Etiology and clinical features of precocious puberty in children referred to the endocrinology clinic of Kashan University of Medical Sciences, Iran

Precocious puberty presents a variety of causes and clinical features, with its prevalence on the rise. This study aimed at investigating the etiology and clinical characteristics of precocious puberty in children referred to the endocrinology clinic of Kashan University of Medical Sciences, Iran.

In this retrospective study, the medical records of children diagnosed with precocious puberty who attended the pediatric endocrinology clinic at Kashan University of Medical Sciences, Iran, between 2007 and 2014, were retrospectively reviewed. A comprehensive history and clinical examination were conducted by a pediatric endocrinologist, along with left hand X-rays and specific hormonal tests.

Among the 357 children meeting the inclusion criteria, only two were boys, one with isolated adrenarche and the other with central precocious puberty. Out of the 355 girls, 315 (88.2%) had central precocious puberty, 19 (5.3%) presented with premature thelarche, 20 (5.6%) exhibited pubarche, and three (0.8%) had transient thelarche. Only 172 children maintained regular follow-up visits, with an average follow-up duration of 23±16 months. Of these, 42 were undergoing treatment, while 130 were monitored for the progression of puberty and the necessity for intervention. Over a 3-6-month period, no change in pubertal stage was observed in 49.6% of children, while 42.6% progressed in thelarche or pubarche, and 7.8% advanced in both pubarche and thelarche. Additionally, 24.8% of children experienced a height growth rate exceeding the 97th percentile.

Central precocious puberty emerged as the predominant cause of precocious puberty symptoms in this study. Furthermore, more than half of girls with true precocious puberty displayed a slow progressive course that did not warrant therapeutic interventions.