Abstract
Studies of gonadotrophin pulsatility and pelvic ultrasound morphology distinguish between isolated premature thelarche (IPT) and central precocious puberty (CPP) (Eur J Pediatr 1986; 145:190) We have observed 6 girls (age range, 2.2 - 6.9 yrs) with premature sexual development which fitted neither diagnostic category.
Features characteristic of IPT were absent pubic hair (n=6), fluctuating breast size (n=4), a small uterus on ultrasound without an endometrial echo (n=6). Features more consistant with CPP were accelerated growth (n=5) and progressive breast enlargement (n=2). Ovarian ultrasound morphology showed that all 6 girls had ovaries containing large numbers of small cysts between 3 - 4 mm in diameter.
5 girls had predominant FSH response to i/v GnRH. The results of overnight serum gonadotrophin secretion were not typical of CPP or IPT. Discrete LH and FSH pulses were seen with neither prcdominating.
5 girls were treated unsuccessfully with intranasal (D-Ser6) GnRH but 2 girls responded to subcutaneous administration. 2 girls had spontaneous regression of breast development after intranasal therapy ceased.
We believe that our patients represent a spectrum between IPT and CPP which is relevant for prognosis and treatment as well as for understanding disorders of ovarian maturation.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Stanhope, R., Pringle, P., Adams, J. et al. 139 PREMATURE THELARCHE VARIANT: A NEW SYNDROME OF PRECOCIOUS SEXUAL MATURATION. Pediatr Res 24, 540 (1988). https://doi.org/10.1203/00006450-198810000-00160
Issue Date:
DOI: https://doi.org/10.1203/00006450-198810000-00160