Etiological profile of precocious puberty in children at a Tertiary Care Hospital.

Objective: To determine the etiological profile of precocious puberty in children. Study Design: Cross-sectional study. Setting: Department of Endocrinology, National Institute of Child Health, Karachi, Pakistan. Period: October 2023 to September 2024. Methods: Children of either gender, girls aged below 8 years, boys below < 9 years, and newly diagnosed cases of precocious puberty were analyzed. At the time of enrollment, demographic and clinical features were documented. Radiological and hormonal profiling were performed for the confirmation of etiology and type of precocious puberty. Results: In a total of 48 children, 23 (47.9%) were boys, and 25 (52.1%) girls. The mean age was 5.72±1.78 years. The most frequent clinical features were rapid height growth, adult body odor, and breast enlargement, noted in 48 (100%), 42 (87.5%), and 25 (52.1%) cases, respectively. Precocious puberty type was central, and peripheral among 25 (52.1%), and 23 (47.9%) children, respectively. Among central precocious puberty cases (n=25), the evaluation of etiology revealed that idiopathic in 17 (68.0%) children, hypothalamic hemartoma 3 (12.0%), mitochondrial encephalopathy 2 (8.0%), craniopharyngioma 2 (8.0%), and arachnoid cyst 1 (4.0%). Among 23 peripheral puberty cases, congenital adrenal hyperplasia was identified in 18 (78.3%) children, adrenocorticol carcinoma 2 (8.7%), ovarian teratoma 2 (8.7%), and Mccune-Albright syndrome in 1 (4.3%). Conclusion: Idiopathic central precocious puberty and congenital adrenal hyperplasia emerged as the most common causes of central and peripheral precocious puberty, respectively.