Treatment of Central Precocious Puberty

Eugster, Erica A.

doi:10.1210/js.2019-00036

Cited by 68 publications

(52 citation statements)

References 61 publications

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“…Girls with CPP typically experience the onset of secondary sexual characteristics before the age of 8 years (1). Given that central nervous system (CNS) abnormalities are much more likely (40-75%) to accompany CPP diagnoses in boys (1,(3)(4)(5), CNS imaging is usually conducted for all boys with CPP. However, brain MRI may not necessary for all girls with CPP due to a lower risk of having other CNS abnormalities.…”

Section: Introductionmentioning

confidence: 99%

Pathological and Incidental Findings in 403 Taiwanese Girls With Central Precocious Puberty at Initial Diagnosis

Chiu

Chen

2020

Front. Endocrinol.

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Background: Whether girls with central precocious puberty (CPP) should undergo routine brain magnetic resonance imaging (MRI) to identify potential intracranial pathologies is controversial. Aims: To evaluate the brain MRI results of girls with CPP and identify the clinical and endocrine predictors of brain abnormalities. Methods: This retrospective study obtained data from pediatric endocrine clinics at Chang Gung Children's Hospital. From 1997 and 2017, 403 girls were consecutively diagnosed with CPP. After the exclusion of patients with a history of central nervous system (CNS) insults or associated neuropsychiatric symptom or signs, we studied the prevalence of brain abnormalities in 251 girls with CPP who received detailed MRI examinations of the hypothalamus and pituitary area. We also recorded the demographic data of the participants, including the onset of puberty; initial pubertal status; height; weight; uterus and ovary sizes; and basal luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol levels, and the response to GnRH stimulation test. Results: Among the 251 girls with CPP, we observed no brain alterations in 190 (75.70%), abnormalities in the hypothalamic-pituitary (H-P) area in 54 (21.51%), and abnormalities in the non-H-P area in 7 (2.79%). Among the 54 patients that had H-P lesions, we noted pathological findings related to CPP (hypothalamic hamartoma) in only one (0.4%) girl aged below 6 years old. We also identified incidental findings in the other girls with H-P lesions, including non-functioning pituitary microadenomas (12.35%), pituitary pars intermedia cysts (4.38%), Rathke's pouch cysts (1.99%), pituitary hypoplasia (1.59%), and pineal gland cysts (0.8%). The patients that had non-H-P lesions were found to have arachnoid cysts (1.59%), Chiari I malformation (0.4%), prepontine nodule (0.4%), and choroidal fissure cyst (0.4%). Of all the patients with brain lesions, 45 (73.77%) underwent regular MRI follow-up. While none of the H-P and non-H-P lesions showed progression, 19.67% of these regressed during the follow-up. None of the participants exhibited other hormonal abnormalities or underwent surgery. Conclusion: The prevalence of true pathological brain lesions related to CPP in girls without prior symptoms or signs of CNS lesions was low (0.4%). None of the girls with intracranial lesions required further intervention besides the GnRH agonist treatment. These data question the routine use of brain MRI in all girls with CPP, especially in those who are healthy without neurologic symptoms.

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Section: Introductionmentioning

confidence: 99%

Pathological and Incidental Findings in 403 Taiwanese Girls With Central Precocious Puberty at Initial Diagnosis

Chiu

Chen

2020

Front. Endocrinol.

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“…Central precocious puberty (CPP) is caused by premature activation of the hypothalamic-pituitary-gonadal (HPG) axis, which ultimately leads to the premature development of secondary sexual characteristics in children [ 1 – 3 ]. According to reports, 1 out of every 5,000 to 10,000 children develops CPP, and, in general, the incidence of CPP in girls is much higher than in boys [ 4 ]. If CPP is not properly treated, it affects a child's growth and leads to a shorter height in adulthood than normal adults.…”

Section: Introductionmentioning

confidence: 99%

The Therapeutic Effect of Shugan Xiehuo Formula in the Female Rat Model with Central Precocious Puberty

Yin

Zhang

et al. 2020

Evidence-Based Complementary and Alternative Medicine

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Central precocious puberty (CPP) severely affects children’s physical and mental health and needs to be treated promptly and effectively. This article aimed to research the therapeutic effect of Shugan Xiehuo Formula (SXF) on CPP. A female CPP rat model was established and then treated with leuprolide and different doses of SXF. Sex organ volume and index were measured. Ovaries and uteri were visualized by hematoxylin-eosin staining. The concentrations of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), and estradiol (E2) in peripheral blood were determined. The expression levels of gonadotropin-releasing hormone (GnRH), gonadotropin-releasing hormone receptor (GnRHR), estrogen receptor alpha (ERα), and G protein-coupled receptor 30 (GPR30) in the hypophysis were investigated by Real-Time Quantitative Reverse Transcription PCR and western blot. GnRH expression in the hypothalamus and GnRHR expression in the ovary were detected by immunohistochemistry. SXF reduced the volume of the bilateral ovaries, as well as the volumes of the uterus, hypothalamus, and hypophysis in the female CPP rats and diminished the index of the ovary, uterus, hypothalamus, and hypophysis in the female CPP rats ( P < 0.05 or P < 0.01 ). SXF treatment inhibited follicle maturation and uterine wall thickening in the female CPP rats. SXF decreased the concentrations of FSH, LH, PRL, and E2 in the peripheral blood in the female CPP rats ( P < 0.01 or P < 0.001 ). SXF suppressed the expressions of GnRH, GnRHR, ERα, and GPR30 in the hypophysis ( P < 0.05 ), the expression of GnRH in the hypothalamus ( P < 0.01 ), and the expression of GnRHR in the ovaries ( P < 0.001 ) of the female CPP rats. Overall, our study revealed that SXF had therapeutic effects on CPP in female rats. This is worthy of promoting clinically.

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“…Central precocious puberty (CPP) is caused by premature activation of the hypothalamic-pituitary-gonad (HPG) axis, which ultimately leads to the premature development of secondary sexual characteristics in children [1][2][3]. According to report, 1 out of every 5000 to 10,000 children develops CPP, and in general, the incidence of CPP in girls is much higher than that in boys [4]. If CPP is not properly treated, it will affect the growth of children and lead to a shorter height than normal adults.…”

Section: Introductionmentioning

confidence: 99%

The Therapeutic Effect of Shugan Xiehuo Formula in Female Rat Model with Central Precocious Puberty

Yin

Zhang

et al. 2020

Preprint

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Background: Central precocious puberty (CPP) severely affected children’s physical and mental health, which needs to be treated promptly and effectively.Objective: To research the therapeutic effect of Shugan Xiehuo Formula (SXF) on CPP.Methods: CPP female rat model was established and treated by leuprolide and different dose of SXF. Sex organs volume and index were measured. The ovary and uterus was experienced HE staining. Concentration of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL) and estradiol (E2) in peripheral blood was determined. Expression of gonadotropin-releasing hormone (GnRH), gonadotropin-releasing hormone receptor (GnRHR), estrogen receptor alpha (ERα) and G protein-coupled receptor 30 (GPR30) in hypophysis was investigated by qRT-PCR and Western Blot. GnRH expression in hypothalamus and GnRHR expression in ovary was detected by immunohistochemistry.Results: SXF reduced the volume of bilateral ovaries, uterus, hypothalamus and hypophysis in CPP female rat, and diminished the index of ovary, uterus, hypothalamus and hypophysis in CPP female rat (P < 0.05 or P < 0.01). SXF treatment inhibited follicles maturation and uterine wall thickening in CPP female rat. SXF declined FSH, LH, PRL and E2 concentration in peripheral blood in CPP female rat (P < 0.01or P < 0.001). SXF suppressed the expression of GnRH, GnRHR, ERα and GPR30 in hypophysis, the expression of GnRH in hypothalamus and GnRHR in ovary of CPP female rat (P < 0.05, P < 0.01 or P < 0.001).Conclusions: SXF had effective therapeutic effects on CPP female rat, which was worthy of promotion clinically.

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Treatment of Central Precocious Puberty

Cited by 68 publications

References 61 publications

Pathological and Incidental Findings in 403 Taiwanese Girls With Central Precocious Puberty at Initial Diagnosis

Pathological and Incidental Findings in 403 Taiwanese Girls With Central Precocious Puberty at Initial Diagnosis

The Therapeutic Effect of Shugan Xiehuo Formula in the Female Rat Model with Central Precocious Puberty

The Therapeutic Effect of Shugan Xiehuo Formula in Female Rat Model with Central Precocious Puberty

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