苏丹的中枢性性早熟:儿科内分泌中心 10 年的经验。

Olivia A Al-Hassan, Mary S Limbe, Justin Warner, Salwa A Musa, Mohamed A Abdullah
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摘要

中枢性性早熟(CPP)是内分泌门诊的常见病。这项研究的目的是获得有关这一病症的基础数据,试图指出苏丹可能存在的任何独特之处,并探讨在管理中面临的挑战以及文化和传统习俗可能如何阻碍护理工作。在此,我们首次报告了苏丹受试者在这方面的数据。2006 年 1 月至 2016 年期间在加法尔-伊布纳夫儿童医院和索巴大学医院内分泌诊所被诊断为 CPP 的患者被纳入了一项以医院为基础的描述性研究,该研究在这两个主要的儿科内分泌中心进行了 10 年。研究回顾了所有 CPP 患者的记录,并确定了诊断和管理方面的挑战。大多数 CPP 患儿发病较晚。与文献报道的情况相比,器质性病因在女孩中更为常见;在大多数男孩中,CPP是特发性的。几乎半数有潜在病因的患者年龄超过 6 岁。包括女孩在内的大多数病例都有器质性病因,因此所有患者都应进行磁共振成像检查。在资源有限的国家,性早熟的治疗面临着各种挑战(如昂贵的检查和药物)。我们建议制定统一的方案来管理这些病例,并在政府、非政府组织和医疗服务机构之间建立合作关系。
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Central precocious puberty in Sudan: 10 years' experience of paediatric endocrinology centres.

Central precocious puberty (CPP) is frequently seen among cases presenting to our endocrine clinics. The purpose of this study was to have base line data on this condition with an attempt to point out any possible unique features of Sudan and to explore challenges faced in management and how that cultural and traditional practices may hamper care. Here, we are reporting the first data on this aspect from Sudanese subjects. Patients labelled as having CPP in Gafaar Ibnauf Children's Hospital and Soba University Hospital Endocrinology Clinics from January 2006 to 2016 are included in a descriptive hospital-based study which was conducted over 10 years in these two main paediatric endocrinology centres. Records of all patients with CPP were reviewed and challenges in diagnosis and management were identified. Most of the children with CPP presented late. Organic causes were more frequent among girls than what has been reported in the literature; in most boys, it was idiopathic. Almost half of the patients with underlying pathology were older than 6 years of age. Most cases including girls have an organic cause, thus magnetic resonance image should be done in all patients. Management of precocious puberty in a resource-limited country is faced with various challenges (e.g., expensive investigations and medications). We suggest establishing a unified protocol for managing these cases and creating collaboration between governmental, nongovernmental organisations and health services.

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