越南南部中枢性性早熟女童初诊时的病理性脑损伤
Pathological brain lesions in girls with central precocious puberty at initial diagnosis in Southern Vietnam.
作者信息
Huynh Quynh Thi Vu, Ho Ban Tran, Le Nguyen Quoc Khanh, Trinh Tung Huu, Lam Luu Ho Thanh, Nguyen Ngan Thi Kim, Huang Shih-Yi
机构信息
Department of Pediatrics, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh city, Ho Chi Minh City, Vietnam.
Department of Nephrology and Endocrinology, Children's Hospital 2, Ho Chi Minh City, Vietnam.
出版信息
Ann Pediatr Endocrinol Metab. 2022 Jun;27(2):105-112. doi: 10.6065/apem.2142146.073. Epub 2022 May 16.
PURPOSE
Cranial magnetic resonance imaging (MRI) is recommended to identify intracranial lesions in girls with central precocious puberty (CPP). Yet, the use of routine MRI scans in girls with CPP is still debatable, as pathological findings in girls 6 years of age or older with CPP are limited. Therefore, we aimed to identify the prevalence of brain lessons in CPP patients stratified by age group (0-2, 2-6, and 6-8 years).
METHODS
This retrospective cross-sectional study recruited 257 girls diagnosed with CPP for 6 years (2010-2016). MRI was used to detect brain abnormalities. Levels of luteinizing hormone, follicle-stimulating hormone, and sex hormones in blood samples were measured.
RESULTS
Most girls had no brain lesions (82.9%, n=213), and of the minor proportion of girls with CPP that exhibited brain lesions (17.1%, n=44), 32 girls had organic CPP. Pathological findings were detected in 33.3% (2 of 6) of girls aged 0-2 years, 15.6% (5 of 32) of girls aged 2-6 years, and 3.6% (8 of 219) of girls aged 6-8 years. Hypothalamic hamartoma and tumors in the pituitary stalk were the most common pathological findings. The likelihood of brain lesions decreased with age. Girls with organic CPP were more likely to be younger (6.1±2.4 vs. 7.3±1.3 years, p<0.01) than girls with idiopathic CPP.
CONCLUSION
Older girls appeared to have a lower prevalence of organic CPP. Clinicians should cautiously use cranial MRI for girls aged 6-8 years with CPP.
目的
推荐采用头颅磁共振成像（MRI）来识别中枢性性早熟（CPP）女童的颅内病变。然而，对于CPP女童进行常规MRI扫描的应用仍存在争议，因为6岁及以上CPP女童的病理检查结果有限。因此，我们旨在确定按年龄组（0 - 2岁、2 - 6岁和6 - 8岁）分层的CPP患者脑部病变的患病率。
方法
这项回顾性横断面研究纳入了257例在6年期间（2010 - 2016年）被诊断为CPP的女童。采用MRI检测脑部异常情况。测量血样中黄体生成素、卵泡刺激素和性激素的水平。
结果
大多数女童没有脑部病变（82.9%，n = 213），在少数有脑部病变的CPP女童中（17.1%，n = 44），32例女童患有器质性CPP。在0 - 2岁女童中有33.3%（6例中的2例）、2 - 6岁女童中有15.6%（32例中的5例）以及6 - 8岁女童中有3.6%（219例中的8例）检测到病理检查结果。下丘脑错构瘤和垂体柄肿瘤是最常见的病理检查结果。脑部病变的可能性随年龄增长而降低。与特发性CPP女童相比，器质性CPP女童年龄更小（6.1±2.4岁 vs. 7.3±1.3岁，p<0.01）。
结论
年龄较大的女童器质性CPP的患病率似乎较低。临床医生对于6 - 8岁的CPP女童应谨慎使用头颅MRI。
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