Premature thelarche: a possible adrenal disorder.

Dumić, Miroslav; Tajić, M; Mardesić, D; Kalafatić, Z

doi:10.1136/adc.57.3.200

Cited by 34 publications

(13 citation statements)

References 21 publications

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“…The age of onset and clinical features of the girls in group B were nearly identical to those in group A, except for the bone age advancement. Several researchers have found bone age advancement in girls with isolated thelarche whose follow-up studies excluded the diagnosis of central precocious puberty (15)(16)(17). Three of the 5 girls in group B were followed for 3-12 months and had no further pubertal progression; they were also given the tentative diagnosis of premature thelarche.…”

Section: Subjectsmentioning

confidence: 99%

Premature Thelarche and Central Precocious Puberty: The Relationship Between Clinical Presentation and the Gonadotropin Response to Luteinizing Hormone-Releasing Hormone

et al. 1988

The Journal of Clinical Endocrinology & Metabolism

188

117

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Premature thelarche is a benign condition that affects young girls. In contrast, central precocious puberty is considered a more serious disorder that causes progressive secondary sexual development, accelerated growth and skeletal maturation, early epiphyseal fusion, and short adult stature. Differentiation between these 2 conditions is important, but may be difficult on clinical grounds, since patients with both disorders may present initially as isolated breast development. To examine the potential usefulness of gonadotropin measurements in distinguishing early central precocious puberty from premature thelarche, we measured basal and LHRH-stimulated plasma gonadotropin levels in 58 girls with idiopathic premature breast development.The girls were divided into six clinically distinct groups, based on the severity of clinical presentation, ranging from isolated breast development (group A) to complete secondary sexual development and accelerated growth and skeletal maturation (group F). The mean basal plasma LH levels and the peak LH response to LHRH stimulation were significantly less in girls with isolated thelarche (group A) than in girls with complete sexual development (group F). The mean basal plasma FSH levels did not differ between these groups, but the peak FSH response to LHRH was greater in girls with isolated thelarche than in girls with complete sexual development. Thus, girls with isolated premature thelarche had a FSH-predominant response to LHRH [mean ratio of peak LH to peak FSH, 0.29 ± 0.10 (± SD)], while girls with complete sexual development had a LHpredominant response (peak LH/FSH, 4.16 ± 1.80). All girls with isolated thelarche had peak LH/FSH ratios less than 1, and all girls with complete sexual development had a ratio greater than 1. Girls with early or intermediate manifestations of central precocious puberty, who had features of puberty in addition to breast development but lacked all of the features of group F, comprised groups B-E. These girls also had intermediate peak LH/FSH ratios, ranging from 0.29 ± 0.10 (group B) to 3.35 ± 2.66 (group E).We conclude that girls with early central precocious puberty frequently have LH and FSH responses to LHRH that are indistinguishable from the FSH-predominant responses of girls with isolated thelarche. These data are consistent with the hypothesis that premature thelarche and central precocious puberty may represent different positions along a continuum of hypothalamic LHRH neuron activation. (J Clin Endocrinol Metab 67: 474, 1988)

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Section: Subjectsmentioning

confidence: 99%

Premature Thelarche and Central Precocious Puberty: The Relationship Between Clinical Presentation and the Gonadotropin Response to Luteinizing Hormone-Releasing Hormone

et al. 1988

The Journal of Clinical Endocrinology & Metabolism

188

117

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“…In humans, the onset of pubertal breast development and LH response to GnRH can be accelerated by elevating the levels of adrenal androgens in patients with congenital adrenal hyperplasia due to 11β-hydroxylase or 21-hydroxylase deficiency [40,41] . Higher levels of serum DHEA and urinary C-19 steroids are associated with an early onset of pubertal breast development [42,43] . However, the interaction of the early elevated DHEA secretion with the neurobiological mechanisms that control the pulsatile GnRH release and maturation of the HPG axis in humans is unknown.…”

Section: Discussionmentioning

confidence: 99%

Puberty-Related Changes in Cortisol, Dehydroepiandrosterone, and Estradiol-17β Secretions within the First Hour after Waking in Premenarcheal Girls

et al. 2014

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Objective: The onset of menstruation is the hallmark of female pubertal development. The present study determined whether pubertal girls experience adrenocortical and ovarian steroid secretions within their first waking hour before getting their period, similar to those observed in adult females with regular cycles. Methods: Cortisol, dehydroepiandrosterone (DHEA), and estradiol-17β concentrations were measured in saliva samples collected after awakening (0, 30, and 60 min after awakening) from 158 normal premenarcheal pubertal girls and 69 adult females with regular menstrual cycles. The girls were subgrouped according to self-reported Tanner breast (B) and pubic hair (PH) stages (B1PH1, B2PH1, B2PH2, B3PH1, and B3PH2). Results: All the subgroups showed a similar pattern of cortisol secretion. However, cortisol levels were higher in girls at B3PH1 and at B3PH2 than other subgroups. DHEA secretion showed a similar pattern across the groups examined. The largest increase in DHEA levels occurred between B1PH1 and B2PH1 stages, and further increased with pubertal progression. DHEA levels in girls at B3PH2 were approximately one half of the adult value. Estradiol-17β profiles in girls at B3PH1 and B3PH2 differed from those of other subgroups of girl. A sharp increase in estradiol-17β levels after awakening which observed in adult females emerged in girls at B3PH1 and B3PH2. However, the estradiol-17β levels did not reach adult values until B3PH2 stage. Conclusions: The progression of female puberty includes an increase in the levels of adrenocortical and ovarian steroid secretions and a gain of adult female-like patterns of estradiol-17β secretion within their first waking hour.

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“…Minipuberty [34,35], increased breast sensitivity to estradiol [36], transient secretion of estradiol by ovarian follicular cysts [37], estrogen production from adrenal precursors [38] and increased dietary intake of estrogens [39] have been proposed as potential causes of PT. The vast majority of girls with PT show spontaneous regression in infancy and early childhood.…”

Section: Discussionmentioning

confidence: 99%

Serum Levels of Polybrominated Diphenyl Ethers in Girls with Premature Thelarche

et al. 2016

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Background/Aims: Polybrominated diphenyl ethers (PBDEs) are widely used as flame retardants and have shown endocrine disruption properties in experimental studies. The aim of this study was to investigate the association between the exposure to PBDEs and alterations of puberty in girls referred for idiopathic central precocious puberty (ICPP) and premature thelarche (PT). Methods: A case-control study was conducted in 124 girls: 37 girls with ICPP (mean age 7.4 ± 0.9 years), 56 with PT (mean age 5.7 ± 2.1 years) and 31 controls (mean age 5.4 ± 1.9 years). PBDE serum concentrations, hormone levels and anthropometry were assessed. PBDE concentrations were corrected for total serum lipid content. Individual exposure to PBDEs was evaluated through ad hoc questionnaires. Results: PBDE serum concentrations corrected for total lipid content were significantly higher in girls with PT (mean 1.49 ± 0.63 log ng/g) than in controls (mean 1.23 ± 0.54 log ng/g; p < 0.05). PT girls showed higher levels of PBDE than ICPP girls (1.49 ± 0.63 vs. 1.37 ± 0.49 log ng/g), though this was not significant. An analysis of the questionnaires revealed no significant differences in exposure between the three groups. Conclusion: Our findings suggest that higher concentrations of serum PBDEs are associated with PT in girls.

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Premature thelarche: a possible adrenal disorder.

Cited by 34 publications

References 21 publications

Premature Thelarche and Central Precocious Puberty: The Relationship Between Clinical Presentation and the Gonadotropin Response to Luteinizing Hormone-Releasing Hormone

Premature Thelarche and Central Precocious Puberty: The Relationship Between Clinical Presentation and the Gonadotropin Response to Luteinizing Hormone-Releasing Hormone

Puberty-Related Changes in Cortisol, Dehydroepiandrosterone, and Estradiol-17β Secretions within the First Hour after Waking in Premenarcheal Girls

Serum Levels of Polybrominated Diphenyl Ethers in Girls with Premature Thelarche

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