Background: Female idiopathic central precocious puberty (ICPP) is a rare disease characterized by the early onset of secondary sexual characteristics before 8 years of age. According to recent reports adult women with early menarche (< 11 years) have a lower lung function and a higher prevalence of asthma symptoms. Objective: The aim of our study is to analyse the lung function and the incidence of asthma symptoms in young women with a history of ICPP treated during childhood with Gonadotropin Releasing Hormone agonist (Gn-Rha). Methods: We compared 23 patients with a history of treated ICPP (mean age 18.7, range 14-27 years) and 20 healthy girls (mean age 21.8, range 14-26). All were evaluated using a questionnaire, spirometry pre and post β2 agonist, impulse oscillometry and measurement of fractional exhaled nitric oxide (FeNo). Results: 8,7% (N=2) of women with a history of ICPP had a significant reversibility of FEV1 after β2-agonist, in absence of asthma symptoms. Patients, non-smokers, had FEV1 (mean 103,5 vs 110,1; p=0,042), FEV1 post β2-agonist (mean 107,1 vs 114,6; p=0,043), FEV1/FVC post β2, (mean 107,1 vs 111,1; p=0,046), PEF (mean 93,9 vs 97,4; p=0,05) and MMEF (mean 90,2 vs 106,5; p=0,023) significantly lower than in healthy controls. Tiffeneau index and MMEF post β2-agonist correlate negatively with the hysterometry at diagnosis of ICPP (p < 0.01 and p < 0.05 respectively). There was a negative correlation between age at diagnosis of ICPP and pulmonary resistance. Unexpectedly FeNo was significantly lower in patients with pre-existing ICPP compared with healthy controls. Conclusions: In our experience, girls treated for ICPP reach a lower lung function and develop a greater bronchial hyperreactivity in adulthood, despite treatment with Gn-Rha. As metabolic and hormonal factors seem to play an important role in achieving pulmonary health in adulthood, it would be useful the evaluation of spirometric parameters in new diagnosis and follow-up of ICPP.
Idiopathic Central Precocious Puberty (ICPP), Adulth lung function and Asthma
GAUDINO, Rossella;MURRI, Virginia;PIAZZA, Michele;Morandi, Grazia;CAVARZERE, Paolo;MAINES, Evelina;ANTONIAZZI, Franco;BONER, Attilio
2013-01-01
Abstract
Background: Female idiopathic central precocious puberty (ICPP) is a rare disease characterized by the early onset of secondary sexual characteristics before 8 years of age. According to recent reports adult women with early menarche (< 11 years) have a lower lung function and a higher prevalence of asthma symptoms. Objective: The aim of our study is to analyse the lung function and the incidence of asthma symptoms in young women with a history of ICPP treated during childhood with Gonadotropin Releasing Hormone agonist (Gn-Rha). Methods: We compared 23 patients with a history of treated ICPP (mean age 18.7, range 14-27 years) and 20 healthy girls (mean age 21.8, range 14-26). All were evaluated using a questionnaire, spirometry pre and post β2 agonist, impulse oscillometry and measurement of fractional exhaled nitric oxide (FeNo). Results: 8,7% (N=2) of women with a history of ICPP had a significant reversibility of FEV1 after β2-agonist, in absence of asthma symptoms. Patients, non-smokers, had FEV1 (mean 103,5 vs 110,1; p=0,042), FEV1 post β2-agonist (mean 107,1 vs 114,6; p=0,043), FEV1/FVC post β2, (mean 107,1 vs 111,1; p=0,046), PEF (mean 93,9 vs 97,4; p=0,05) and MMEF (mean 90,2 vs 106,5; p=0,023) significantly lower than in healthy controls. Tiffeneau index and MMEF post β2-agonist correlate negatively with the hysterometry at diagnosis of ICPP (p < 0.01 and p < 0.05 respectively). There was a negative correlation between age at diagnosis of ICPP and pulmonary resistance. Unexpectedly FeNo was significantly lower in patients with pre-existing ICPP compared with healthy controls. Conclusions: In our experience, girls treated for ICPP reach a lower lung function and develop a greater bronchial hyperreactivity in adulthood, despite treatment with Gn-Rha. As metabolic and hormonal factors seem to play an important role in achieving pulmonary health in adulthood, it would be useful the evaluation of spirometric parameters in new diagnosis and follow-up of ICPP.
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