ABSTRACT
A "transient" precocious puberty with ovarian follicular cysts was observed in four girls. Each girl presented with several successive and transient episodes of development of secondary sex characters: breast development, areolar pigmentation, brown abdominal median line were the clinical signs of oestrogen secretion. At the time of referral, plasma and urinary gonadotropins levels were low in the prepubertal range while plasma oestradiol concentrations were elevated, in the pubertal range. At this time, as well as during each episode of "pubertal" development, the gonadotropins response to GnRH stimulation was blunted. In contrast, a prepubertal or pubertal response was observed when the clinical symptoms of estrogenization had resumed. Ultrasonography showed one or several ovarian follicular cysts. In two cases, the treatment with the GnRH agonist, D-TRP 6 GnRH [Decapeptyl (R)], was successful, suggesting a central dysfunction
Subject(s)
Ovarian Cysts/complications , Ovarian Follicle , Puberty, Precocious/etiology , Child , Child, Preschool , Cyproterone/therapeutic use , Estradiol/blood , Female , Gonadotropin-Releasing Hormone/analogs & derivatives , Gonadotropin-Releasing Hormone/therapeutic use , Gonadotropins/analysis , Humans , Ovarian Cysts/therapy , Pituitary Hormone-Releasing Hormones , Remission, Spontaneous , Triptorelin PamoateABSTRACT
Bone infection caused by Kingella kingae (Kk) is rare since there are only 15 published cases. We report 5 additional cases with isolation of Kk from fluid or bone aspiration. Kk was sensitive to the most common antibiotics. The outcome was favorable in every case.
Subject(s)
Arthritis, Infectious/etiology , Bacterial Infections , Osteoarthritis/etiology , Osteomyelitis/etiology , Anti-Bacterial Agents/therapeutic use , Bacterial Infections/drug therapy , Child, Preschool , Drug Therapy, Combination , Female , Humans , Male , Moraxella , Osteoarthritis/microbiology , Osteomyelitis/microbiology , Spondylitis/etiologyABSTRACT
Prolactin dosage in delayed growth and puberty leads to the diagnosis of pituitary prolactinoma in a 14 years old boy. Adenoma's size, visual disturbance leads us to elect surgical treatment but persistent hyperprolactinemia after surgery requires medical treatment with bromocriptine.
Subject(s)
Adenoma/metabolism , Pituitary Neoplasms/metabolism , Prolactin/metabolism , Adenoma/drug therapy , Adenoma/surgery , Adolescent , Humans , Male , Pituitary Neoplasms/drug therapy , Pituitary Neoplasms/surgerySubject(s)
Catheterization/methods , Jugular Veins , Subclavian Vein , Catheterization/instrumentation , Child , Emergencies , Humans , MethodsABSTRACT
Among 59 children presenting with congenital adrenal hyperplasia due to 21-hydroxylase deficiency observed between 1976 and 1982, 12 (9 males, 3 females) aged 3 1/2 to 12 years, were treated with medroxyprogesterone acetate (MPA) associated with the usual glucocorticoid and eventually mineralo-corticoid treatment. There were two indications: precocious puberty after the onset of the gluco-mineralo-corticoid treatment; Unbalanced biological status with advancement of bone maturation. After the onset of MPA, a decrease in plasma 17-hydroxyprogesterone (17 OHP) and testosterone levels is observed, the bone maturation speed decreases when growth in height continues. MPA may be a contributive treatment for congenital adrenal hyperplasia due to 21-hydroxylase deficiency, permitting restoration of biological balance by restraining adrenal function and improving the final height prognosis.
Subject(s)
Adrenal Hyperplasia, Congenital , Adrenal Hyperplasia, Congenital/drug therapy , Medroxyprogesterone/analogs & derivatives , Steroid Hydroxylases/deficiency , Adrenal Hyperplasia, Congenital/enzymology , Body Height/drug effects , Body Weight/drug effects , Bone Development/drug effects , Child, Preschool , Drug Therapy, Combination , Female , Fludrocortisone/therapeutic use , Follow-Up Studies , Humans , Hydrocortisone/therapeutic use , Male , Medroxyprogesterone/therapeutic use , Medroxyprogesterone Acetate , Time FactorsABSTRACT
An assay for urinary gonadotropins (UG) performed after acetone extraction is presented. This dosage was performed either on a sample of the 24 assay urine, or on the fractionated 12 hr/12 hr urines (night/day) in normal children whose ages ranged from 2 to 20 years and in children presenting with various endocrine diseases (on about 2,000 urine samples). Normal values were established according to sex and stage of puberty. In boys, the lack of overlap between values of LH (UI/24 hr) observed in stage I (prepubescent, 9-13 yrs) and those observed in stage II represents an obvious biological marker of the onset of puberty. The night/day ratio of LH also increases close to puberty, reflecting the onset of the well-known night secretion of LH, at the time of the first stages of puberty. In girls, the preferential increase in FSH is the best criterion for the onset of puberty. In children with endocrine diseases, assay for UG/24 hr is a valuable parameter of the gonadotropic function allowing 1. to separate delayed puberty from hypogonadotropic hypogonadism; 2. to confirm a diagnosis of precocious puberty and 3. to control a treatment with LHRH analogous.
Subject(s)
Endocrine System Diseases/urine , Gonadotropins, Pituitary/urine , Puberty , Adolescent , Child , Child, Preschool , Female , Humans , Hypogonadism/urine , Male , Preservation, Biological , Puberty, Delayed/urine , Puberty, Precocious/urine , Reference Values , Time FactorsABSTRACT
A case of bacterial endocarditis in a one year-old boy is reported. There was no underlying heart disease. The organism was a Kingella kingae, an aerobic Gram negative bacillus, a normal inhabitant of the upper respiratory tract. It has rarely been implicated as a pediatric pathogen. Occasionally it can cause bone and joint infections and exceptionally endocarditis.
