Stefania Pedicelli1, Paola Alessio, Giuseppe Scirè, Marco Cappa, Stefano Cianfarani. 1. Dipartimento Pediatrico Universitario Ospedaliero, "Bambino Gesù" Children's Hospital-Tor Vergata University (S.P., P.A., G.S., S.C.), and Endocrinology and Diabetes Unit (M.C.), "Bambino Gesù" Children's Hospital, 00165 Rome, Italy; and Department of Women's and Children's Health (S.C.), Karolinska Institutet, SE-171 77 Stockholm, Sweden.
Abstract
CONTEXT: It is still controversial whether all girls with central precocious puberty (CPP) should undergo brain magnetic resonance imaging (MRI) for unveiling intracranial pathology. OBJECTIVES: The objectives of the study were to determine the prevalence and type of intracranial lesions in otherwise normal girls with central precocious puberty (idiopathic CPP) and to identify the clinical and biochemical predictors of brain abnormalities. DESIGN AND SETTING: This was a retrospective study conducted at the Endocrine Unit of "Bambino Gesù" Children's Hospital (Rome, Italy) from 1990 to 2012. PATIENTS: One hundred eighty-two girls were consecutively diagnosed with CPP. All girls underwent a thorough endocrine assessment and brain MRI with a detailed examination of the hypothalamic-pituitary area. None of them had a history of neurological diseases, endocrine disorders, neurofibromatosis or other genetic syndromes, or previous hormonal therapies. MAIN OUTCOME MEASURE: Prevalence of brain abnormalities at MRI scan was measured. RESULTS: Brain MRI showed no alteration in 157 (86%), incidentalomas of the hypothalamic-pituitary area unrelated to CPP in 19 (11%), and hamartomas in six girls (3%). Girls with hamartomas were younger than 6 years and had significantly higher mean baseline and stimulated LH values (P < .001), LH to FSH ratio (P < .001), serum 17β-estradiol levels (P < .001), and uterine length (P < .05). However, all the parameters overlapped extensively in girls with or without cerebral alterations. CONCLUSIONS: Our data cast doubt on the need of routine screening by brain MRI in girls with idiopathic CPP older than 6 years. Evidence-based criteria to drive clinical decision making about the use of MRI are lacking.
CONTEXT: It is still controversial whether all girls with central precocious puberty (CPP) should undergo brain magnetic resonance imaging (MRI) for unveiling intracranial pathology. OBJECTIVES: The objectives of the study were to determine the prevalence and type of intracranial lesions in otherwise normal girls with central precocious puberty (idiopathic CPP) and to identify the clinical and biochemical predictors of brain abnormalities. DESIGN AND SETTING: This was a retrospective study conducted at the Endocrine Unit of "Bambino Gesù" Children's Hospital (Rome, Italy) from 1990 to 2012. PATIENTS: One hundred eighty-two girls were consecutively diagnosed with CPP. All girls underwent a thorough endocrine assessment and brain MRI with a detailed examination of the hypothalamic-pituitary area. None of them had a history of neurological diseases, endocrine disorders, neurofibromatosis or other genetic syndromes, or previous hormonal therapies. MAIN OUTCOME MEASURE: Prevalence of brain abnormalities at MRI scan was measured. RESULTS: Brain MRI showed no alteration in 157 (86%), incidentalomas of the hypothalamic-pituitary area unrelated to CPP in 19 (11%), and hamartomas in six girls (3%). Girls with hamartomas were younger than 6 years and had significantly higher mean baseline and stimulated LH values (P < .001), LH to FSH ratio (P < .001), serum 17β-estradiol levels (P < .001), and uterine length (P < .05). However, all the parameters overlapped extensively in girls with or without cerebral alterations. CONCLUSIONS: Our data cast doubt on the need of routine screening by brain MRI in girls with idiopathic CPP older than 6 years. Evidence-based criteria to drive clinical decision making about the use of MRI are lacking.
Authors: Quynh Thi Vu Huynh; Ban Tran Ho; Nguyen Quoc Khanh Le; Tung Huu Trinh; Luu Ho Thanh Lam; Ngan Thi Kim Nguyen; Shih-Yi Huang Journal: Ann Pediatr Endocrinol Metab Date: 2022-05-16
Authors: Monica F Stecchini; Delanie B Macedo; Ana Claudia S Reis; Ana Paula Abreu; Ayrton C Moreira; Margaret Castro; Ursula B Kaiser; Ana Claudia Latronico; Sonir R Antonini Journal: Horm Res Paediatr Date: 2016-07-16 Impact factor: 2.852
Authors: João Soares Felício; Angélica Leite de Alcântara; Luísa Corrêa Janaú; Lorena Vilhena de Moraes; Maria Clara Neres Iunes de Oliveira; Manuela Nascimento de Lemos; Norberto Jorge Kzan de Souza Neto; João Felício Abrahão Neto; Wanderson Maia da Silva; Ícaro José Araújo de Souza; Nivin Mazen Said; Gabriela Nascimento de Lemos; Giovana Miranda Vieira; André Salim Khayat; Ândrea Kely Campos Ribeiro Dos Santos; Natércia Neves Marques de Queiroz; Ana Carolina Contente Braga de Sousa; Márcia Costa Dos Santos; Franciane Trindade Cunha de Melo; Pedro Paulo Freire Piani; Karem Miléo Felício Journal: Front Endocrinol (Lausanne) Date: 2021-07-05 Impact factor: 5.555