Trivin C et al. (2006) Presentation and evolution of organic central precocious puberty according to the type of CNS lesion. Clin Endocrinol 65: 239–245

Central precocious puberty (CPP) is often associated with a lesion in the central nervous system. The type of lesion and whether or not patients receive treatment differs, but there are few data on how these factors affect the manifestations of CPP. Accordingly, a French team conducted a study of 100 consecutive patients with CPP, to assess the influence of lesion type and treatment on initial presentation, hypothalamic–pituitary function, and final height.

In total, 33 boys and 67 girls presented with either optic glioma or astrocytoma (n = 45), hydrocephalus (n = 22), hypothalamic hamartoma (n = 15), suprasellar arachnoid cysts (n = 10), or other lesions (n = 8). At initial presentation, boys with hypothalamic hamartoma were taller and had higher bone age, luteinizing-hormone peak, and plasma testosterone levels than boys with optic glioma; girls with suprasellar arachnoid cysts or hypothalamic hamartoma were younger and had a higher luteinizing-hormone peak than girls with any other type of lesion.

Hypothalamic–pituitary deficiencies were observed in all patients treated for optic glioma, and suprasellar arachnoid cysts were also associated with these deficiencies. Patients who received treatment with a gonadotropin-releasing-hormone analog or growth hormone had normal final heights, whereas untreated patients (who showed only moderate signs or had residual lesions) had below-average final heights.

The authors conclude that the influence of lesion type and treatment on the manifestations of CPP is at least partly mediated by hypothalamic–pituitary deficiencies related to the lesion and its treatment.