Prematüre Pubarş Olgularının Değerlendirilmesi: Tek Merkez Deneyimi

Objective: We aimed to evaluate anthropometric, clinical and laboratory findings of cases with premature pubarche (PP) at baseline and during follow-up. Material and Methods: A total of 117 cases (110 girls), who presented with the complaint of pubic and/or axillary hair growth before 8 years of age for girls and 9 years for boys, were evaluated retrospectively (the mean fallow up period was 16.2±13.5 months). Results: The mean age of the girls was 7.2±0.9 years, the mean age at symptom initiation was 6.4±1.3 years and the mean bone age (BA) was 8.0±1.3 years. The ratio of BA/chronological age (CA) was 1.1, height standard deviation score (SDS) was 0.6±1.2, target height was 159.1±5.3 cm and predicted height was 157.7±7.5 cm. The mean CA of boys was 8.4±0.8 years and the mean age at the initiation of symptoms among the patients was 7.7±1.1 years. 53.7% of girls and 56% of boys were overweight. 21% of all patients had low birth weight (LBW) and 14% were premature at birth. Serum dehydroepiandrosterone sulfate level was higher than 40 μg/dL in 76.5% of patients revealing positive correlation with BA. Two patients were diagnosed with classical congenital adrenal hyperplasia (CAH) (21 hydroxylase deficiency) and nine were found to be CAH carriers at the beginning. On follow-up, 12 girls (11%) with accompanying thelarche were diagnosed with central puberte precox (CPP) after the luteinizing hormone releasing hormone test. The final diagnosis of 117 cases that clinically had PP on the beginning was as follows: 94 (80%) PP, 12(11%) CPP, 9 (7.3%) CAH carrier and 2 (2.7%) classical CAH. Conclusion: As another clinic pathology was determined in 20% of PP cases during the repeated evaluations, we would like to emphasize that the differential diagnosis should be performed very attentively not only at the beginning, but also on follow-up. It was found that mildly advanced bone age would not affect the final height unfavorably.