Table of Contents Author Guidelines Submit a Manuscript
International Journal of Endocrinology
Volume 2017, Article ID 4807163, 6 pages
https://doi.org/10.1155/2017/4807163
Research Article

Central Precocious Puberty and Response to GnRHa Therapy in Children with Cerebral Palsy and Moderate to Severe Motor Impairment: Data from a Longitudinal, Case-Control, Multicentre, Italian Study

1Department of Medical and Surgical Sciences of Mothers, Children and Adults, Paediatric Unit, University of Modena & Reggio Emilia, Via del Pozzo, No. 71, 41124 Modena, Italy
2Department of Paediatrics, University of Messina, Padiglione NI Policlinico Universitario, Via Consolare Valeria, 98125 Messina, Italy
3Department of Pediatrics, University of Aquila, Via Vetoio (Coppito 2), 67100 Coppito, Italy

Correspondence should be addressed to Patrizia Bruzzi; ti.ecila@izzurb.aizirtap

Received 17 April 2017; Accepted 13 June 2017; Published 16 July 2017

Academic Editor: Andrea G. Lania

Copyright © 2017 Patrizia Bruzzi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Children affected by neurodevelopmental disability could experience early pubertal changes at least 20 times more than the general population. Limited data about central precocious puberty (CPP) among children affected by cerebral palsy (CP) are available. Methods. This is a longitudinal, observational, retrospective, case-control study involving 22 children affected by CPP and CP (group A), 22 paired with CP but without CPP (group B), and 22 children with CPP without CP. Auxological, biochemical, and instrumental data were collected at diagnosis of CPP and at 2 follow-up visits. Results. No differences were detected between groups A (at baseline) and B. At diagnosis of CPP, height SDS adjusted for target height (H-TH SDS) was significantly reduced in A than in C (−0.63 ± 1.94 versus 1.56 ± 1.38), while basal LH and oestradiol levels were significantly elevated in A than in C. During follow-up, despite an effective treatment, growth impairment deteriorated in A than in C (Δ H-SDS from diagnosis of CPP to last follow-up: −0.49 ± 0.91 versus 0.21 ± 0.33, ). Conclusions. Diagnosis of CPP could be partially mislead in CP due to growth failure that got worse during follow-up despite therapy. CPP in CP seems to progress rapidly along time supporting the hypothesis of a more intense activation of hypothalamic-pituitary-gonadal-axis in these patients.