Clinical and laboratory findings in the differential diagnosis of central precocious puberty and premature thelarche

Çatlı, Gönül; Erdem, Pınar; Anık, Ahmet; Abacı, Ayhan; Böber, Ece

doi:10.5152/tpa.2015.2281

Cited by 22 publications

(22 citation statements)

References 22 publications

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“…Several studies have focused on investigating a single gonadotropin biomarker to identify patients with CPP conveniently. Basal or peak serum luteinizing hormone (LH), follicle-stimulation hormone (FSH), and the ratio LH/FSH are the most common biomarkers reported [3-7]. However, the cut-off values of these single biomarkers depend on the assay used to measure the gonadotropin levels.…”

Section: Introductionmentioning

confidence: 99%

Development of Prediction Models Using Machine Learning Algorithms for Girls with Suspected Central Precocious Puberty: Retrospective Study

Pan¹,

Liu²,

Mao³

et al. 2019

JMIR Med Inform

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BackgroundCentral precocious puberty (CPP) in girls seriously affects their physical and mental development in childhood. The method of diagnosis—gonadotropin-releasing hormone (GnRH)–stimulation test or GnRH analogue (GnRHa)–stimulation test—is expensive and makes patients uncomfortable due to the need for repeated blood sampling.ObjectiveWe aimed to combine multiple CPP–related features and construct machine learning models to predict response to the GnRHa-stimulation test.MethodsIn this retrospective study, we analyzed clinical and laboratory data of 1757 girls who underwent a GnRHa test in order to develop XGBoost and random forest classifiers for prediction of response to the GnRHa test. The local interpretable model-agnostic explanations (LIME) algorithm was used with the black-box classifiers to increase their interpretability. We measured sensitivity, specificity, and area under receiver operating characteristic (AUC) of the models.ResultsBoth the XGBoost and random forest models achieved good performance in distinguishing between positive and negative responses, with the AUC ranging from 0.88 to 0.90, sensitivity ranging from 77.91% to 77.94%, and specificity ranging from 84.32% to 87.66%. Basal serum luteinizing hormone, follicle-stimulating hormone, and insulin-like growth factor-I levels were found to be the three most important factors. In the interpretable models of LIME, the abovementioned variables made high contributions to the prediction probability.ConclusionsThe prediction models we developed can help diagnose CPP and may be used as a prescreening tool before the GnRHa-stimulation test.

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Section: Introductionmentioning

confidence: 99%

Development of Prediction Models Using Machine Learning Algorithms for Girls with Suspected Central Precocious Puberty: Retrospective Study

Pan¹,

Liu²,

Mao³

et al. 2019

JMIR Med Inform

View full text Add to dashboard Cite

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“…Puberty is the period when pulsatile release of the gonadotropin releasing hormone (GnRH) starts as a result of activation of Hypothalamic-Pituitary-Gonadal (HPG) axis and the secondary sex characteristics develop. Central precocious puberty (CPP) is defined as development of secondary sex characteristics in relation to activation of the HPG axis before the age of 8 years in girls and before the age of 9 years in boys [ 1 ]. GnRH analogues (GnRHa) represent the treatment of choice in central precocious puberty, because arresting pubertal development and reducing either growth velocity or bone maturation should improve adult height [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluating the Efficacy of Treatment with a GnRH Analogue in Patients with Central Precocious Puberty

Kendırcı¹,

Ağladıoğlu²,

Baş³

et al. 2015

International Journal of Endocrinology

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Objective. GnRH analogues (GnRHa) are used in the treatment of central precocious puberty (CPP). The purpose of this study was to evaluate the efficacy of treatment with a GnRHa (leuprolide acetate) in patients with CPP. Subjects and Methods. A total of 62 female child patients who had been diagnosed with CPP, rapidly progressive precocious puberty (RP-PP), or advanced puberty (AP) and started on GnRHa treatment (leuprolide acetate, Lucrin depot, 3.75 mg once every 28 days) were included in the study. The efficacy of treatment was evaluated with anthropometric data obtained, progression of pubertal symptoms observed, as well as GnRHa tests, and, when necessary, intravenous GnRH tests carried out in physical examinations that were performed once every 3 months. Results. In the current study, treatment of early/advanced puberty at a dose of 3.75 mg once every 28 days resulted in the suppression of the HHG axis in 85.5% of the patients. Conclusion. The findings of this study revealed that a high starting dose of leuprolide acetate may not be necessary in every patient for the treatment of CPP. Starting at a dose of 3.75 mg once every 28 days and increasing it with regard to findings in follow-ups would be a better approach.

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“…In previous studies, the threshold values for basal FSH were found to range between 1.9 and 2.25 IU/L ( 15 , 28 ). However, it has been reported that basal FSH values were not sufficiently reliable and discriminative in the differentiation of CPP and PT, because these threshold values had low sensitivity and specificity.…”

Section: Discussionmentioning

confidence: 95%

Santral puberte prekoks tanısında bazal lütenizan hormon düzeyinin yeterliliği

et al. 2019

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The known about this topic In the differentiation of central precocious puberty and premature thelarche, ultrasonography findings, basal and stimulated gonadotropin levels, and basal estradiol levels should be evaluated, as well as clinical findings such as growth velocity and bone age. The gold standard test used to demonstrate activation of the hypothalamo-pituitary-gonadal axis is the gonadotropin-releasing hormone stimulation test. Currently, the efficacy is not clear and standardization has not been performed for any alternative approaches to be used instead of the gonadotropinreleasing hormone stimulation test. Contribution of the study In girls presenting with premature breast development, basal luteinizing hormone level (≥0.65 IU/L) and luteinizing hormone/follicle-stimulating hormone ratio (≥0.25) are sensitive methods that can be used in demonstrating the activation of the hypothalamo-pituitary-gonadal axis and in making a diagnosis of central precocious puberty. Among these methods, the variable that gives the best sensitivity and specificity is the measurement of basal luteinizing hormone (≥0.65 IU/L), which is a sensitive test that can be used as a screening test in the diagnosis of central precocious puberty.

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Clinical and laboratory findings in the differential diagnosis of central precocious puberty and premature thelarche

Cited by 22 publications

References 22 publications

Development of Prediction Models Using Machine Learning Algorithms for Girls with Suspected Central Precocious Puberty: Retrospective Study

Development of Prediction Models Using Machine Learning Algorithms for Girls with Suspected Central Precocious Puberty: Retrospective Study

Evaluating the Efficacy of Treatment with a GnRH Analogue in Patients with Central Precocious Puberty

Santral puberte prekoks tanısında bazal lütenizan hormon düzeyinin yeterliliği

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