Precocious puberty in a male with Prader-Labhart-Willi syndrome.

True precocious puberty is reported in a male child with Prader-Labhart-Willi syndrome. The diagnosis of precocious puberty was made at 8 6/12 years of age when a spontaneous migration of previously unpalpable testes (mean volume = 5 ml), an increase in penis length (from 2 to 6 cm) and a growth spurt (8.4 cm/year) occurred. The follow-up until 13 years of age (bone age 15 years) showed a progressive pubertal development, facial acne (10 years), frequent spontaneous erections and ejaculations (11 years). Repeated endocrine and neuroradiological investigations were consistent with an idiopathic form of precocious puberty.

[Premature thelarche and precocious puberty. Clinical findings and endocrinological data useful for differential diagnosis]. / Telarca prematuro e pubertà precoce. Rilievi clinici e dati endocrinologici utili per la diagnosi differenziale.

Clinical features, urocytogram and gonadotropin response to LHRH (100 microgram/1,73 m2 i.v.) were evaluated in 10 girls with premature thelarche and 4 girls with precocious puberty to purpose to describe the differences between the two diseases. The subjects with Premature Thelarche showed peculiar clinical and endocrinological characteristics which allowed their discrimination from patients with Precocious Puberty: 1) breast development of mild degree without any modification of nipples and areolae and not accompanied by pubic hair or morphologic changes of genitalia; 2) spontaneous regression of thelarche more or less complete (6/10 cases); 3) not anticipation of puberal maturation; 4) growth rate not accelerate (only a mild advancement of statural age was observed); 5) LH/FSH ratio at prepuberal levels; 6) mean LH peak values overlapping to those obtained in normal infants under 1 year of age. Our findings confirm that: 1) the girls with Premature Thelarche showed different growth pattern and clinical features than those observed in the girls with Precocious Puberty; 2) LHRH test and urocytogram are further valuable parameters for the differential diagnosis between Premature Thelarche and Precocious Puberty; 3) the isolated breast enlargement in girls under 8 years of age is likely to originate from a protracted gonadotropin hyperstimulation as in early life; 4) it is a variant of the normal, not difficult to asses, which merits, however further follow-up.

[Unilateral monorchidism and cryptorchism. Clinical and biological findings useful in the differential diagnosis]. / Monorchidie et cryptorchidie unilatérale. Données cliniques et biologiques utilisables dans le diagnostic différentiel.

Eighteen prepuberal children with only one testis palpable in the scrotum were studied in order to review the clinical and endocrinological data useful for differentiating monorchidism from unilateral cryptorchidism. Compensatory testicular hypertrophy, high LH and FSH response to LH-RH (100 micrograms/1.73 m2) and well preserved Leydig cell function after HCG (5,000 IU/m2) should lead to the diagnosis of monorchidism, either both congenital or secondary to severe atrophy of the unpalpable testis. When these findings are lacking the diagnosis of unilateral cryptorchidism should be considered.

[Accidental poisoning in children. Epidemiological study and their prevention]. / Le ingestioni accidentali di sostanze tossiche in età pediatrica. Studio epidemiologico e considerazioni sulla loro prevenzione.

A retrospective study was carried out on the incidence of accidental poisoning (A.P.) for children admitted to the Pediatric Clinic of the University of Parma between January Ist 1973 and December 31st 1978. A total of 218 cases of AP, equal to 2,2% of total number of admittances, were registered in this time period. The children were aged from 2 months to 13 years. The toxic substances were divided into two categories: medicinal and household products. The AP tend to increase in Summer (29,8%) and in Winter (30,7%). In this series there was only one fatal outcome (0,5%). Some norms for prevention are considered.