Endocrine Abstracts

JOINT2703

: Central precocious puberty (CPP) is caused by activation of hypothalamic-pituitary-ovarian axis. This leads to the appearance of secondary sexual characteristics in girls under 8 years of age, and in boys under 9 years of age. CPP must be determined on the basis of laboratory and imaging tests, and clinical examination.

The aim: of the study was to analyze the radiological changes of central nervous system (CNS) in MRI in CPP children treated with gonadotropin analogs (Triptorelin/Dipherelin) (aGnRH) in one endocrinology center.

The study group: consisted of 116 children with CPP: 96 girls (82.76%) and 20 boys (17.24%). Mean age of children was 6.77 ± 2.44 years. Significant changes in MRI were considered: pituitary enlargement, optic nerve glioma, hamartoma, pituitary malformation, hypoplasia of the corpus callosum, hydrocephalus, epileptic encephalopathy.

Results: CNS pathology was significantly more prevalent in boys (8/20; 40%) than girls (20/96, 20,8%). The most often diagnosed significantly important lesions of CNS were: enlargement of the pituitary gland/microadenoma (13), hydrocephalus (4), optic nerve glioma (3), hypothalamic hamartoma (3), pituitary deformity (2), gangliocytoma (1), corpus callosum hypoplasia (1), epileptic encephalopathy (1). Children with significant changes in MRI of the head were younger (girls 5.7±2.5 and boys 4.86±3.13) compared to children with a normal radiological image (girls 7.14±2.24 and boys 7.41±1.6). Clinically insignificant lesions included: pineal cyst (5), Rathke’s pouch cyst (1), intermediate layer cyst (2), pituitary cyst (1), asymmetry of the sella turcica (1), mild downward displacement of cerebellar tonsils through the foramen magnum (1), and asymmetry of the left lateral ventricle (1). CNS significant pathology coexisted with the following diseases in our group: congenital adrenal hyperplasia (CAH, 2 boys), neurofibromatosis type I, (NF-1, 2 boys), epilepsy (1 girl), Silver-Russell syndrome during the rhGH therapy (1 girl), cerebral palsy (CP, 1 girl), McCune-Albright syndrome, (1 girl), panhypopituitarism (1 girl).

Conclusions: 1. The frequency of significant abnormalities in the MRI of the head in our group of children with CPP is 24.1%. 2. Children with significant changes in MRI were younger at the time of diagnosis compared to children with a normal radiological image. 3. CPP is much more often diagnosed in girls in comparison to boys.

Keywords: gonadotropin-dependent precocious puberty, radiological imaging