Fifty two girls with isolated breast enlargement, observed in our Paediatric Endocrinology Unit during the past 10 years, were selected for our study on the basis of the following criteria: age at onset of thelarche under 7 years; breast development corresponding to Tanner stage B2 or B3; absence of pubic and axillary hair, vaginal bleeding, or other signs of sexual maturation; bone age within 2 SDs when plotted against chronological age; no history of oestrogen intake through drugs, ointments, or food; no signs of oestrogen secreting tumours; no evidence of true precocious puberty detected by luteinising hormone releasing hormone test (namely, peak values of luteinising hormone greater than 15 mU/ml, according to our laboratory).Of these 52 patients, three subsequently developed true precocious puberty and were thus excluded; nine girls were lost to the follow up; and the remaining 40 girls were followed up for periods ranging between two and eight years.
A 5-year-old girl with McCune-Albright syndrome, was observed over a 7-year period. She presented with gonadotrophin-independent puberty and later developed gonadotrophin-dependent puberty. Hormonal signs of central puberty remained unchanged over the last 2 years.
Five girls with idiopathic true precocious puberty are reported who underwent spontaneous regression of sexual development. In all patients the signs of sexual maturation were of moderate degree. Considering the possible spontaneous regression of precocious puberty, in similar cases it seems advisable to defer suppressive central therapy for about 6-12 months.
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