Haydarpasa Numune Med J. 2019; 59(1): 71-77 | DOI: 10.14744/hnhj.2019.53765

Assessment of Normal, Normal Variants, and Precocious Puberty in Children Referred With Signs of Early Pubertal Development to a Pediatric Endocrine Unit

Suna Kýlýnç
Department of Pediatric Endocrinology, University of Health Sciences Istanbul Bagcilar Training and Research Hospital, Istanbul, Turkey

INTRODUCTION: The aim of this study was to evaluate the etiologic distribution and clinical features of children referred to a pediatric endocrinology clinic with signs of early puberty, and to compare clinical, biochemical, and anthropometric properties of the patients followed-up with the diagnosis of precocious puberty and normal variants puberty.
METHODS: In this single-center study, we included children referred with signs of early puberty between July 2015 and July 2017. We retrospectively evaluated the anthropometric measurements and pubertal status of the patients. In the evaluation of patients with suspected early puberty, biochemical tests, bone age, and pelvic ultrasound were used. If indicated, a standard gonadotropin-releasing hormone stimulation test and brain magnetic resonance imaging were performed.
RESULTS: A total of 476 children were referred for evaluation of early puberty. There were 454 (95.3%) females. The mean age of the patients at the time of referral was 8.97±2.5 years for girls and 9.56±0.74 years for boys. Out of 476 children, only 139 (29.2%) had early pubertal development, and the remaining 337 (70.8%) had normal puberty or no puberty. Out of 139 patients, 45 (9.4%) had precocious puberty, 59 (12.3%) had premature thelarche, and 35 (7.3%) had premature adrenarche.
DISCUSSION AND CONCLUSION: Most of children referred for the evaluation of early pubertal development showed normal puberty or puberty variants. This study emphasizes the importance of a good diagnostic evaluation of these patients.

Keywords: Precocious puberty, premature adrenarche; premature thelarche; puberty.

---

Erken ergenlik bulgularý ile çocuk endokrin polikliniðine yönlendirilen hastalarýn normal, normalin varyantý ve erken ergenlik durumlarýnýn deðerlendirilmesi

Suna Kýlýnç
Saðlýk Bilimleri Üniversitesi Ýstanbul Baðcýlar Eðitim Ve Araþtýrma Hastanesi,Çocuk Endokrinolojisi

GÝRÝÞ ve AMAÇ: Bu çalýþmada amaç erken ergenlik þüphesi ile çocuk endokrin polikliniðine yönlendirilen hastalarýn tanýsal daðýlýmýný ve klinik özelliklerini belirlemek, erken puberte ve normal varyant puberte bozukluklarý tanýsý ile takip edilen ve tedavi baþlanan hastalarýn klinik bulgularýný saptamak, biyokimyasal ve antropometrik özelliklerini karþýlaþtýrmaktýr.
YÖNTEM ve GEREÇLER: Hastanemiz çocuk endokrin polikliniðine Temmuz 2015-Temmuz 2017 tarihleri arasýnda erken ergenlik bulgularý ile yönlendirilen hastalarýn verisi hasta dosyalarý ve hasta kayýt formlarýndan geriye dönük olarak tarandý. Hastalarýn antropometrik bulgularý ve baþvuru sýrasýnda fizik muayene ile belirlenmiþ ergenlik evresi kaydedildi. Ayrýca erken ergenlik þüphesi olan hastalarý deðerlendirmek amacý ile yapýlmýþ biyokimyasal tetkikler, kemik yaþý, suprapubik pelvik ultrasonografi, gonadotropin salgýlatýcý hormon uyarý testi ve kranial manyetik rezonans görüntüleme sonuçlarý kaydedildi.
BULGULAR: Erken ergenlik bulgularý ile baþvuran hasta sayýsý 476 idi. Bu hastalarýn 454’ü (%95,3) kýz idi. Baþvuru sýrasýnda yaþ ortalamasý kýzlarda 8,97±2,5 yýl, erkeklerde 9,56±0,74 yýl idi. Baþvuran hastalarýn sadece 139 (%29,2)’unda erken pubertal bozukluk saptandý, geriye kalan 337 (%70.8) hastanýn pubertesi normal ya da henüz baþlamamýþtý. Erken pubertal bozukluk saptanan hastalarýn 45 (%9,4)’i puberte prekoks, 59 (%12,3)’u prematür telarþ, 35 (%7,3)’i prematür adrenarþ idi.
TARTIÞMA ve SONUÇ: Baþvurularýn çoðunluðunu normal puberte ve normal varyant erken puberte oluþturmaktaydý. Bu çalýþma ile hastalarýn taný aþamasýnda iyi deðerlendirilmesinin önemi vurgulanmak istendi.

Anahtar Kelimeler: Ergenlik, erken ergenlik, prematür telarþ, prematür adrenarþ

---

CITE