Highlights & Basics
- Precocious puberty should be considered when secondary sexual characteristics appear before 8 years of age in girls and 9 years in boys.
- It results in accelerated bone development and sometimes a reduced adult height, and may have a psychosocial impact, especially due to early menses in girls.
- Two forms exist: gonadotropin-dependent precocious puberty (known as central precocious puberty [CPP]; due to premature activation of the hypothalamo-pituitary-gonadal axis) and gonadotropin-independent precocious puberty (GIPP; due to autonomous secretion of sex steroids).
- History should be directed dependent on whether puberty is consonant or disconsonant (i.e., whether the pattern of body changes are consistent with normal puberty or not).
- Treatment of CPP is usually straightforward with gonadotropin-releasing hormone agonists.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Female with GIPP and café au lait hyperpigmented macules in McCune-Albright Syndrome
Hypothalamo-pituitary-gonadal feedback loop. GnRH, gonadotropin releasing hormone; FSH, follicle stimulating hormone; LH, luteinizing hormone
Prader orchidometer
Method of comparing testicular size using the Prader orchidometer
Tanner staging: A, genital rating standards in boys; B, pubic hair rating standards in boys; C, breast rating standards in girls; D, pubic hair rating standards in girls
Male with consonant pubertal development
Male with congenital adrenal hyperplasia and disconsonant pubertal development
Axillary freckling in neurofibromatosis type I
Investigations in patients with precocious puberty
Citations
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Bangalore Krishna K, Fuqua JS, Rogol AD, et al. Use of gonadotropin-releasing hormone analogs in children: update by an international consortium. Horm Res Paediatr. 2019;91(6):357-72. [Abstract][Full Text]
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