Vanelli M, Bernasconi S, Caronna N, Balestrazzi P, Cavagni G, Ziveri M, Rocca M, Rossi S, Turni A
Acta Biomed Ateneo Parmense. 1981;52(2-3):153-8.
Clinical features, urocytogram and gonadotropin response to LHRH (100 microgram/1,73 m2 i.v.) were evaluated in 10 girls with premature thelarche and 4 girls with precocious puberty to purpose to describe the differences between the two diseases. The subjects with Premature Thelarche showed peculiar clinical and endocrinological characteristics which allowed their discrimination from patients with Precocious Puberty: 1) breast development of mild degree without any modification of nipples and areolae and not accompanied by pubic hair or morphologic changes of genitalia; 2) spontaneous regression of thelarche more or less complete (6/10 cases); 3) not anticipation of puberal maturation; 4) growth rate not accelerate (only a mild advancement of statural age was observed); 5) LH/FSH ratio at prepuberal levels; 6) mean LH peak values overlapping to those obtained in normal infants under 1 year of age. Our findings confirm that: 1) the girls with Premature Thelarche showed different growth pattern and clinical features than those observed in the girls with Precocious Puberty; 2) LHRH test and urocytogram are further valuable parameters for the differential diagnosis between Premature Thelarche and Precocious Puberty; 3) the isolated breast enlargement in girls under 8 years of age is likely to originate from a protracted gonadotropin hyperstimulation as in early life; 4) it is a variant of the normal, not difficult to asses, which merits, however further follow-up.
对10例乳房早发育女童和4例性早熟女童的临床特征、尿细胞图以及促性腺激素对促黄体生成素释放激素(LHRH,100微克/1.73平方米静脉注射)的反应进行了评估,目的是描述这两种疾病之间的差异。乳房早发育的患儿表现出独特的临床和内分泌特征,可与性早熟患儿相鉴别:1)乳房轻度发育,乳头和乳晕无任何改变,且不伴有阴毛生长或生殖器形态变化;2)乳房发育或多或少完全自发消退(6/10例);3)青春期成熟未提前;4)生长速度未加快(仅观察到身高年龄有轻度提前);5)促黄体生成素/促卵泡生成素比值处于青春期前水平;6)促黄体生成素峰值均值与1岁以下正常婴儿的峰值均值重叠。我们的研究结果证实:1)乳房早发育女童的生长模式和临床特征与性早熟女童不同;2)促黄体生成素释放激素试验和尿细胞图是乳房早发育和性早熟鉴别诊断的更有价值的参数;3)8岁以下女童单纯乳房增大可能源于生命早期持续的促性腺激素过度刺激;4)这是一种正常变异,不难评估,但仍需进一步随访。