Selecting girls with precocious puberty for brain imaging: Validation of European evidence-based diagnosis rule

Martin Chalumeau, Charalambos G. Hadjiathanasiou, Sze M. Ng, Alessandra Cassio, Dick Mul, Mariangela Cisternino, Carl Joachim Partsch, Charalambos Theodoridis, Mohammed Didi, Emanuele Cacciari, Wilma Oostdijk, Alessandro Borghesi, Wolfgang G. Sippell, Gérard Bréart, Raja Brauner

Research output: Contribution to journalArticlepeer-review


Objectives: To test the sensitivities of recently published American recommendations predicting occult intracranial lesion (OICL) in girls with central precocious puberty (CPP), and to validate a previously derived diagnosis rule predicting OICL based on age at puberty onset and estradiol (E2) level. Study design: A retrospective, multicenter, hospital-based, cohort study was performed, including all girls with CPP seen in 7 centers in 6 European countries during given periods. American recommendations and the previously derived diagnosis rule were tested. Results: Girls with CPP (n = 443), including 35 with OICL, were recruited. American recommendations did not identify all OICL. Previously identified independent risk factors for OICL were confirmed: age 45th percentile (3.0; 95% CI, 1.3-7.1). The previously derived diagnosis rule had 100% sensitivity (95% CI, 90-100): all girls with OICL had either an age 45th percentile. The specificity was 39% (95% CI, 34-44). Conclusions: American recommendations do not seem safe to select European girls with CPP who require brain imaging. In settings where systematic brain imaging is not possible, the proposed diagnosis rule could safely help to avoid more than one third of unnecessary brain imaging.

Original languageEnglish
Pages (from-to)445-450
Number of pages6
JournalJournal of Pediatrics
Issue number4
Publication statusPublished - Oct 2003

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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