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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Hacettepe University Institute of Child Health
2020-10-01
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| 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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| format | Article |
| id | doaj-art-7cbd2ce74ab74642a2ed88e31da4f313 |
| institution | DOAJ |
| issn | 0041-4301 2791-6421 |
| 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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