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Vaginal bleeding in a 4-month-old preterm girl: extreme minipuberty mimicking central precocious puberty

  • Aafke H.M. de Lange and Gianni Bocca EMAIL logo
Published/Copyright: December 21, 2011
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 26 Issue 5-6

Abstract

We present a 4-month-old girl who showed vaginal bleeding and breast development. She was born preterm at 25 weeks and 4 days of gestation. Luteinizing hormone and follicle-stimulating hormone levels were extremely elevated. Magnetic resonance imaging showed a lesion of unknown nature in the pituitary gland, most likely a Rathke’s cleft cyst. Because central precocious puberty (CPP) was suspected, a gonadotropin-releasing hormone analogue was started. At the age of 18 months, the treatment was stopped. Thereafter, no signs of puberty developed. The pituitary lesion remained unchanged. Therefore, the initial diagnosis of CPP was incorrect, and instead, an extreme minipuberty had occurred. If treatment for idiopathic CPP in girls younger than 2 years is started, we recommend the treatment be stopped after a certain period, for reevaluation of the diagnosis of CPP.

Keywords: central precocious puberty; minipuberty; prematurity; vaginal bleeding
Corresponding author: Gianni Bocca, Department of Pediatric Endocrinology, Beatrix Children’s Hospital, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands Phone: +31 503619868, Fax: +31 503614235

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Received: 2011-7-25
Accepted: 2011-11-16
Published Online: 2011-12-21
Published in Print: 2013-05-01

©2013 by Walter de Gruyter Berlin Boston

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https://doi.org/10.1515/jpem.2011.363
Keywords for this article
central precocious puberty; minipuberty; prematurity; vaginal bleeding

Articles in the same Issue

  1. Masthead
  2. Masthead
  3. Editorial
  4. Success has many fathers, failure is orphan
  5. Review Article
  6. Normosmic idiopathic hypogonadotropic hypogonadism: update on the genetic background and future challenges
  7. Original Articles
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  10. Application of liquid chromatography-tandem mass spectrometry in the diagnosis and follow-up of maple syrup urine disease in a Chinese population
  11. The role of uncoupling protein 2 and 3 genes polymorphism and energy expenditure in obese Indonesian children
  12. Thyroid dysfunctions of prematurity and their impacts on neurodevelopmental outcome1)
  13. Frequency of the E23K polymorphism of the KCNJ11 gene in children born small for gestational age and its influence on auxological and metabolic parameters in the prepubertal period
  14. Reference intervals for serum thyroid hormones in preterm hospitalized infants1)
  15. The clinical and biochemical presentation of vitamin D deficiency and insufficiency in children and adolescents
  16. A risk score for identifying overweight adolescents with dysglycemia in primary care settings1)
  17. Thyroid function and morphology in overweight and obese children and adolescents in a Chinese population
  18. Propionic acidaemia: demographic characteristics and complicationsa
  19. Negative correlation between serum IL-6 level and cardiorespiratory fitness in 10- to 11-year-old boys with increased BMI
  20. Penile length and genital anomalies in Egyptian male newborns: epidemiology and influence of endocrine disruptors
  21. Efficacy of vitamin D loading doses on serum 25-hydroxy vitamin D levels in school going adolescents: an open label non-randomized prospective trial
  22. Characteristics of infants admitted with hypoglycemia to a neonatal unit
  23. Increasing thyroid-stimulating hormone is associated with impaired glucose metabolism in euthyroid obese children and adolescents
  24. The role of FTO genotype on eating behavior in obese Sardinian children and adolescents
  25. Prevalence of multiple forms of autoimmunity in Egyptian patients with Turner syndrome: relation to karyotype
  26. A novel DAX-1 mutation presented with precocious puberty and hypogonadotropic hypogonadism in different members of a large pedigree
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  29. Diabetic ketoacidosis with cerebral hemorrhage and alpha coma in an adolescent female
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  32. A case of autosomal dominant osteopetrosis type II with a novel TCIRG1 gene mutation
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