Benign vaginal bleeding in 24 prepubertal patients

Clinical, biochemical and imaging features

Aikaterini A. Nella, Paul B. Kaplowitz, Mary Scott Ramnitz, Radha Nandagopal

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objective: Premature menarche is an uncommon, benign condition characterized by isolated or recurrent menstrual bleeding in the absence of secondary sexual characteristics. Methods: We performed an observational retrospective study to further characterize the clinical, biochemical and imaging features of benign prepubertal vaginal bleeding (BPVB). Out of 1037 girls evaluated for precocious puberty over a 5-year period, 24 girls with BPVB were identified based on ≥1 episodes of vaginal bleeding, Tanner I or non-progressive Tanner II breast development, and lack of physical findings suggesting genital infection, trauma or foreign body. Results: Age at presentation ranged from 3 years 2 months to 9 years 11 months. Ten patients (42%) had one episode of vaginal bleeding, six (25%) had two episodes and eight patients (33%) had three or more. First bleeding episode lasted 3 days (range; 1-30 days). Six girls had intermittent spotting for up to 1 year. No breast development was noted in 19 (79%) patients. Minimal breast was present in five girls; early pubic hair was present in 2. LH and FSH were prepubertal; estradiol was >20 pg/mL in two girls. Pelvic ultrasound, performed in 11 patients, showed pre-pubertal uterus and ovaries without adnexal masses. Conclusion: Isolated prepubertal vaginal bleeding is typically benign and self-limited, in the absence of sexual precocity signs or other vaginal pathology. Laboratory and imaging studies are generally unrevealing.

Original languageEnglish (US)
Pages (from-to)821-825
Number of pages5
JournalJournal of Pediatric Endocrinology and Metabolism
Volume27
Issue number9-10
DOIs
StatePublished - Sep 20 2014
Externally publishedYes

Fingerprint

Uterine Hemorrhage
Breast
Hemorrhage
Precocious Puberty
Metrorrhagia
Menarche
Foreign Bodies
Hair
Uterus
Observational Studies
Ovary
Estradiol
Retrospective Studies
Pathology
Wounds and Injuries
Infection

Keywords

  • isolated menses
  • precocious puberty
  • premature menarche

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Pediatrics, Perinatology, and Child Health

Cite this

Benign vaginal bleeding in 24 prepubertal patients : Clinical, biochemical and imaging features. / Nella, Aikaterini A.; Kaplowitz, Paul B.; Ramnitz, Mary Scott; Nandagopal, Radha.

In: Journal of Pediatric Endocrinology and Metabolism, Vol. 27, No. 9-10, 20.09.2014, p. 821-825.

Research output: Contribution to journalArticle

Nella, Aikaterini A. ; Kaplowitz, Paul B. ; Ramnitz, Mary Scott ; Nandagopal, Radha. / Benign vaginal bleeding in 24 prepubertal patients : Clinical, biochemical and imaging features. In: Journal of Pediatric Endocrinology and Metabolism. 2014 ; Vol. 27, No. 9-10. pp. 821-825.
@article{c79e89834bd64547a8965329dd3c64d3,
title = "Benign vaginal bleeding in 24 prepubertal patients: Clinical, biochemical and imaging features",
abstract = "Objective: Premature menarche is an uncommon, benign condition characterized by isolated or recurrent menstrual bleeding in the absence of secondary sexual characteristics. Methods: We performed an observational retrospective study to further characterize the clinical, biochemical and imaging features of benign prepubertal vaginal bleeding (BPVB). Out of 1037 girls evaluated for precocious puberty over a 5-year period, 24 girls with BPVB were identified based on ≥1 episodes of vaginal bleeding, Tanner I or non-progressive Tanner II breast development, and lack of physical findings suggesting genital infection, trauma or foreign body. Results: Age at presentation ranged from 3 years 2 months to 9 years 11 months. Ten patients (42{\%}) had one episode of vaginal bleeding, six (25{\%}) had two episodes and eight patients (33{\%}) had three or more. First bleeding episode lasted 3 days (range; 1-30 days). Six girls had intermittent spotting for up to 1 year. No breast development was noted in 19 (79{\%}) patients. Minimal breast was present in five girls; early pubic hair was present in 2. LH and FSH were prepubertal; estradiol was >20 pg/mL in two girls. Pelvic ultrasound, performed in 11 patients, showed pre-pubertal uterus and ovaries without adnexal masses. Conclusion: Isolated prepubertal vaginal bleeding is typically benign and self-limited, in the absence of sexual precocity signs or other vaginal pathology. Laboratory and imaging studies are generally unrevealing.",
keywords = "isolated menses, precocious puberty, premature menarche",
author = "Nella, {Aikaterini A.} and Kaplowitz, {Paul B.} and Ramnitz, {Mary Scott} and Radha Nandagopal",
year = "2014",
month = "9",
day = "20",
doi = "10.1515/jpem-2013-0415",
language = "English (US)",
volume = "27",
pages = "821--825",
journal = "Journal of Pediatric Endocrinology and Metabolism",
issn = "0334-018X",
publisher = "Walter de Gruyter GmbH & Co. KG",
number = "9-10",

}

TY - JOUR

T1 - Benign vaginal bleeding in 24 prepubertal patients

T2 - Clinical, biochemical and imaging features

AU - Nella, Aikaterini A.

AU - Kaplowitz, Paul B.

AU - Ramnitz, Mary Scott

AU - Nandagopal, Radha

PY - 2014/9/20

Y1 - 2014/9/20

N2 - Objective: Premature menarche is an uncommon, benign condition characterized by isolated or recurrent menstrual bleeding in the absence of secondary sexual characteristics. Methods: We performed an observational retrospective study to further characterize the clinical, biochemical and imaging features of benign prepubertal vaginal bleeding (BPVB). Out of 1037 girls evaluated for precocious puberty over a 5-year period, 24 girls with BPVB were identified based on ≥1 episodes of vaginal bleeding, Tanner I or non-progressive Tanner II breast development, and lack of physical findings suggesting genital infection, trauma or foreign body. Results: Age at presentation ranged from 3 years 2 months to 9 years 11 months. Ten patients (42%) had one episode of vaginal bleeding, six (25%) had two episodes and eight patients (33%) had three or more. First bleeding episode lasted 3 days (range; 1-30 days). Six girls had intermittent spotting for up to 1 year. No breast development was noted in 19 (79%) patients. Minimal breast was present in five girls; early pubic hair was present in 2. LH and FSH were prepubertal; estradiol was >20 pg/mL in two girls. Pelvic ultrasound, performed in 11 patients, showed pre-pubertal uterus and ovaries without adnexal masses. Conclusion: Isolated prepubertal vaginal bleeding is typically benign and self-limited, in the absence of sexual precocity signs or other vaginal pathology. Laboratory and imaging studies are generally unrevealing.

AB - Objective: Premature menarche is an uncommon, benign condition characterized by isolated or recurrent menstrual bleeding in the absence of secondary sexual characteristics. Methods: We performed an observational retrospective study to further characterize the clinical, biochemical and imaging features of benign prepubertal vaginal bleeding (BPVB). Out of 1037 girls evaluated for precocious puberty over a 5-year period, 24 girls with BPVB were identified based on ≥1 episodes of vaginal bleeding, Tanner I or non-progressive Tanner II breast development, and lack of physical findings suggesting genital infection, trauma or foreign body. Results: Age at presentation ranged from 3 years 2 months to 9 years 11 months. Ten patients (42%) had one episode of vaginal bleeding, six (25%) had two episodes and eight patients (33%) had three or more. First bleeding episode lasted 3 days (range; 1-30 days). Six girls had intermittent spotting for up to 1 year. No breast development was noted in 19 (79%) patients. Minimal breast was present in five girls; early pubic hair was present in 2. LH and FSH were prepubertal; estradiol was >20 pg/mL in two girls. Pelvic ultrasound, performed in 11 patients, showed pre-pubertal uterus and ovaries without adnexal masses. Conclusion: Isolated prepubertal vaginal bleeding is typically benign and self-limited, in the absence of sexual precocity signs or other vaginal pathology. Laboratory and imaging studies are generally unrevealing.

KW - isolated menses

KW - precocious puberty

KW - premature menarche

UR - http://www.scopus.com/inward/record.url?scp=84906979853&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84906979853&partnerID=8YFLogxK

U2 - 10.1515/jpem-2013-0415

DO - 10.1515/jpem-2013-0415

M3 - Article

VL - 27

SP - 821

EP - 825

JO - Journal of Pediatric Endocrinology and Metabolism

JF - Journal of Pediatric Endocrinology and Metabolism

SN - 0334-018X

IS - 9-10

ER -