a diagnostic scoring system to distinguish precocious puberty from premature thelarche based on clinical and laboratory findings

Background: the diagnosis of patients who present with early pubertal signs can pose a challenge. objectives: the aim of this study was to design a new diagnostic scoring system based on clinical and laboratory findings to distinguish precocious puberty (pp) from premature thelarche (pt) among girls diagnosed with early puberty. methods: we enrolled 267 girls (pp, n = 164; pt, n = 103) previously diagnosed with early puberty using gnrh test, retrospectively. a diagnostic scoring model (m) was constructed with five variables and their cut off values were determined for scoring: age of onset (6.5 years), bone age (ba)/choronologic age (ca) ratio (≥ 1.1), estradiol (12 pg/ml), uterine length (32 mm) and ovarian volume (1.09 cm³). overall score was determined for model. the model was also applied prospectively to a second girls population (n = 86) that showed signs of early puberty. results: the sensitivity and specificity of model was 89.6% and 87.4%, respectively. in the cohort group, the sensitivity and specificity of model was 90% and 89.4%, prospectively. conclusions: a diagnostic scoring system, based on clinical and laboratory findings can be an alternative or complementary method for the differential diagnosis of early puberty.