{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T07:56:08Z","timestamp":1761897368843,"version":"3.44.0"},"reference-count":8,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,7,3]]},"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:p>Vaginal bleeding can occur shortly after delivery in 3%\u20135% of newborns as a consequence of placental hormone withdrawal . Although usually benign, its differential diagnosis includes central precocious puberty, tumours and other pathological conditions. A girl born at 26 weeks of gestation presented with five episodes of vaginal bleeding, each lasting less than a week, initiated at 4 months of age. Luteinising hormone and oestradiol levels were in the pubertal range. Later, she exhibited breast development, with no other pubertal signs. An ultrasonography test revealed an impregnated endometrium and a right ovarian cyst with 43 mm of diameter. A cranioencephalic MRI was unremarkable. Clinicians adopted expectant management and there was clinical, hormonal and radiological resolution in 3 months. The spontaneous resolution suggested mini-puberty of infancy. This is usually an asymptomatic condition, but to date, four cases of an exacerbated form in extremepremature infants have been reported. Long-term follow-up data are missing.<\/jats:p>\n               <jats:p>A girl born at 26 weeks of gestation presented with five episodes of vaginal bleeding, each lasting less than a week, initiated at 4 months of age. Luteinising hormone and oestradiol levels were in the pubertal range. Later, she exhibited breast development, with no other pubertal signs. An ultrasonography test revealed an impregnated endometrium and a right ovarian cyst with 43 mm of diameter. A cranioencephalic MRI was unremarkable. Clinicians adopted expectant management and there was clinical, hormonal and radiological resolution in 3 months. The spontaneous resolution suggested mini-puberty of infancy. This is usually an asymptomatic condition, but to date, four cases of an exacerbated form in extremepremature infants have been reported. Long-term follow-up data are missing.<\/jats:p>","DOI":"10.1136\/bcr-2020-235492","type":"journal-article","created":{"date-parts":[[2020,9,3]],"date-time":"2020-09-03T02:35:30Z","timestamp":1599100530000},"page":"e235492","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Exacerbated mini-puberty of infancy in an ex-extreme preterm girl"],"prefix":"10.1136","volume":"13","author":[{"given":"Mafalda Casinhas","family":"Santos","sequence":"first","affiliation":[{"name":"Servi\u00e7o de Pediatria, Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Lim\u00e3o","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Pediatria, Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patr\u00edcia","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Pediatria, Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,9,2]]},"reference":[{"key":"2025082709161003000_13.9.e235492.1","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/j.jpeds.2016.08.021","article-title":"Menstrual bleeding as a manifestation of Mini-Puberty of infancy in severe prematurity","volume":"178","author":"Vogiatzi","year":"2016","journal-title":"J Pediatr"},{"key":"2025082709161003000_13.9.e235492.2","unstructured":"Saenger P , Crowley WF , Martin KA . Definition, etiology, and evaluation of precocious puberty, 2020. Available: http:\/\/uptodate.com\/contents [Accessed Jan 2019]."},{"key":"2025082709161003000_13.9.e235492.3","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2015-3732","article-title":"Evaluation and referral of children with signs of early puberty","volume":"137","author":"Kaplowitz","year":"2016","journal-title":"Pediatrics"},{"key":"2025082709161003000_13.9.e235492.4","doi-asserted-by":"crossref","first-page":"186","DOI":"10.5152\/tpa.2014.2038","article-title":"Mini puberty and its interpretation","volume":"49","author":"Kurto\u011flu","year":"2014","journal-title":"Turk Pediatri Ars"},{"key":"2025082709161003000_13.9.e235492.5","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1515\/jpem.2011.363","article-title":"Vaginal bleeding in a 4-month-old preterm girl: extreme minipuberty mimicking central precocious puberty","volume":"26","author":"de Lange","year":"2013","journal-title":"J Pediatr Endocrinol Metab"},{"key":"2025082709161003000_13.9.e235492.6","unstructured":"KBG Syndrome . Genetics home reference. Available: https:\/\/ghr.nlm.nih.gov\/condition\/kbg-syndrome [Accessed Oct 2019]."},{"key":"2025082709161003000_13.9.e235492.7","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.jpag.2017.03.061","article-title":"Mini-Puberty of infancy in extreme prematurity","volume":"30","author":"Perez-Milicua","year":"2017","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"2025082709161003000_13.9.e235492.8","unstructured":"National Comprehensive Cancer Network Clinical Practical Guidelines in Oncology - Genetical\/Familial High-risk Assessment Breast and Ovarian Version I.2018; 2017."}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-235492","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:16:22Z","timestamp":1756311382000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-235492"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9]]},"references-count":8,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2020,9,2]]},"published-print":{"date-parts":[[2020,9]]}},"alternative-id":["10.1136\/bcr-2020-235492"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-235492","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2020,9]]}}}