mineral density and body mass index in relation to CPP and its treatment, as well as long-term outcome information on adults previously treated for CPP. Over time, additional observations have allowed a refinement of the diagnostic process, the definition of characteristics during therapy, and more verification of outcome and safety parameters. In summary, a combination of findings should be used to help document the diagnosis of CPP, and therapy should be considered when progression may cause untimely development and limited growth, while the dosing used and the best tools for monitoring therapy effectiveness remain unclear.
Tài liệu tham khảo
Tirumuru SS, Arya P, Latthe P, Kirk J. Understanding precocious puberty in girls. The Obstet Gynecologist. doi:10.1111/j.1744-4667.2012.0094.x.
•• Herman-Giddens ME, Steffes J, Harris D, et al. Secondary sexual characteristics in boys; Data from the Pediatric Research in Office Settings Network. Pediatrics. 2012;130:e1058. doi:10.1542/peds.2011-3291. This is an important publication regarding the onset of the early physical changes of puberty among boys. These data should be used with discretion since the early changes without progression are not necessarily the onset of pubertal hypothalamic-pituitary-testicular activity and also because there are no historical data, particularly based on racial-ethnic groups, that document similar changes.
• Mouritsen A, Aksglaede L, Sorensen K, et al. The pubertal transition in 179 healthy Danish children: associations between pubarche, adrenarche, gonadarche and body composition. Eur J Endocrinol. 2012;168(2):129–36. doi:10.1530/EJE-12-0191. Important documentation of pubertal events among Danish children.
Stephen MD, Zage PE, WaguespackSG. Gonadotropin-dependent precocious puberty: neoplastic causes and endocrine considerations. Int J Pediatr Endocrinol. 2011;2011(1):184502.
Mogensen SS, Annette L, Mouritsen A, et al. Girls with early or precocious puberty. PLoS ONE. 2012;7(1):e29829.
Proos L, Gustafsson J. Is early puberty triggered by catch-up growth following undernutrition? Int J Environ Res Public Health. 2012;9(5):1791–809.
Yazdani P, Lin Y, Raman V, Haymond M. A single sample GnRHa stimulation test in the diagnosis of precocious puberty. Int J Pediatr Endocrinol. 2012;2012(1):23.
• Chi CH, Durham E, Neely EK. Pharmacodynamics of aqueous leuprolide acetate stimulation testing in girls: correlation between clinical diagnosis and time of peak luteinizing hormone level. J Pediatr. 2012;161(4):757–9.e1. doi:10.1016/j.jpeds.2012.06.015. Verification of efficacy of a short GnRHa stimulation test.
Kandemir N, Demirbilek H, Özön ZA, Gönç N, Alikaşifoğlu A. GnRH stimulation test in precocious puberty: single sample is adequate for diagnosis and dose adjustment. J Clin Res PediatrEndocrinol. 2011;3(1):12–7.
Nam H-K, Rhie YJ, Son CS, Park SH. Lee K-H. Factors to predict positive results of gonadotropin releasing hormone stimulation test in girls with suspected precocious puberty. J Korean Med Sci. 2012;27(2):194–9.
Kim EY, Lee MI. Psychosocial aspects in girls with idiopathic precocious puberty. Psychiatry Investig. 2012;9(1):25–8.
Huibregtse BM, Bornovalova MA, Hicks B, McGue M, Iacono W. Testing the role of adolescent sexual initiation in later-life sexual risk behavior: a longitudinal twin design. Psychol Sci. 2011;22(7):924–33.
• Neely EK, Lee PA, Bloch CA, et.al. Leuprolide acetate 1-month depot for central precocious puberty: hormonal suppression and recovery. Int J Pediatr Endocrinol. 2010;2010:398639. This report verified gonadotropin suppression and recovery from an historically important study.
Lewis KA, Eugster EA. Random luteinizing hormone often remains pubertal in children treated with the histrelin implant for central precocious puberty. J Pediatr. 2012. doi:10.1016/j.jpeds.2012.08.038. [Epub ahead of print].
Lee PA, Neely EK, Fuqua J, et.al. Efficacy of leuprolide acetate 1-month depot for central precocious puberty (CPP): growth outcomes during a prospective, longitudinal study. Int J Pediatr Endocrinol. 2011;2011(1):7.
Alessandri SB, de A. Pereira F, Villela RA, et al. Bone mineral density and body composition in girls with idiopathic central precocious puberty before and after treatment with a gonadotropin-releasing hormone agonist. Clinics (Sao Paulo). 2012;67(6):591–6.
Lee SJ, Yang EM, Seo JY, Kim CJ. Effects of gonadotropin-releasing hormone agonist therapy on body mass index and height in girls with central precocious puberty. Chonnam Med J. 2012;48(1):27–31.
• Lee PA, Klein K, Mauras N, et al. Efficacy and safety of leuprolide acetate 3-month depot 11.25 mg or 30 mg for the treatment of central precocious puberty. J Clin Endocrinol Metab. 2012;97(5):1572–80. This report provides data regarding a 3-month depot GnRHa therapy.
Chiocca E, Dati E, Baroncelli GI, et al. Central precocious puberty: treatment with triptorelin 11.25 mg. Sci World J. 2012;2012:583751.