Human Reproduction Update, Vol.10, No.2 pp.135-147, 2004
© European Society of Human Reproduction and Embryology 2004; all rights reserved
Precocious puberty and statural growth
1 Groupe hospitalier Cochin-Saint Vincent de Paul, Faculté Cochin – Université Paris V and INSERM U561, Paris, 2 Laboratory of Hormonal Biochemistry, Groupe hospitalier Cochin-Saint Vincent de Paul, Paris and 3 IREM, Groupe hospitalier Cochin-Saint Vincent de Paul, Paris, France 4 To whom correspondence should be addressed at: Paediatric Endocrinology and INSERM U561, Groupe hospitalier Cochin-Saint Vincent de Paul, 82 av Denfert Rochereau, 75014 Paris, France. e-mail: carel{at}paris5.inserm.fr
Precocious puberty results mostly from the precocious activation of the gonadotropic axis. Although the age limits have recently been discussed, most physicians consider that onset of pubertal development before the age of 8 years in a girl or 9 years in a boy warrants at least a clinical and bone age evaluation by a paediatric endocrinologist. The major concern in precocious puberty is the underlying condition, and central nervous system or gonadal neoplasm have to be formally excluded as a first step in the diagnosis. A secondary concern is height, since precocious puberty leads to accelerated growth, accelerated bone maturation and ultimately reduced stature. Precocious puberty is heterogeneous and strict criteria should be used to define it, both in terms of age and in terms of potential for progression. Depot forms of GnRH agonists are now the standard treatment for progressive central precocious puberty and aim at alleviating the clinical symptoms of early pubertal development, their psychological consequences and the effects on growth. Here, we review the consequences of both central and gonadotropin-independent precocious puberty on adult stature and the information available on outcomes using the therapeutic regimens currently available. In girls with progressive precocious puberty, all published evidence indicates a gain of adult height over height predicted before treatment or over untreated historical controls. However, the apparent height gain (derived from the comparison of predicted and actual heights) is very variable, in large part due to the inaccuracy of height prediction methods. In girls with onset of puberty at the lower half of the normal age (8–10 years) distribution, trials using GnRH agonists have given negative results (no benefit of treatment). In boys, precocious puberty is rare and fewer results are available but point in the same direction. The most appropriate time for interrupting the treatment is still controversial. In conclusion, GnRH agonists restore adult height in children when it is compromised by precocious puberty.
Key words: bone maturation/GnRH agonist/height/precocious puberty/weight gain
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  J.-C. Carel, E. A. Eugster, A. Rogol, L. Ghizzoni, M. R. Palmert, and on behalf of the members of the ESPE-LWPES GnRH An Consensus Statement on the Use of Gonadotropin-Releasing Hormone Analogs in Children Pediatrics, April 1, 2009; 123(4): e752 - e762. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D Mul and I A Hughes The use of GnRH agonists in precocious puberty Eur. J. Endocrinol., December 1, 2008; 159(suppl_1): S3 - S8. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. N. Brito, A. C. Latronico, P. Cukier, M. G. Teles, L. F. G. Silveira, I. J. P. Arnhold, and B. B. Mendonca Factors Determining Normal Adult Height in Girls with Gonadotropin-Dependent Precocious Puberty Treated with Depot Gonadotropin-Releasing Hormone Analogs J. Clin. Endocrinol. Metab., July 1, 2008; 93(7): 2662 - 2669. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.-C. Carel and J. Leger Precocious Puberty N. Engl. J. Med., May 29, 2008; 358(22): 2366 - 2377. [Full Text] [PDF]
|
|
|
|
|
|
A. M. Pasquino, I. Pucarelli, F. Accardo, V. Demiraj, M. Segni, and R. Di Nardo Long-Term Observation of 87 Girls with Idiopathic Central Precocious Puberty Treated with Gonadotropin-Releasing Hormone Analogs: Impact on Adult Height, Body Mass Index, Bone Mineral Content, and Reproductive Function J. Clin. Endocrinol. Metab., January 1, 2008; 93(1): 190 - 195. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Maghnie, L. Ambrosini, M. Cappa, G. Pozzobon, L. Ghizzoni, M. G. Ubertini, N. di Iorgi, C. Tinelli, S. Pilia, G. Chiumello, et al. Adult Height in Patients with Permanent Growth Hormone Deficiency with and without Multiple Pituitary Hormone Deficiencies J. Clin. Endocrinol. Metab., August 1, 2006; 91(8): 2900 - 2905. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-C. Carel, J. Blumberg, C. Seymour, C. Adamsbaum, N. Lahlou, and for the Triptorelin 3-month CPP Study Group Three-month sustained-release triptorelin (11.25 mg) in the treatment of central precocious puberty Eur. J. Endocrinol., January 1, 2006; 154(1): 119 - 124. [Abstract] [Full Text] [PDF]
|
|