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Neuroimaging in 205 consecutive Children Diagnosed with Central Precocious Puberty in Denmark

Abstract

Introduction

A brain magnetic resonance image (MRI) is considered part of routine evaluation in children diagnosed with central precocious puberty (CPP) to rule out intracranial pathology. We evaluated the occurrence of pathological findings on neuroimaging among children diagnosed with CPP.

Methods

A retrospective study based on an evaluation of 1544 children referred with early signs of puberty from 2009–2019. Of these, 205 children (29 boys) with confirmed CPP had a brain MRI performed, and we report MRI results, pubertal stage, bone age, and hormonal analyses. All abnormal MRI results were re-evaluated by a trained neuroradiologist.

Results

A new intracranial pathology was found by brain MRI in 6 out of 205 patients aged 1.5 to 6.1 years. The occurrence of intracranial pathology was 3/162 (1.8%) and 3/24 (12.5 %) in girls and boys respectively.

Conclusion

Organic causes of precocious puberty are more frequent in boys with CPP than in girls. No cases of organic CPP were seen above age 6.1 years of age. The age cut off value for routine brain MRI could be lowered to seven or perhaps even six years of age for girls, except in rapidly progressing puberty or presence of neurological symptoms.

Impact

In our study of children with central precocious puberty (CPP), intracranial pathology is a rare cause and occurs only in younger children. It supports the general trend, that younger children are at higher risk of having organic causes to CPP and supports the clinical practice, that only high-risk patients with CPP should undergo routine brain MRI.

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Fig. 1: MRI of the brain of the six subjects with intracranial pathology with marking around pathological finding.

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Authors and Affiliations

Authors

Contributions

Substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data: A.B.H., C.H.R., D.W., P.G., A.J., R.B.J Drafting the article or revising it critically for important intellectual content: A.B.H., A.J., R.B.J. Approval of the version to be published: A.B.H., C.H.R., D.W., P.G., A.J., R.B.J.

Corresponding author

Correspondence to Rikke Beck Jensen.

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Competing interests

The authors declare no competing interests.

Consent Statement

This study was approved by the Danish Health Authorities no. 31-1521-50 and has been processes in concordance with the General Data Protection Regulation (GDPR) and Danish Health Law.

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Hansen, A.B., Renault, C.H., Wøjdemann, D. et al. Neuroimaging in 205 consecutive Children Diagnosed with Central Precocious Puberty in Denmark. Pediatr Res (2022). https://doi.org/10.1038/s41390-022-02047-2

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