Gender-related differences in etiology of organic central precocious puberty

Background. Central precocious puberty (CPP) is idiopathic in 90% of girls and 60% of boys, while some cases are caused by lesions of central nervous system (CNS), a condition often referred to as organic CPP. We aimed to analyze the etiology of organic CPP in a large cohort of girls and boys...

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Main Authors: Doğuş Vurallı, Alev Özön, E Nazlı Gönç, Kader K Oğuz, Nurgün Kandemir, Ayfer Alikaşifoğlu
Format: Article
Language:English
Published: Hacettepe University Institute of Child Health 2020-10-01
Series:The Turkish Journal of Pediatrics
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Online Access:https://turkjpediatr.org/article/view/511
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author Doğuş Vurallı
Alev Özön
E Nazlı Gönç
Kader K Oğuz
Nurgün Kandemir
Ayfer Alikaşifoğlu
author_facet Doğuş Vurallı
Alev Özön
E Nazlı Gönç
Kader K Oğuz
Nurgün Kandemir
Ayfer Alikaşifoğlu
author_sort Doğuş Vurallı
collection DOAJ
description Background. Central precocious puberty (CPP) is idiopathic in 90% of girls and 60% of boys, while some cases are caused by lesions of central nervous system (CNS), a condition often referred to as organic CPP. We aimed to analyze the etiology of organic CPP in a large cohort of girls and boys and determine gender-related differences. Methods. Medical files of 256 girls and 120 boys diagnosed and treated for CPP in a single center in the last two decades were reviewed. Patients were classified into four groups with respect to previous history and MRI findings: (1) previously established CNS pathology at the time of diagnosis, (2) novel CNS pathology previously asymptomatic, (3) incidentalomas considered to be unrelated to CPP, and (4) completely normal MRI. Group 1 and 2 were considered as organic CPP whereas group 3 and 4 were considered as idiopathic CPP. Results. Prevalence of CNS pathology was significantly higher in boys than girls (21.7% vs 6.2%). Previous CNS pathologies such as developmental anomaly of CNS, parenchymal injury, necrotic lesions and hydrocephalus were present in 3.5% of girls and 8.3% of boys. Prevalence of novel CNS pathology as determined by imaging among neurologically asymptomatic patients was 2.8% in girls and 14.5% in boys. The most common novel CNS pathologies in boys were hamartomas (5%) and suprasellar arachnoid cysts (3.3%); which were significantly lower in girls (0.8 and 0.8% respectively). Onset of organic CPP was before six years in girls, and seven years in boys. Conclusions. Organic CPP was 3.5 times more common in boys compared to girls. It is possible to detect an underlying CNS pathology in one out of every five boys with CPP. Frequency and distribution of organic etiology also differ between girls and boys, hypothalamic hamartomas and suprasellar arachnoid cysts being more common in boys than girls. The likelihood of novel intracranial pathology associated with CPP is quite low in girls with an onset after six years of age and in boys with an onset after seven years of age.
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id doaj-art-7cbd2ce74ab74642a2ed88e31da4f313
institution DOAJ
issn 0041-4301
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language English
publishDate 2020-10-01
publisher Hacettepe University Institute of Child Health
record_format Article
series The Turkish Journal of Pediatrics
spelling doaj-art-7cbd2ce74ab74642a2ed88e31da4f3132025-08-20T03:01:14ZengHacettepe University Institute of Child HealthThe Turkish Journal of Pediatrics0041-43012791-64212020-10-0162510.24953/turkjped.2020.05.007Gender-related differences in etiology of organic central precocious pubertyDoğuş Vurallı0Alev Özön1E Nazlı Gönç2Kader K Oğuz3Nurgün Kandemir4Ayfer Alikaşifoğlu5Division of Pediatric Endocrinology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.Division of Pediatric Endocrinology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.Division of Pediatric Endocrinology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.Division of Pediatric Endocrinology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.Division of Pediatric Endocrinology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey. Background. Central precocious puberty (CPP) is idiopathic in 90% of girls and 60% of boys, while some cases are caused by lesions of central nervous system (CNS), a condition often referred to as organic CPP. We aimed to analyze the etiology of organic CPP in a large cohort of girls and boys and determine gender-related differences. Methods. Medical files of 256 girls and 120 boys diagnosed and treated for CPP in a single center in the last two decades were reviewed. Patients were classified into four groups with respect to previous history and MRI findings: (1) previously established CNS pathology at the time of diagnosis, (2) novel CNS pathology previously asymptomatic, (3) incidentalomas considered to be unrelated to CPP, and (4) completely normal MRI. Group 1 and 2 were considered as organic CPP whereas group 3 and 4 were considered as idiopathic CPP. Results. Prevalence of CNS pathology was significantly higher in boys than girls (21.7% vs 6.2%). Previous CNS pathologies such as developmental anomaly of CNS, parenchymal injury, necrotic lesions and hydrocephalus were present in 3.5% of girls and 8.3% of boys. Prevalence of novel CNS pathology as determined by imaging among neurologically asymptomatic patients was 2.8% in girls and 14.5% in boys. The most common novel CNS pathologies in boys were hamartomas (5%) and suprasellar arachnoid cysts (3.3%); which were significantly lower in girls (0.8 and 0.8% respectively). Onset of organic CPP was before six years in girls, and seven years in boys. Conclusions. Organic CPP was 3.5 times more common in boys compared to girls. It is possible to detect an underlying CNS pathology in one out of every five boys with CPP. Frequency and distribution of organic etiology also differ between girls and boys, hypothalamic hamartomas and suprasellar arachnoid cysts being more common in boys than girls. The likelihood of novel intracranial pathology associated with CPP is quite low in girls with an onset after six years of age and in boys with an onset after seven years of age. https://turkjpediatr.org/article/view/511central precocious pubertycranial MRIetiologypituitary MRIprecocious puberty
spellingShingle Doğuş Vurallı
Alev Özön
E Nazlı Gönç
Kader K Oğuz
Nurgün Kandemir
Ayfer Alikaşifoğlu
Gender-related differences in etiology of organic central precocious puberty
The Turkish Journal of Pediatrics
central precocious puberty
cranial MRI
etiology
pituitary MRI
precocious puberty
title Gender-related differences in etiology of organic central precocious puberty
title_full Gender-related differences in etiology of organic central precocious puberty
title_fullStr Gender-related differences in etiology of organic central precocious puberty
title_full_unstemmed Gender-related differences in etiology of organic central precocious puberty
title_short Gender-related differences in etiology of organic central precocious puberty
title_sort gender related differences in etiology of organic central precocious puberty
topic central precocious puberty
cranial MRI
etiology
pituitary MRI
precocious puberty
url https://turkjpediatr.org/article/view/511
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AT enazlıgonc genderrelateddifferencesinetiologyoforganiccentralprecociouspuberty
AT kaderkoguz genderrelateddifferencesinetiologyoforganiccentralprecociouspuberty
AT nurgunkandemir genderrelateddifferencesinetiologyoforganiccentralprecociouspuberty
AT ayferalikasifoglu genderrelateddifferencesinetiologyoforganiccentralprecociouspuberty