True precocious puberty: a long-term complication in children with shunted non-tumoral hydrocephalus

In 4/37 (10.8%) children, adolescents and young adults with successfully shunted hydrocephalus, puberty occurred or was occurring precociously, at an age ranging from 7.5 to 8.6 years, with a consequent impairment of their effective or predicted adult height as compared to the familial target height. All four patients had undergone a surgical intervention for the insertion of a ventricular-atrial or a ventricular-peritoneal shunt during the first year of life; since the last surgical shunt revision (at the age of 5 years) no relapse of hydrocephalus had been recorded. The authors conclude that precocious puberty is to be regarded as a not infrequent long-term complication in patients with successfully shunted hydrocephalus.     

True precocious puberty in girl. Therapy with LHRH analogs

The authors observed an occurrence of pubertas praecox vera by 42 girls from 8 months to 7 years of age. The purpose of the investigations was to elucidate the possible causes of the precocious symptoms and to estimate the effect of the therapy with various LHRH-analogues. Only in 2 children a cranial tumor was found. In the remaining cases an idiopathic precocious puberty was diagnosed. These children received a therapy with LHRH-analogues: Relefact, Busserelin or Decapeptyl. The authors obtained the best results with the slow releasing Decapeptyl.     

Psychological aspects of precocious puberty. An overview.

During the last three decades the psychological consequences of precocious puberty have received considerable attention. The nature and shortcomings of relevant studies are described. It is emphasized that specialized counselling and guidance of families with children who have to cope with precocious puberty is important, since it often contributes to an appropriate behaviour adjustment without the development of psychiatric symptomatology. Guidelines for medical service and psychological management are provided.     

Transient true precocious puberty. A report of five cases

Five girls with idiopathic true precocious puberty are reported who underwent spontaneous regression of sexual development. In all patients the signs of sexual maturation were of moderate degree. Considering the possible spontaneous regression of precocious puberty, in similar cases it seems advisable to defer suppressive central therapy for about 6–12 months.Abbreviations FSH follicle stimulating hormone - Gn-RH gonadotrophin releasing hormone - LH-RH luteinizing hormone releasing hormone     

Growth in precocious puberty

Growth in precocious puberty is a subject of concern to families and clinicians alike. The definition of precocious puberty and the role of obesity in the age of onset have also been areas of debate since the Lawson Wilkins Society recommended a lowering of the age of onset of precocious puberty in US girls. An understanding of growth patterns in normal children with earlier or later onset of puberty and the variable rate of progression between individuals with central precocious puberty as well as the imprecision in available height prediction methods are important in assessing height outcomes in this condition. In the absence of randomised controlled trials in this area, only qualified conclusions about the effectiveness of interventions can be drawn. In general, it appears that height outcome is not compromised in untreated slowly progressive variants of central precocious puberty. In rapidly progressing central precocious puberty in girls, gonadotrophin releasing hormone agonists (GnRH agonists) appear to increase final height by about 5cm in girls treated before the age of eight, but there is no height benefit in those treated after eight years. Scanly data is available to assess treatment effects in boys. GnRH agonists appear to be relatively safe. The decision to treat central precocious puberty should take into account rate of progression of pubertal changes as well as biochemical markers and may need to address other factors (for example psychosocial and behavioural issues) as well as height outcome.     

Epileptic laughter with precocious puberty.

A child with associated epileptic laughter and precocious puberty is reported. The significance of epileptic laughter as a possible marker of hypothalamic disease is noted.     

Cyproterone acetate in treatment of precocious puberty.

Twenty-nine children (23 girls, 6 boys) with precocious puberty were treated with cyproterone acetate for various periods of time ranging from 6 months to 3 years 4 months. They received an oral dose ranging from 70-150 mg/m2 per day, or an intramuscular depot injection once a fortnight or once a month at a dose ranging from 107-230 mg/m2. Both forms of therapy were found to suppress the signs of sexual maturation, but the oral form proved to be superior. Only the younger patients with a bone age under 11 years showed a beneficial effect upon linear growth and bone maturation. No side effects were noted, but additional advantageous effects upon behaviour and sociability were. It is concluded that at present cyproterone acetate by mouth is the drug of choice in the treatment of precocious puberty. The treatment should be initiated as early as possible to attain maximum benefit.     

特发性性早熟女童心脏自主神经功能分析

目的研究特发性性早熟(ICPP)女童的心脏自主神经功能状态。方法选取ICPP女童66例,其中合并肥胖36例,非肥胖30例;另选年龄相匹配的健康女童68例(正常对照)及单纯肥胖女童51例为对照。对所有受试者行24 h动态心电图检查,比较组间的心率减速力(DC)、心率加速力(AC)、心率变异性(HRV)及体重指数(BMI)。结果 ICPP组的DC、RR间期总体标准差(SDNN)、RR间期平均值的标准差(SDANN)、相邻RR间期差值的均方根(RMSSD)和高频功率(HF)均低于正常对照组,AC和BMI高于正常对照组;ICPP组的RMSSD、BMI均低于单纯肥胖组(P0.05)。ICPP女童中合并肥胖组的DC、RMSSD及HF均低于非肥胖组,AC和BMI高于非肥胖组(P0.05)。结论 ICPP女童的心脏自主神经功能紊乱,其中合并肥胖者尤为突出,以迷走神经张力降低为主。