Zeynep Hizli Demirkale1, Zehra Yavas Abali2, Firdevs Bas2, Sukran Poyrazoglu2, Ruveyde Bundak2, Feyza Darendeliler3. 1. Istanbul Faculty of Medicine, Department of Pediatrics, Istanbul University, Istanbul, Turkey. 2. Istanbul Faculty of Medicine, Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul, Turkey. 3. Istanbul Faculty of Medicine, Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul, Turkey. Electronic address: feyzadarendeliler@gmail.com.
Abstract
STUDY OBJECTIVE: Risks associated with precocious puberty might be observed in the rapidly progressive form of borderline early puberty (BEP). Differentiating the rate of progression is important for deciding treatment with gonadotropin-releasing hormone analogue (GnRHa). The aim was to examine the treatment characteristics and effect of treatment on predicted adult height (PAH). DESIGN: Retrospective observational study. SETTING: Single-center, a pediatric endocrinology unit. PARTICIPANTS: A total of 135 girls, pubertal findings starting between 7-10 years of age. INTERVENTIONS: Data were collected via chart review. Patient groups were defined as treated with GnRHa (n = 63) or untreated (n = 72) girls. MAIN OUTCOME MEASURES: Referral characteristics and anthropometric and pubertal findings of the patients with BEP, effect of treatment on PAH, and final height of the groups were compared. RESULTS: The mean (±SD) age of the patients at admission and for the first appearence of pubertal findings was 8.8 ± 1.0 and 8.0 ± 0.8 years, respectively. Target height and PAH-target height values at admission were similar. At initiation of treatment, PAH of the treated girls (157.8 ± 7.2 cm) were significantly lower compared with untreated girls (160.7 ± 6.5 cm). The age at menarche of patients in the treated and untreated groups were 12.3 ± 1.0 and 11.3 ± 1.1 years, respectively. The final height of the groups were similar (157.1 ± 6.6 vs 157.0 ± 5.9 cm; P = .922) despite a lower PAH of the treated group. CONCLUSION: GnRHa treatment resulted in an increase in PAH and normalized the age of menarche in patients with BEP. In selected girls with rapidly progressive BEP, GnRHa treatment may be considered.
STUDY OBJECTIVE: Risks associated with precocious puberty might be observed in the rapidly progressive form of borderline early puberty (BEP). Differentiating the rate of progression is important for deciding treatment with gonadotropin-releasing hormone analogue (GnRHa). The aim was to examine the treatment characteristics and effect of treatment on predicted adult height (PAH). DESIGN: Retrospective observational study. SETTING: Single-center, a pediatric endocrinology unit. PARTICIPANTS: A total of 135 girls, pubertal findings starting between 7-10 years of age. INTERVENTIONS: Data were collected via chart review. Patient groups were defined as treated with GnRHa (n = 63) or untreated (n = 72) girls. MAIN OUTCOME MEASURES: Referral characteristics and anthropometric and pubertal findings of the patients with BEP, effect of treatment on PAH, and final height of the groups were compared. RESULTS: The mean (±SD) age of the patients at admission and for the first appearence of pubertal findings was 8.8 ± 1.0 and 8.0 ± 0.8 years, respectively. Target height and PAH-target height values at admission were similar. At initiation of treatment, PAH of the treated girls (157.8 ± 7.2 cm) were significantly lower compared with untreated girls (160.7 ± 6.5 cm). The age at menarche of patients in the treated and untreated groups were 12.3 ± 1.0 and 11.3 ± 1.1 years, respectively. The final height of the groups were similar (157.1 ± 6.6 vs 157.0 ± 5.9 cm; P = .922) despite a lower PAH of the treated group. CONCLUSION: GnRHa treatment resulted in an increase in PAH and normalized the age of menarche in patients with BEP. In selected girls with rapidly progressive BEP, GnRHa treatment may be considered.