Pathological brain lesions in girls with central precocious puberty at initial diagnosis in Southern Vietnam
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Purpose: Cranial magnetic resonance imaging (MRI) is recommended to identify intracranial lesions in girls with central precocious puberty (CPP). Yet, the use of routine MRI scans in girls with CPP is still debatable, as pathological findings in girls 6 years of age or older with CPP are limited. Therefore, we aimed to identify the prevalence of brain lessons in CPP patients stratified by age group (0–2, 2–6, and 6–8 years). Methods: This retrospective cross-sectional study recruited 257 girls diagnosed with CPP for 6 years (2010–2016). MRI was used to detect brain abnormalities. Levels of luteinizing hormone, follicle-stimulating hormone, and sex hormones in blood samples were measured. Results: Most girls had no brain lesions (82.9%, n=213), and of the minor proportion of girls with CPP that exhibited brain lesions (17.1%, n=44), 32 girls had organic CPP. Pathological findings were detected in 33.3% (2 of 6) of girls aged 0–2 years, 15.6% (5 of 32) of girls aged 2–6 years, and 3.6% (8 of 219) of girls aged 6–8 years. Hypothalamic hamartoma and tumors in the pituitary stalk were the most common pathological findings. The likelihood of brain lesions decreased with age. Girls with organic CPP were more likely to be younger (6.1±2.4 vs. 7.3±1.3 years, P<0.01) than girls with idiopathic CPP. Conclusion: Older girls appeared to have a lower prevalence of organic CPP. Clinicians should cautiously use cranial MRI for girls aged 6–8 years with CPP.
Abstract
Purpose: Cranial magnetic resonance imaging (MRI) is recommended to identify intracranial lesions in girls with central precocious puberty (CPP). Yet, the use of routine MRI scans in girls with CPP is still debatable, as pathological findings in girls 6 years of age or older with CPP are limited. Therefore, we aimed to identify the prevalence of brain lessons in CPP patients stratified by age group (0–2, 2–6, and 6–8 years). Methods: This retrospective cross-sectional study recruited 257 girls diagnosed with CPP for 6 years (2010–2016). MRI was used to detect brain abnormalities. Levels of luteinizing hormone, follicle-stimulating hormone, and sex hormones in blood samples were measured. Results: Most girls had no brain lesions (82.9%, n=213), and of the minor proportion of girls with CPP that exhibited brain lesions (17.1%, n=44), 32 girls had organic CPP. Pathological findings were detected in 33.3% (2 of 6) of girls aged 0–2 years, 15.6% (5 of 32) of girls aged 2–6 years, and 3.6% (8 of 219) of girls aged 6–8 years. Hypothalamic hamartoma and tumors in the pituitary stalk were the most common pathological findings. The likelihood of brain lesions decreased with age. Girls with organic CPP were more likely to be younger (6.1±2.4 vs. 7.3±1.3 years, P<0.01) than girls with idiopathic CPP. Conclusion: Older girls appeared to have a lower prevalence of organic CPP. Clinicians should cautiously use cranial MRI for girls aged 6–8 years with CPP.
참고문헌 (36)
- Kaplowitz PB, "Reexamination of the age limit for defining when puberty is precocious in girls in the United States : implications for evaluation and treatment", Pediatrics, 104, pp.936~941 (1999)
- Jung H, "Pathogenesis of precocious puberty in hypothalamic hamartoma", Horm Res, 57(Suppl 2), pp.31~34 (2002)
- Latronico AC, "Causes, diagnosis, and treatment of central precocious puberty", Lancet Diabetes Endocrinol, 4, pp.265~274 (2016)
- Dossus L, "Reproductive risk factors and endometrial cancer : the European Prospective Investigation into Cancer and Nutrition", Int J Cancer, 127, pp.442~451 (2010)
- Oerter Klein K, "Precocious puberty : who has it? Who should be treated?", J Clin Endocrinol Metab, 84, pp.411~414 (1999)
- Cantas-Orsdemir S, "Prevalence of cranial MRI findings in girls with central precocious puberty : a systematic review and meta-analysis", J Pediatr Endocrinol Metab, 31, pp.701~710 (2018)
- Chiu CF, "Pathological and incidental findings in 403 Taiwanese girls with central precocious puberty at initial diagnosis", Front Endocrinol(Lausanne), 11, pp.256~ (2020)
- 윤종서, "Prevalence of Pathological Brain Lesions in Girls with Central Precocious Puberty: Possible Overestimation?", Journal of Korean Medical Science, 33(51), pp.1~9 (2018), 대한의학회
- Marshall WA, "Variations in pattern of pubertal changes in girls", Arch Dis Child, 44, pp.291~303 (1969)
- Yazdani P, "A single sample GnRHa stimulation test in the diagnosis of precocious puberty", Int J Pediatr Endocrinol, 2012, pp.23~ (2012)
- Carel JC, "Consensus statement on the use of gonadotropin-releasing hormone analogs in children", Pediatrics, 123, pp.e752~e762 (2009)
- "Child growth standards" (2020)[URL]
- Mughal AM, "Bone age assessment methods : a critical review", Pak J Med Sci, 30, pp.211~ (2014)
- Greulich WW, "Radiographic atlas of skeletal development of the hand and wrist" (1959), Stanford University Press
- Arita K, "Hypothalamic hamartoma", Neurol Med Chir(Tokyo), 45, pp.221~231 (2005)
- Jung H, "Some hypothalamic hamartomas contain transforming growth factorα, a puberty-inducing growth factor, but not luteinizing hormone-releasing hormone neurons", J Clin Endocrinol Metab, 84, pp.4695~4701 (1999)
- Mahachoklertwattana P, "The luteinizing hormone-releasing hormone-secreting hypothalamic hamartoma is a congenital malformation : natural history", J Clin Endocrinol Metab, 77, pp.118~124 (1993)
- Harrison VS, "Hypothalamic hamartoma with epilepsy : review of endocrine comorbidity", Epilepsia, 58, pp.50~59 (2017)
- Rupp D, "Pituitary stalk lesions", Curr Opin Endocrinol Diabetes Obes, 15, pp.339~345 (2008)
- Wijetilleka S, "Cranial diabetes insipidus with pituitary stalk lesions", QJM, 109, pp.703~708 (2016)
- Kluczyński Ł, "Diversity of pathological conditions affecting pituitary stalk", J Clin Med, 10, pp.1692~ (2021)
- Brauner R, "Hypothalamic-pituitary function and growth in children with intracranial lesions", Childs Nerv Syst, 15, pp.662~669 (1999)
- Mohn A, "The endocrine spectrum of arachnoid cysts in childhood", Pediatr Neurosurg, 31, pp.316~321 (1999)
- Rivarola M, "Precocious puberty in children with tumours of the suprasellar and pineal areas : organic central precocious puberty", Acta Paediatr, 90, pp.751~756 (2001)
- Abdolvahabi RM, "A brief review of the effects of chronic hydrocephalus on the gonadotropin releasing hormone system : implications for amenorrhea and precocious puberty", Neurol Res, 22, pp.123~126 (2000)
- Adan L, "Growth, puberty and hypothalamic-pituitary function in children with suprasellar arachnoid cyst", Eur J Pediatr, 159, pp.348~355 (2000)
- Acharya SV, "Precocious puberty due to Rathke cleft cyst in a child", Endocr Pract, 15, pp.134~137 (2009)
- 조은정, "Clinical manifestations of Rathke’s cleft cysts and their natural progression during 2 years in children and adolescents", Annals of Pediatric Endocrinology & Metabolism, 22(3), pp.164~169 (2017), 대한소아내분비학회
- Esiri M, "Russell and Rubinstein's pathology of tumors of the nervous system. Sixth edition", J Neurol Neurosurg Psychiatry, 68, pp.538~ (2000)
- 오연정, "Clinical and radiological findings of incidental Rathke’s cleft cysts in children and adolescents", Annals of Pediatric Endocrinology & Metabolism, 19(1), pp.20~26 (2014), 대한소아내분비학회
- Pedicelli S, "Routine screening by brain magnetic resonance imaging is not indicated in every girl with onset of puberty between the ages of 6 and 8 years", J Clin Endocrinol Metab, 99, pp.4455~4461 (2014)
- Freda PU, "Pituitary incidentaloma : an endocrine society clinical practice guideline", J Clin Endocrinol Metab, 96, pp.894~904 (2011)
- Chalumeau M, "Central precocious puberty in girls : an evidence-based diagnosis tree to predict central nervous system abnormalities", Pediatrics, 109, pp.61~67 (2002)
- "Definition, etiology, and evaluation of precocious puberty" (2012)[URL]
- Kaplowitz PB, "Do 6-8 year old girls with central precocious puberty need routine brain imaging?", Int J Pediatr Endocrinol, 2016, pp.9~ (2016)
- Mogensen SS, "Pathological and incidental findings on brain MRI in a single-center study of 229 consecutive girls with early or precocious puberty", PLoS One, 7, pp.e29829~ (2012)