Is cranial imaging necessary in girls between 6-8 years diagnosed with central precocious puberty?

Background: There is no clear consensus on whether a cranial MRI should be performed in all cases of central precocious puberty (CPP). In this study, we aimed to evaluate the incidence of intracranial lesions and to analyze cranial imaging results in females with CPP.

Methods: In the retrospective study medical records of the case, the age at the time of admission, anthropometric measurements, bone age, Tanner stages, serum follicle-stimulating hormone (FSH), serum luteinizing hormone (LH), serum estradiol (E2) levels, the peak LH level during the gonadotropin-releasing hormone (GnRH) stimulation test and the cranial MRI findings at the time of the diagnosis of CPP were collected.

Results: The mean age diagnosis of the 154 girls included in the study was 6.9±1.08. Nine (5.8%) of 154 patients were diagnosed with organic-caused CPP. Four of the nine cases diagnosed with organic CPP had a previously known CNS pathology. The other five cases did not have any neurological finding at the time of diagnosis. Incidental lesions were detected at cranial MRI of nine of the 145 cases diagnosed with idiopathic CPP. The basal E2, basal LH, basal FSH, peak LH and peak LH/FSH levels of the cases with organic CPP were higher than those with idiopathic CPP.

Conclusions: In our study, approximately 90% of organic CPP due to intracranial lesions were between 6-8 years old. Therefore, we believe that cranial imaging should be performed in all females with CPP.