The relation between ultrasonographic findings and hormonal profile in girls with central precocious puberty

Abstract

Background Central precocious puberty (CPP) in girls refers to the early activation of the hypothalamic-pituitary-gonadal axis, leading to the development of pubertal changes before the age of 8 years. The gold standard diagnostic tool in CPP is the gonadotropin-releasing hormone stimulation test, but it is expensive, time-consuming, and requires multiple samples. High-resolution ultrasonography is a noninvasive, less time-consuming, and affordable tool that is also effective in assessing uterine and ovarian measurements and breast development, indirectly measuring hypothalamic-pituitary-gonadal axis activation. Aim To describe the clinical characteristics and the hormonal profile of the girls diagnosed with CPP and correlate their ultrasonographic findings with their hormonal profile. Patients and methods The study included 27 girls diagnosed with CPP. Tanner staging, anthropometric measurements, bone age assessment, MRI of the brain and sella turcica, endocrinal profile, and ultrasound of the abdomen and pelvis were performed. Genetic analysis was performed when accessible. Results Breast enlargement was the most common presentation (48.1%). The bone age was advanced in 59.2% of patients. The majority (81.5%) were idiopathic CPP. The length of the uterus, the ovarian volume, and the ovarian circumference were found to be statistically significantly correlated with the hormonal profile, including basal luteinizing hormone (LH), peak LH, and peak LH/follicle-stimulating hormone ratio after the gonadotropin-releasing hormone stimulation test ( P <0.001). Conclusion Noninvasive transabdominal ultrasound could be used to help in the diagnosis of CPP, but multicenter studies and larger sample sizes are recommended.