Document Detail


Central precocious puberty: current treatment options.
MedLine Citation:
PMID:  15339200     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Central precocious puberty (CPP) is characterized by early pubertal changes, acceleration of growth velocity, and rapid bone maturation that often result in reduced adult height. An onset of pubertal signs before the age of 8 years in girls and 9 years in boys should always be evaluated. A combination of clinical signs, bone age, pelvic echography in girls, and hormonal data are required to diagnose CPP and make a judgment concerning progression and prognosis. Not all children with apparently true CPP require medical intervention. The main reasons for treatment are to prevent compromised adult height and to avoid psychosocial or behavioral problems. The need for treatment for auxologic reasons is based on estimation of predicted adult height, with the finding of a reduced height potential, which may require a follow-up. Indication for treatment on the basis of psychologic and behavioral anomalies has to be determined on an individual basis. The main short-term aims of therapy are to stop the progression of secondary sex characteristics and menses (in girls) and to treat the underlying cause, when known. Long-term goals are to increase final adult height and to promote psychosocial well-being. Once it has been decided that treatment is appropriate, it should be initiated immediately with depot gonadotropin-releasing hormone (GnRH) agonists. The effective suppression of pituitary gonadal function is achieved with these compounds in practically all CPP patients. Long-term data are now available from 2 decades of GnRH agonist treatment for patients with CPP. Treatment preserves height potential in the majority of patients (especially in younger patients) and improves the final adult height of children with rapidly progressing CPP, with a complete recovery of the hypothalamic-pituitary-gonadal axis after treatment. GnRH agonist treatment using depot preparations is useful and has a good safety profile, with minimal adverse effects and no severe long-term consequences. Although further data are need, there may be a role in the future for combining somatropin (growth hormone) and GnRH agonist treatment for some patients with significantly impaired growth velocity. The introduction of GnRH antagonists is likely to improve the treatment options for CPP.
Authors:
Franco Antoniazzi; Giorgio Zamboni
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Paediatric drugs     Volume:  6     ISSN:  1174-5878     ISO Abbreviation:  Paediatr Drugs     Publication Date:  2004  
Date Detail:
Created Date:  2004-09-01     Completed Date:  2005-01-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100883685     Medline TA:  Paediatr Drugs     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  211-31     Citation Subset:  IM    
Affiliation:
Pediatric Clinic, University of Verona, Verona, Italy. franco.antoniazzi@univr.it
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MeSH Terms
Descriptor/Qualifier:
Body Height / drug effects
Buserelin / adverse effects,  therapeutic use
Child
Diagnosis, Differential
Female
Fertility Agents, Female / administration & dosage,  adverse effects,  therapeutic use
Gonadotropin-Releasing Hormone / agonists*
Humans
Male
Puberty, Precocious / diagnosis,  drug therapy*,  physiopathology
Chemical
Reg. No./Substance:
0/Fertility Agents, Female; 33515-09-2/Gonadotropin-Releasing Hormone; 57982-77-1/Buserelin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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