Premature Thelarche: Age at Presentation Affects Clinical Course but Not Clinical Characteristics or Risk to Progress to Precocious Puberty

Objectives

To determine whether age at premature thelarche (PT) onset affects the clinical characteristics, course, and risk of progression to precocious puberty (PP).

Study design

Data regarding course of growth and puberty were retrieved from the medical files of 139 girls with PT followed up from 1995 to 2005. Analysis was based on age at PT appearance (birth, 1-24 months, and 2-8 years); course was categorized as regressive, persistent, progressive, or cyclic.

Results

At diagnosis, height standard deviation score, bone age-chronological age ratio, and hormonal values were comparable in the 3 age groups. PT regressed in 50.8%, persisted in 36.3%, progressed in 3.2% and had a cyclic course in 9.7%. A progressive or cyclic course was significantly more prevalent among girls presenting after 2 years (52.6%) compared with girls presenting at birth (13.0%) or at 1 to 24 months (3.8%) (P < .001). PP occurred in 13% irrespective of age at PT presentation or clinical course.

Conclusions

Clinical and anthropometric characteristics at admission and risk of PP were similar in all girls with PT, regardless of age at onset. There are currently no clinical or laboratory tests that can predict the risk of progression to PP at presentation.

BA, Bone age, BMI, Body mass index, CA, Chronological age, FSH, Follicle-stimulating hormone, GnRH, Gonadotropin-releasing hormone, Ht-SDS, Height standard deviation score, LH, Luteinizing hormone, PP, Precocious puberty, PT, Premature thelarche, SDS, Standard deviation score, SGA, Small for gestational age, Wt-SDS, Weight standard deviation score