Sonographic monitoring of LHRH analogue therapy in idiopathic precocious puberty in young girls
✍ Scribed by Deborah A. Hall; William F. Crowley; Margaret E. Wierman; Joseph F. Simeone; Kathleen A. McCarthy
- Publisher
- John Wiley and Sons
- Year
- 1986
- Tongue
- English
- Weight
- 612 KB
- Volume
- 14
- Category
- Article
- ISSN
- 0091-2751
No coin nor oath required. For personal study only.
✦ Synopsis
Precocious puberty in young girls is defined as the development of secondary sexual characteristics and gonadal growth before 8 years of age. Approximately 60% of isosexual precocious development in girls has no organic cause and is termed idiopathic precocious puberty. Thirteen young girls with idiopathic precocious puberty were treated with LHRH analogue under a well-established protocol. Pelvic ultrasound was added to the protocol to examine ultrasound's role in supplying a morphologic parameter of suppression of the pubertal process. Initially, 11 patients had ovarian volumes greater than normal, and ovarian cysts measuring 0.5 cm to 4 cm in diameter were identified in seven patients. All 13 patients had enlarged pretreatment uteri greater than 3 cm in length. Eleven of these patients had a pubertal or adult uterine configuration. After 1 year of therapy, 11 patients had normal prepubertal ovarian volumes, and 12 of 13 patients had a decrease in ovarian volume. No demonstrable cysts were present at 1 year. Eleven had a reduction in uterine length. Nine of the 11 patients with a pubertal uterine configuration reverted to a more prepubertal-like morphology. The sonographic morphologic changes correlated well with laboratory and clinical data indicating suppression of the hypothalamic-pituitary-gonadal axis. Indexing Words: Precocious puberty * Uterus -Ovaries * LHRH analogue Isosexual precocious puberty is defined as the premature development of secondary sexual characteristics with growth and activation of the gonads before 8 years of age in girls and 9 years of age in boys.'.* Organic lesions such as central nervous system tumors, gonadal tumors, or adrenal disorders are responsible for the majority of cases of precocious sexual development in young boys. Premature activation of the hypothalamicpituitary-gonadal axis without organic cause is termed idopathic precocious puberty and is the diagnosis in 35-50% of boys and 80-90% of girls.';' A careful clinical history and physical examination, bone age determination, hormonal analysis, cranial computed axial tomography, and gonadal and adrenal sonography have been utilized to es- From the Departments of