FINAL HEIGHT AFTER SPONTANEOUS GROWTH IN GIRLS WITH SLOW EVOLUTIVE FORM OF CENTRAL PRECOCIOUS PUBERTY (CPP)

Abstract

The indications and the effect on final height (FH) of luteinizing hormone releasing hormone agonist (LHRHa) therapy in girls with CPP remain difficult to evaluate because of 1) the variability on the level and on the evolution of estrogenic activity before therapy, and 2) the limited number of patients having reached their FH after LHRHa. We have shown that LHRHa is more likely to improve FH prognosis in girls who initially have a markedly advanced bone age and a great difference between their target and predicted heights (Eur J Pediatr 1992, p728). Eleven girls with slow evolutive form (prepubertal estradiol and gonadotropin response to LHRH, bone age advance < 2 yrs at the 1st evaluation) of idiopathic CPP (breast, pubic hair development and growth acceleration <8 yrs, 7.1 ±0.2yrs, m±SE) receiving no therapy were followed until their FH. The age at 1st menstruation was 10.2 ±0.2 yrs (8.9 to 11.4yrs). It did not correlate with that of their mothers (12.3 ±0.5yrs). The total height gain between breast development and FH was 32.4±1.5cm (22.1 to 40); which correlated with the age at breast development (r=−0.86, p<0.005). The FH was 160.3±1.7cm, which was not different from the predicted height (162.7±2cm by Bayley-Pinneau method, difference −7.7 to 4.6cm) at the first evaluation (7.8±0.2yrs) nor with the target height (161.3±1.2cm). However the FH was significantly lower than the height level at 4 yrs (1.4 ±0.3 vs 0±0.3SD, p<0.05).

Conclusion, Precocious and persistant low secretion of estradiol in girls did not decrease the final height. This development may be explained by an early growth acceleration preceeding the breast development and by an increased pubertal height gain.

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