Endocrine Abstracts

Introduction: Precocious puberty (PP) is the development of secondary sexual characteristics before the age of 8 years in girls and beforethe age of 9 years in boys. Central PP has an idiopathic origin in upto 95% of girls while in up to 50% of males. The diagnostic and the management of PP can beparticularly complex. Here we describe cases of two sisters having central PP with different presentation and evolution.

Observations: First case: A 13-years-old female diagnosed at the age of 6 years and a half with central PP. She presented anaccelerated linear growth with an initial height equal to 126 cm/+3SD, Tanner stage 3 and advanced bone age by 3 years and a half. Basal LH level was high at 2.5 mIU/mL which was multiplied by 14 after GnRH administration, estradiol was 12 pg/mL. Brain Imaging was normal. She received GnRH agonist therapy during 3 years and a half with a final height of 155 cm. Second case: Her little sister aged of 10-years 3 months was followed-up from the age of 4 years and a half. Her initial height was 104 cm/-1SD,Tanner stage 2 and she had an advanced bone age by 1 year. Basal LH and FSH was respectively 1.2 and 2 mIU/mL and its peak concentrations after GnRH agonist stimulation was respectively 6.5 and 12 mIU/mL. Brainimaging was normal. The decision was to follow-up the patient. During her irregular follow-up, she experienced an accelerated growth rate of 16 cm between the age of 7-9 years followed by a gain of only 1 cmin the year after. Menarche occurred at the age of 10 years, her height was 137 cm VS target height of 147 cm.

Conclusion: The management of PP has several challenges especially distinguishing normal from pathologicalpubertal development, achieving normal adult height and avoiding its psychosocial consequences.