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Different Faces of Minipuberty in Preterm Twin Girls: A Case Report and Review of the Literature

Minipuberty (MP) consists of a postnatal activation of the hypothalamic-pituitary-gonadal (HPG) axis, which occurs physiologically during the first months of life. In preterm infants, MP might lead to stronger hormonal stimulation, but specific literature is still scarce. We present the case of a pa...

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Autores principales: Pepe, Giorgia, Calafiore, Mariarosa, Velletri, Maria Rosa, Corica, Domenico, Li Pomi, Alessandra, Wasniewska, Malgorzata, Aversa, Tommaso
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9863334/
https://www.ncbi.nlm.nih.gov/pubmed/36675445
http://dx.doi.org/10.3390/jcm12020517
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author Pepe, Giorgia
Calafiore, Mariarosa
Velletri, Maria Rosa
Corica, Domenico
Li Pomi, Alessandra
Wasniewska, Malgorzata
Aversa, Tommaso
author_facet Pepe, Giorgia
Calafiore, Mariarosa
Velletri, Maria Rosa
Corica, Domenico
Li Pomi, Alessandra
Wasniewska, Malgorzata
Aversa, Tommaso
author_sort Pepe, Giorgia
collection PubMed
description Minipuberty (MP) consists of a postnatal activation of the hypothalamic-pituitary-gonadal (HPG) axis, which occurs physiologically during the first months of life. In preterm infants, MP might lead to stronger hormonal stimulation, but specific literature is still scarce. We present the case of a pair of monochorionic diamniotic twin girls, born at 31 weeks of gestation and adequate for gestational age (AGA). At one month old, one of the twins presented with severe edema in the vulva and swelling of the major and minor labia. Laboratory evaluations highlighted increased LH, FSH and estradiol serum concentration. Pelvic ultrasonography and MRI showed a pubertal pattern. Brain imaging was unremarkable. During the one-year follow-up, a decreasing trend of hormonal levels was detected, together with the spontaneous regression of clinical and sonographic pubertal signs. The same hormonal workup was also performed on the other twin, who displayed mildly elevated gonadotropins and estradiol, without evidence of pubertal clinical signs. This case suggests that the amplitude of postnatal HPG activation might be exacerbated in preterm infants, with evidence of puberty changes in clinical, laboratory and sonography data. The spontaneous resolution, together with the exclusion of other causes of precocious puberty, is suggestive for MP of infancy.
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spelling pubmed-98633342023-01-22 Different Faces of Minipuberty in Preterm Twin Girls: A Case Report and Review of the Literature Pepe, Giorgia Calafiore, Mariarosa Velletri, Maria Rosa Corica, Domenico Li Pomi, Alessandra Wasniewska, Malgorzata Aversa, Tommaso J Clin Med Case Report Minipuberty (MP) consists of a postnatal activation of the hypothalamic-pituitary-gonadal (HPG) axis, which occurs physiologically during the first months of life. In preterm infants, MP might lead to stronger hormonal stimulation, but specific literature is still scarce. We present the case of a pair of monochorionic diamniotic twin girls, born at 31 weeks of gestation and adequate for gestational age (AGA). At one month old, one of the twins presented with severe edema in the vulva and swelling of the major and minor labia. Laboratory evaluations highlighted increased LH, FSH and estradiol serum concentration. Pelvic ultrasonography and MRI showed a pubertal pattern. Brain imaging was unremarkable. During the one-year follow-up, a decreasing trend of hormonal levels was detected, together with the spontaneous regression of clinical and sonographic pubertal signs. The same hormonal workup was also performed on the other twin, who displayed mildly elevated gonadotropins and estradiol, without evidence of pubertal clinical signs. This case suggests that the amplitude of postnatal HPG activation might be exacerbated in preterm infants, with evidence of puberty changes in clinical, laboratory and sonography data. The spontaneous resolution, together with the exclusion of other causes of precocious puberty, is suggestive for MP of infancy. MDPI 2023-01-08 /pmc/articles/PMC9863334/ /pubmed/36675445 http://dx.doi.org/10.3390/jcm12020517 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Pepe, Giorgia
Calafiore, Mariarosa
Velletri, Maria Rosa
Corica, Domenico
Li Pomi, Alessandra
Wasniewska, Malgorzata
Aversa, Tommaso
Different Faces of Minipuberty in Preterm Twin Girls: A Case Report and Review of the Literature
title Different Faces of Minipuberty in Preterm Twin Girls: A Case Report and Review of the Literature
title_full Different Faces of Minipuberty in Preterm Twin Girls: A Case Report and Review of the Literature
title_fullStr Different Faces of Minipuberty in Preterm Twin Girls: A Case Report and Review of the Literature
title_full_unstemmed Different Faces of Minipuberty in Preterm Twin Girls: A Case Report and Review of the Literature
title_short Different Faces of Minipuberty in Preterm Twin Girls: A Case Report and Review of the Literature
title_sort different faces of minipuberty in preterm twin girls: a case report and review of the literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9863334/
https://www.ncbi.nlm.nih.gov/pubmed/36675445
http://dx.doi.org/10.3390/jcm12020517
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