Precocious puberty in children

Objective

To determine the etiology of precocious puberty at tertiary care hospital and to compare the clinical and laboratory parameters of central and peripheral precocious puberty.

Study design

Cross sectional study.

Place and duration of study

Endocrine clinic at National Institute of child health, Karachi, Pakistan from January 2009 to December 2011.

Methodology

Children who fulfilled the criteria of precocious puberty were included. Precocious puberty defined as the development of secondary sexual characteristics before the age of 8 years in girls and 9 years in boys. All patients evaluated clinically and on laboratory investigations. Data was entered and analyzed using SPSS version 17.0. Independent sample t-test/ Mann-Whitney U-test were applied.

Result

Total numbers of patients registered during this period were 84.The conditions causing precocious puberty were central precocious puberty (36.5%), peripheral precocious puberty (38.8%), premature pubarche (10.6%) and premature thelarche (14.1%). In central precocious puberty 26 were female and 5 were male. The causes identified in them were idiopathic (67.74%), hypothalamic hamartoma (12.90%), craniopharagioma (9.67%), arachnoid cyst (3.22%), hypothalamic astrocytoma (3.2%), hydrocephalus (3.2%). In peripheral precocious puberty21 were male and 12 were female. Congenital adrenal hyperplasia (81.8%), adenocarcinoma (9.1%), ovarian teratoma (6.1%) and Mc Cune Albright syndrome (3%) were diagnosed in them. There was difference in the age of onset of puberty of central precocious puberty 3(2-6) versus peripheral precocious puberty 5.25(3.62-7.0). Central precocious puberty children showed higher height SDS, weight SDS, FSH, LH than peripheral precocious puberty.

Conclusion

Peripheral precocious puberty is more common than central precocious puberty. Height SDS, weight SDS, FSH, LH was higher in central precocious puberty versus peripheral precocious puberty.