Pelvic ultrasound findings in different forms of sexual precocity

Griffin, Ian J.; Cole, TJ; Duncan, Karen A.; Hollman, A. S.; Donaldson, M. D. C.

doi:10.1111/j.1651-2227.1995.tb13691.x

Cited by 40 publications

(43 citation statements)

References 12 publications

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“…However, when we narrowed our comparison to patients with a prepubertal response to GnRH stimulation, there was an overlap in values between the groups, and the differences lost their significance (Table 4). Earlier studies (25,30) also reported that after age 7 years, the FCR does not differentiate prepubertal from pubertal girls. Thus, it is a poorer parameter than other uterine findings for distinguishing among forms of sexual precocity.…”

Section: Discussionmentioning

confidence: 91%

“…Although previous studies have compared the ultrasonographic parameters of girls with PP and PT (22)(23)(24)(25), only one examined the efficacy of ultrasound against GnRH stimulation test (11). The PT group in the latter study was significantly younger than the PP group, as was the case in other studies (12,24,26).…”

Section: Discussionmentioning

confidence: 99%

“…We focused on girls older than 4 years with premature breast budding because PT in this age group may represent a different entity from "classical" PT and poses a greater diagnostic challenge. In addition, some of the earlier studies used pubertal response to the GnRH stimulation test as a diagnostic criterion for PP (25,26), creating a possible preselection bias (26). The GnRH test has a low sensitivity (11)(12)(13), perhaps because the transition to a LH-predominant response is often a relatively late development in the clinical progression of PP (12).…”

Section: Discussionmentioning

confidence: 99%

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Ultrasonographic and clinical parameters for early differentiation between precocious puberty and premature thelarche

Vries¹,

Horev²,

Schwartz³

et al. 2006

eur j endocrinol

147

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Objective: To determine if uterine and ovarian measurements can significantly distinguish between precocious puberty (PP) and premature thelarche (PT) and whether ultrasound has any advantage over the gonadotropin-releasing hormone (GnRH) stimulation test. Design: Prospective. Methods: One hundred and three girls referred consecutively for evaluation of breast budding before age 8 years underwent physical examination, GnRH stimulation test, bone age assessment, and transabdominal pelvic ultrasound. The diagnosis of PP or PT was based on clinical judgment. The clinical, laboratory, and ultrasound data of the PP and PT groups were compared. Results: Eighty-one girls were diagnosed with PP and 22 with PT. Significant differences in most of the uterine and ovarian measurements were found between the groups. On logistic regression analysis, bone age standard deviation score, uterine transverse diameter, and uterine volume were the most significant variables predicting PP. Comparison of 30 girls with PP and 21 with PT in whom peak luteinizing hormone was !5 mIU/ml on the GnRH stimulation test, using analysis of variance, yielded significant differences in uterine width (P!0.001), fundus diameter (P !0.04), uterine volume (PZ 0.006), and ovarian circumference (P !0.02). Conclusions: Increased uterine and ovarian measurements may be an early and sensitive sign of PP. Pelvic ultrasound, a noninvasive, inexpensive, and reliable tool, may give the clinician a complementary indication to the GnRH test in distinguishing isolated PT from early-stage PP in girls with early breast budding.European Journal of Endocrinology 154 891-898

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Ultrasonographic and clinical parameters for early differentiation between precocious puberty and premature thelarche

Vries¹,

Horev²,

Schwartz³

et al. 2006

eur j endocrinol

147

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“…Ultra-sonografia pélvica:o volume e o aspecto dos ovários parecem ser de pouco valor no diagnóstico de PP (29)(30)(31). Aparentemente, a medida longitudinal do útero e o seu volume são melhores indicadores de puberdade.…”

Section: Exames De Imagemunclassified

Crescimento em meninos e meninas com puberdade precoce

Silva¹,

Adan²

2003

Arq Bras Endocrinol Metab

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Arq Bras Endocrinol Metab vol 47 nº 4 Agosto 2003 422 RESUMOO desenvolvimento puberal acompanha-se de aceleração da velocidade de crescimento, secundária à elevação dos esteróides sexuais, do hormônio de crescimento e do IGF-1. O número de centímetros ganhos nesse período representa 16% da estatura adulta. A puberdade precoce (PP) pode levar à fusão prematura da cartilagem de crescimento, reduzindo a duração do crescimento e a estatura final. Assim, o principal objetivo do tratamento frenador da PP é evitar o comprometimento estatural. É importante ressaltar que a PP não evolui uniformemente, podendo ter curso lento (slow evolutive form) e não requerer tratamento. Os autores abordam aspectos do crescimento puberal normal, da puberdade precoce e suas variantes, destacando os efeitos do tratamento com GnRHa (análogos de GnRH) na estatura adulta. Situações especiais, como as puberdades avançada e acelerada, são também discutidas. ABSTRACT Growth in Boys and Girls with Precocious Puberty.Pubertal development is associated with increased growth velocity secondary to the interaction of three hormones: sex steroids, growth hormone and IGF-1. The pubertal spurt represents 16% of adult height. Precocious puberty (PP) may induce early fusion of growth plates, reducing growth duration and, consequently, adult height. Thus, the main objective of the treatment with GnRH analogues is to avoid the height commitment. It is important to emphasize that PP does not evolve uniformly, sometimes having a slow course (slow evolutive form), which does not require treatment. The authors discuss aspects of normal pubertal growth, precocious puberty and its variants, and the effects of treatment on final height. Special situations as early and fast puberty are also mentioned. Keywords: Precocious puberty; Early puberty; Fast puberty; Growth; GnRH analogues A PUBERDADE É O PERÍODO DE TRANSIÇÃO entre a infância e a idade adulta, durante o qual os caracteres sexuais secundários aparecem, o estirão puberal ocorre, e profundas mudanças psicológicas acontecem. Ao final dessa fase, o indivíduo está apto para a reprodução. O mecanismo neuro-endócrino responsável pelo desencadeamento da puberdade não está totalmente esclarecido, mas evidências sugerem que aminoácidos com ações inibidoras ou estimuladoras estão envolvidos no processo. Acredita-se que o glutamato desempenha um papel facilitador, enquanto o ácido gama-amino-butírico (GABA) exerce uma ação inibidora (1,2). O fator de crescimento transformante α (TGF α, transforming growth factor) e as IGFs (insulin-like growth factors) revisão Crescimento em Meninos e Meninas Com Puberdade Precoce

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“…A ultra-sonografia pélvica provou ser técnica não invasiva e precisa na avaliação da genitália interna de meninas com puberdade precoce central. Vários parâmetros ultra-sonográficos são citados como indicadores do efeito da secreção estrogênica, destacando-se o aumento dos volumes uterino [11][12][13][14] e ovariano [15][16][17] , o incremento do comprimento longitudinal do útero 16 e da relação entre as medidas do corpo e do colo uterinos 17,18 e a presença do eco endometrial 11,14,17,18 . Após e durante o tratamento, a ultra-sonografia pélvica pode monitorizar se essas mudanças puberais precocemente desenvolvidas estão regredindo.…”

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