Clinical Management and Therapy of Precocious Puberty in the Sapienza University Pediatrics Hospital of Rome, Italy
Puberty identifies the transition from childhood to adulthood. Precocious puberty is the onset of signs of pubertal development before age eight in girls and before age nine in boys, it has an incidence of 1/5000–1/10,000 with an F:M ratio ranging from 3:1 to 20:1. Precocious puberty can be divided...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-10-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/10/10/1672 |
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| author | Ginevra Micangeli Roberto Paparella Francesca Tarani Michela Menghi Giampiero Ferraguti Francesco Carlomagno Matteo Spaziani Ida Pucarelli Antonio Greco Marco Fiore Luigi Tarani |
| author_facet | Ginevra Micangeli Roberto Paparella Francesca Tarani Michela Menghi Giampiero Ferraguti Francesco Carlomagno Matteo Spaziani Ida Pucarelli Antonio Greco Marco Fiore Luigi Tarani |
| author_sort | Ginevra Micangeli |
| collection | DOAJ |
| description | Puberty identifies the transition from childhood to adulthood. Precocious puberty is the onset of signs of pubertal development before age eight in girls and before age nine in boys, it has an incidence of 1/5000–1/10,000 with an F:M ratio ranging from 3:1 to 20:1. Precocious puberty can be divided into central, also known as gonadotropin-dependent precocious puberty or true precocious puberty, and peripheral, also recognized as gonadotropin-independent precocious puberty or precocious pseudopuberty. Thus, the main aim of this narrative report is to describe the standard clinical management and therapy of precocious puberty according to the experience and expertise of pediatricians and pediatric endocrinologists at Policlinico Umberto I, Sapienza University of Rome, Italy. In the suspicion of early sexual maturation, it is important to collect information regarding the age of onset, the speed of maturation of secondary sexual features, exposure to exogenous sex steroids and the presence of neurological symptoms. The objective examination, in addition to the evaluation of secondary sexual characteristics, must also include the evaluation of auxological parameters. Initial laboratory investigations should include serum gonadotropin levels (LH and FSH) and serum levels of the sex steroids. Brain MRI should be performed as indicated by the 2009 Consensus Statement in all boys regardless of chronological age and in all girls with onset of pubertal signs before 6 years of age. The gold standard in the treatment of central precocious puberty is represented by GnRH analogs, whereas, as far as peripheral forms are concerned, the triggering cause must be identified and treated. At the moment there are no reliable data establishing the criteria for discontinuation of GnRH analog therapy. However, numerous pieces of evidence suggest that the therapy should be suspended at the physiological age at which puberty occurs. |
| first_indexed | 2024-03-10T21:20:16Z |
| format | Article |
| id | doaj.art-08c2f8530794490a9b770b06a8f40134 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-10T21:20:16Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-08c2f8530794490a9b770b06a8f401342023-11-19T16:05:26ZengMDPI AGChildren2227-90672023-10-011010167210.3390/children10101672Clinical Management and Therapy of Precocious Puberty in the Sapienza University Pediatrics Hospital of Rome, ItalyGinevra Micangeli0Roberto Paparella1Francesca Tarani2Michela Menghi3Giampiero Ferraguti4Francesco Carlomagno5Matteo Spaziani6Ida Pucarelli7Antonio Greco8Marco Fiore9Luigi Tarani10Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, ItalyDepartment of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, ItalyDepartment of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, ItalyDepartment of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, ItalyDepartment of Experimental Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, ItalyDepartment of Experimental Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, ItalyDepartment of Experimental Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, ItalyDepartment of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, ItalyDepartment of Sensory Organs, Sapienza University of Rome, 00185 Rome, ItalyInstitute of Biochemistry and Cell Biology, IBBC-CNR, 00185 Rome, ItalyDepartment of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, ItalyPuberty identifies the transition from childhood to adulthood. Precocious puberty is the onset of signs of pubertal development before age eight in girls and before age nine in boys, it has an incidence of 1/5000–1/10,000 with an F:M ratio ranging from 3:1 to 20:1. Precocious puberty can be divided into central, also known as gonadotropin-dependent precocious puberty or true precocious puberty, and peripheral, also recognized as gonadotropin-independent precocious puberty or precocious pseudopuberty. Thus, the main aim of this narrative report is to describe the standard clinical management and therapy of precocious puberty according to the experience and expertise of pediatricians and pediatric endocrinologists at Policlinico Umberto I, Sapienza University of Rome, Italy. In the suspicion of early sexual maturation, it is important to collect information regarding the age of onset, the speed of maturation of secondary sexual features, exposure to exogenous sex steroids and the presence of neurological symptoms. The objective examination, in addition to the evaluation of secondary sexual characteristics, must also include the evaluation of auxological parameters. Initial laboratory investigations should include serum gonadotropin levels (LH and FSH) and serum levels of the sex steroids. Brain MRI should be performed as indicated by the 2009 Consensus Statement in all boys regardless of chronological age and in all girls with onset of pubertal signs before 6 years of age. The gold standard in the treatment of central precocious puberty is represented by GnRH analogs, whereas, as far as peripheral forms are concerned, the triggering cause must be identified and treated. At the moment there are no reliable data establishing the criteria for discontinuation of GnRH analog therapy. However, numerous pieces of evidence suggest that the therapy should be suspended at the physiological age at which puberty occurs.https://www.mdpi.com/2227-9067/10/10/1672precocious pubertypseudopubertychildrenpediatricianGnRh analogs |
| spellingShingle | Ginevra Micangeli Roberto Paparella Francesca Tarani Michela Menghi Giampiero Ferraguti Francesco Carlomagno Matteo Spaziani Ida Pucarelli Antonio Greco Marco Fiore Luigi Tarani Clinical Management and Therapy of Precocious Puberty in the Sapienza University Pediatrics Hospital of Rome, Italy Children precocious puberty pseudopuberty children pediatrician GnRh analogs |
| title | Clinical Management and Therapy of Precocious Puberty in the Sapienza University Pediatrics Hospital of Rome, Italy |
| title_full | Clinical Management and Therapy of Precocious Puberty in the Sapienza University Pediatrics Hospital of Rome, Italy |
| title_fullStr | Clinical Management and Therapy of Precocious Puberty in the Sapienza University Pediatrics Hospital of Rome, Italy |
| title_full_unstemmed | Clinical Management and Therapy of Precocious Puberty in the Sapienza University Pediatrics Hospital of Rome, Italy |
| title_short | Clinical Management and Therapy of Precocious Puberty in the Sapienza University Pediatrics Hospital of Rome, Italy |
| title_sort | clinical management and therapy of precocious puberty in the sapienza university pediatrics hospital of rome italy |
| topic | precocious puberty pseudopuberty children pediatrician GnRh analogs |
| url | https://www.mdpi.com/2227-9067/10/10/1672 |
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