Hormone profile end pelvic ultrasonography were studied in 41 girls with premature thelarche aged 21 .2 ± 9.7 months and in 39 non affected conrrol girls of the same age and social status. Estrogenic contaminants were looked for both in girls sera and in poultry samples through serum and tissue levels of zearalenone and diethilbestrol. Total estrogenic activity was measured by radioreceptor assay. Basal serum levels or LH, FSH, prolactine and estradiol [E2] were not different between both groups. Total estrogenic activity was significantly higher in girls with thelarche [201 ± 102 vs 78 ± 20 pg E2 eauivalent), turning later to sim'lar levels than in controls in five patients in which thelarche eventually subsided. After LHRH greater FSH than LH peak response was observed (28.7 ± 1 7.5 Up/ml vs 5, ~; ± 2.7 Uu/m!|. No differences were detected in uterine size and squeletal maturation, but a greater mean ovarian volume was seen in patients with thelarquia. No estrogenic contaminants v/ere detected in poultry samples. Partial activation of ihe hypothalamus-pituitary-axis, mainly through FSH secretion, might thus be the responsible of ovarian secretion of E2 or another substance w ; tn estrogenic action.
Premature thelarche was looked for among 460 healthy girls of different socioeconomic level (SEL], aged 6 to 36 months. Sixty five girls (14.1%) had palpable, diameter 10 mm or more, breast tissue. No significant difference was observed in the prevalence of palpable breast tissue between girls of different socioeconomic levels. Fixty three girls with prernalure thelarche, who had never been given hormones, were compared to fourty seven girls without premature thelarche and their corresponding mothers were asked to answer a written questionare. No significant differences were found in evolution of pregnancy, delivery, neonatal period, medical history or nutrition between patients and controls. In 26 cases premature thelarche represented persistence of neonatal thelarche up to the time of the study. Growth and bone age of patients were appropriate for chronological age. Breast tissue size decreased in 21 {75%}, disappeared in 5 |18%) and increased without other signs of puberty in 2 (7%) of 28 patients who were followed up 5 to 15 months. Premature thelarche is a benign condition that tends to improve spontaneously, not apparently related to hormonal contamination of food, although it is rot possible to exclude other environmental agents. It probably represents a variant form of normal development in youngs females.(Key words thelarche premature.)
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