OBJECTIVES: To test the sensitivities of recently published American recommendations predicting occult intracranial lesion (OICL) in girls with central precocious puberty (CPP), and to validate a previously derived diagnosis rule predicting OICL based on age at puberty onset and estradiol (E2) level. STUDY DESIGN: A retrospective, multicenter, hospital-based, cohort study was performed, including all girls with CPP seen in 7 centers in 6 European countries during given periods. American recommendations and the previously derived diagnosis rule were tested. RESULTS: Girls with CPP (n=443), including 35 with OICL, were recruited. American recommendations did not identify all OICL. Previously identified independent risk factors for OICL were confirmed: age <6 years (adjusted odds ratio 20.5; 95% CI, 8.1-52.1) and E2 >45th percentile (3.0; 95% CI, 1.3-7.1). The previously derived diagnosis rule had 100% sensitivity (95% CI, 90-100): all girls with OICL had either an age <6 years or an E2 level >45th percentile. The specificity was 39% (95% CI, 34-44). CONCLUSIONS: American recommendations do not seem safe to select European girls with CPP who require brain imaging. In settings where systematic brain imaging is not possible, the proposed diagnosis rule could safely help to avoid more than one third of unnecessary brain imaging.
OBJECTIVES: To test the sensitivities of recently published American recommendations predicting occult intracranial lesion (OICL) in girls with central precocious puberty (CPP), and to validate a previously derived diagnosis rule predicting OICL based on age at puberty onset and estradiol (E2) level. STUDY DESIGN: A retrospective, multicenter, hospital-based, cohort study was performed, including all girls with CPP seen in 7 centers in 6 European countries during given periods. American recommendations and the previously derived diagnosis rule were tested. RESULTS:Girls with CPP (n=443), including 35 with OICL, were recruited. American recommendations did not identify all OICL. Previously identified independent risk factors for OICL were confirmed: age <6 years (adjusted odds ratio 20.5; 95% CI, 8.1-52.1) and E2 >45th percentile (3.0; 95% CI, 1.3-7.1). The previously derived diagnosis rule had 100% sensitivity (95% CI, 90-100): all girls with OICL had either an age <6 years or an E2 level >45th percentile. The specificity was 39% (95% CI, 34-44). CONCLUSIONS: American recommendations do not seem safe to select European girls with CPP who require brain imaging. In settings where systematic brain imaging is not possible, the proposed diagnosis rule could safely help to avoid more than one third of unnecessary brain imaging.
Authors: G Russo; P Brambilla; F Della Beffa; M Ferrario; M Pitea; T Mastropietro; R Marinello; M Picca; G Nizzoli; G Chiumello Journal: J Endocrinol Invest Date: 2011-11-08 Impact factor: 4.256
Authors: Wassim Chemaitilly; Thomas E Merchant; Zhenghong Li; Nicole Barnes; Gregory T Armstrong; Kirsten K Ness; Ching-Hon Pui; Larry E Kun; Leslie L Robison; Melissa M Hudson; Charles A Sklar; Amar Gajjar Journal: Clin Endocrinol (Oxf) Date: 2015-11-16 Impact factor: 3.478
Authors: Signe Sloth Mogensen; Lise Aksglaede; Annette Mouritsen; Kaspar Sørensen; Katharina M Main; Peter Gideon; Anders Juul Journal: PLoS One Date: 2012-01-12 Impact factor: 3.240
Authors: Mariangela Cisternino; Erika Della Mina; Laura Losa; Alexandra Madè; Giulia Rossetti; Lorenzo Andrea Bassi; Giovanni Pieri; Baran Bayindir; Jole Messa; Orsetta Zuffardi; Roberto Ciccone Journal: Case Rep Genet Date: 2013-07-31