Endocrine Abstracts (2011) 26 P44

Real-idiopathic precocious puberty: therapeutic approach

I Bistriceanu1, M E Preda1, M Bistriceanu2, L Putinelu3, S Bondari2, A Covei1, A Turcu2 & D Bondari2


1Department of Endocrinology, Emergency Hospital, Craiova, Romania; 2Department of Endocrinology, University of Medicine and Pharmacy, Craiova, Romania; 3Department of Geriatry, Chronics Affections and Geriatric Hospital’s, Stefanesti Arges, Romania.


Early sexualisation defines the appearance of any sign of sexual maturation at a younger age than 2 S.D. from the mean, namely <8 years at girls and 9 years at boys. The really precocious puberty is always isosexual, sexuality program runs in line with genetic sex and gonads of the subject. In making her part of the whole system gonadal function: the hypothalamus–pituitary–gonad-receptors, and gonads is fully enabled not only hormonogenetic, both also gametogenetic.

Methods: The study was conducted on six girls, aged 6–8 years whose sexual characters were installed early (thelarche – 4 years) and one of them (MF – 7 years), menarche at 6 years with the cyclical trend (monthly). Diagnostic algorithm that we applied was represented by: assessing LH and FSH to GnRH test. As MRI brain imaging was performed.

Results: LH and FSH values were increased (>190 mUI/ml) and the GnRH test, the response was normal. MRI brain showed no signal changes or gadolinium signal the pituitary parenchyma, which is why the cases were labeled as the treatment of precocious idiopathic puberty. Is established analogues of LH–RH agonists (Triptorellin 3.75 mg/month) to reduce low-level regulation of gonadotrophin receptors and LH–RH. After 6 months of treatment, her periods have been suspended from patient MF – 7 years, and leap stature was only 1 cm.

Conclusions: Early puberty causes two formidable complications: i) a stature and bone age advance, which compromise the final size by early fusion of growth cartilage; ii) The emotional disturbance resulting from development of sexual characteristics in the absence of adequate intellectual maturation and somatic; consequently, response to treatment should be monitored and will appreciate the opportunity to amend the therapeutic regimen.

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