Clinical, laboratory and evaluative aspects of patients with isolated premature thelarche

• Grant number: 22/00847-2
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: May 01, 2022
• End date: April 30, 2023
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Vinicius Nahime de Brito
• Grantee: Giovana Wiezel
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil
• Associated research grant: 19/27631-7 - Genetic and epigenetic studies of endocrine disorders related with reproductive axis, AP.TEM

Abstract

Puberty is considered precocious when there is the development of secondary sexual characteristics before 8 years of age in girls and, before 9 years of age, in boys. Etiologically, it can be classified into (1) central precocious puberty (CPP), resulting from premature reactivation of the hypothalamic-pituitary-gonadal axis, (2) precocious peripheral puberty, which results from inappropriate secretion of sex steroids. Isolated thelarche precocious (IPT) is a variation of normal pubertal development, characterized by unilateral or bilateral breast enlargement in girls before the age of 8 years, without other signs of sexual maturation. This is a benign condition that can spontaneously regress, remain until pubertal development at the usual age, or progress to the progressive form of CPP. Initially, the diagnostic investigation of patients with IPT includes hormonal measurements at baseline, bone age assessment, and pelvic ultrasound. Clinical and laboratory aspects are essential to differentiate IPT from CPP. In cases of IPT, the management is expectant, while in cases of progressive CPP, the treatment of choice is long-acting GnRH agonist analogs. According to previous studies in the literature, the analysis of growth velocity is useful to differentiate CPP from IPT. Other variants were also cited as effective, including SHBG levels and the LH/FSH ratio stimulated by GnRH. Therefore, the aim of this project is to evaluate the clinical and laboratory aspects of girls with IPT and describe their evolutionary aspects.(AU)