Precocious Puberty

2006 ◽  
Vol 00 (02) ◽  
Author(s):  
Paul B Kaplowitz
Keyword(s):  
Precocious Puberty ◽  
Linear Growth ◽  
Pubertal Development ◽  
Black Girls ◽  
Pubic Hair ◽  
Growth Spurt ◽  
Tall Stature ◽  
Early Puberty ◽  
Bone Maturation ◽  
Early Appearance

Precocious puberty refers to the appearance of physical and hormonal signs of pubertal development at an earlier age than is considered normal.Although traditionally, any signs of puberty in girls prior to age eight years have been considered abnormal, recent studies indicate that signs of early puberty (breasts and pubic hair) are often present in girls (particularly black girls) between ages 6–8 years.The early growth spurt initially can cause tall stature, but rapid bone maturation can cause linear growth to cease too early and result in short adult stature.The early appearance of breasts or menses in girls and increased libido in boys can cause emotional distress for some children.

scholarly journals Heritability of Testosterone Levels in 12-Year-Old Twins and Its Relation to Pubertal Development

2006 ◽  
Vol 9 (4) ◽  
pp. 558-565 ◽  
Author(s):  
Rosa A. Hoekstra ◽  
Meike Bartels ◽  
Dorret I. Boomsma
Keyword(s):  
Pubertal Development ◽  
Environmental Influences ◽  
Pubic Hair ◽  
Self Report ◽  
Early Puberty ◽  
Salivary Testosterone ◽  
Testosterone Levels ◽  
Genital Development ◽  
Opposite Sex ◽  
Hair Development

AbstractThe aim of this study was to estimate the heritability of variation in testosterone levels in 12-year-old children, and to explore the overlap in genetic and environmental influences on circulating testosterone levels and androgen-dependent pubertal development. Midday salivary testosterone samples were collected on 2 consecutive days in a sample of 183 unselected twin pairs. Androgen-induced pubertal development was assessed using self-report Tanner scales of pubic hair development (boys and girls) and genital development (boys). A significant contribution of genetic effects to the variance in testosterone levels was found. Heritability was approximately 50% in both boys and girls. The remaining proportion of the variance in testosterone levels could be explained by nonshared environmental influences. The relatively high correlation between testosterone levels of opposite-sex dizygotic twins suggests that sex differences in genes influencing variation in testosterone levels have not yet developed in preand early puberty. Variance in pubertal development was explained by a large genetic component, moderate shared environmental influences, and a small nonshared environmental effect. Testosterone levels correlated moderately (r = .31) with pubertal development; the covariance between testosterone levels and pubertal development was entirely accounted for by genetic influences.

scholarly journals Adult Height in Girls with Central Precocious Puberty Treated with Gonadotropin-Releasing Hormone Analogues and Growth Hormone

1999 ◽  
Vol 84 (2) ◽  
pp. 449-452 ◽  
Author(s):  
Anna Maria Pasquino ◽  
Ida Pucarelli ◽  
Maria Segni ◽  
Marco Matrunola ◽  
Fabio Cerrone
Keyword(s):  
Precocious Puberty ◽  
Adult Height ◽  
Final Height ◽  
Pubertal Development ◽  
Central Precocious Puberty ◽  
Chronological Age ◽  
Control Group ◽  
Bone Maturation ◽  
Gnrh Analogues ◽  
Age Progression

GnRH analogues (GnRHa) represent the treatment of choice in central precocious puberty (CPP), because arresting pubertal development and reducing either growth velocity (GV) or bone maturation (BA) should improve adult height. However, in some patients, GV decrease is so remarkable that it impairs predicted adult height (PAH); and therefore, the addition of GH is suggested. Out of twenty subjects with idiopathic CPP (treated with GnRHa depot-triptorelin, at a dose of 100 μg/kg im every 21 days, for at least 2–3 yr), whose GV fall below the 25th percentile for chronological age, 10 received, in addition to GnRHa, GH at a dose of 0.3 mg/kg·week sc, 6 days weekly, for 2–4 yr; and 10 matched for BA, chronological age, and duration of GnRHa treatment, who showed the same growth pattern but refused GH treatment, served to evaluate the efficacy of GH addition. No patient showed classical GH deficiency. Both groups discontinued treatment at a comparable BA (mean ± sem): 13.2 ± 0.2 in GnRHa plus GH vs. 13.0 ± 0.1 yr in the control group. At the conclusion of the study, all the patients had achieved adult height. Adult height was considered to be attained when the growth during the preceding year was less than 1 cm, with a BA of over 15 yr. Patients of the group treated with GH plus GnRHa showed an adult height significantly higher (P < 0.001) than pretreatment PAH (160.6 ± 1.3 vs. 152.7 ± 1.7 cm). Target height (TH) was significantly exceeded. The group treated with GnRH alone reached an adult height not significantly higher than pretreatment PAH (157.1 ± 2.5 vs. 155.5 ± 1.9 cm). TH was just reached but not significantly exceeded. The gain in centimeters obtained, calculated between pretreatment PAH and final height, was 7.9 ± 1.1 cm in patients treated with GH combined with GnRHa; whereas in patients treated with GnRHa alone, the gain was just 1.6 ± 1.2 cm (P = 0.001). Furthermore, no side effects have been observed either on bone age progression or ovarian cyst appearance and the gynecological follow-up in the GH-treated patients (in comparison with those treated with GnRHa alone). In conclusion, a gain of 7.9 cm in adult height represents a significant improvement, which justifies the addition of GH for 2–3 yr during the conventional treatment with GnRHa, especially in patients with CPP, and a decrease in GV so marked as to impair PAH, not allowing it to reach even the third centile.

scholarly journals Premature Menarche Associated with Primary Hypothyroidism in a 5.5-Year-Old Girl

2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
Dhrubajyoti Sharma ◽  
Devi Dayal ◽  
Anju Gupta ◽  
Akshay Saxena
Keyword(s):  
Precocious Puberty ◽  
Vaginal Bleeding ◽  
Linear Growth ◽  
Pubertal Development ◽  
Primary Hypothyroidism ◽  
Autoimmune Hypothyroidism ◽  
Rare Association ◽  
History Of ◽  
Multiple Cysts

Children with hypothyroidism generally have delayed pubertal development. Rare association with precocious puberty may occur especially in long standing untreated patients. The cardinal features of hypothyroidism induced pseudo precocious pubertal development include thelarche, galactorrhea and menarche. Other characteristics features are an absence of sexual hair and retardation of linear growth. Its manifestation as isolated menarche has been rarely reported. Recently, a five and half year old girl presented to us with history of one episode of vaginal bleeding. A pelvic ultrasonogram revealed multiple cysts in both ovaries and subsequent investigations led to a diagnosis of autoimmune hypothyroidism.

THE TREATMENT OF PRECOCIOUS PUBERTY WITH CYPROTERONE ACETATE

1973 ◽  
Vol 74 (2) ◽  
pp. 399-408 ◽  
Author(s):  
K. Rager ◽  
R. Huenges ◽  
D. Gupta ◽  
J. R. Bierich
Keyword(s):  
Urinary Excretion ◽  
Precocious Puberty ◽  
Cyproterone Acetate ◽  
Vaginal Bleeding ◽  
Pubic Hair ◽  
Breast Size ◽  
Height Increment ◽  
Bone Maturation ◽  
Growth Prognosis ◽  
Axillary Hair

ABSTRACT Nine patients (8 girls and 1 boy) suffering from precocious puberty received daily 100 mg/m2 cyproterone acetate orally. This treatment inhibited the vaginal bleeding; breast-size and the axillary hair and pubic hair did not further increase. The height increment per year and the bone maturation slowed down. The urinary excretion of androgens was temporarily diminished. It is probable that the growth prognosis could be improved by the administration of cyproterone acetate.

scholarly journals The Role of Pediatric Nutrition as a Modifiable Risk Factor for Precocious Puberty

Life ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 1353
Author(s):  
Valeria Calcaterra ◽  
Elvira Verduci ◽  
Vittoria Carlotta Magenes ◽  
Martina Chiara Pascuzzi ◽  
Virginia Rossi ◽  
...  
Keyword(s):  
Precocious Puberty ◽  
Pubertal Development ◽  
Protective Role ◽  
Positive Influence ◽  
Early Puberty ◽  
Future Health ◽  
Childhood Nutrition ◽  
Nutritional Recommendations ◽  
Complex Process

Puberty is a critical phase of growth and development characterized by a complex process regulated by the neuroendocrine system. Precocious puberty (PP) is defined as the appearance of physical and hormonal signs of pubertal development at an earlier age than is considered normal. The timing of puberty has important public health, clinical, and social implications. In fact, it is crucial in psychological and physical development and can impact future health. Nutritional status is considered as one of the most important factors modulating pubertal development. This narrative review presents an overview on the role of nutritional factors as determinants of the timing of sexual maturation, focusing on early-life and childhood nutrition. As reported, breast milk seems to have an important protective role against early puberty onset, mainly due to its positive influence on infant growth rate and childhood overweight prevention. The energy imbalance, macro/micronutrient food content, and dietary patterns may modulate the premature activation of the hypothalamic–pituitary–gonadal axis, inducing precocious activation of puberty. An increase in knowledge on the mechanism whereby nutrients may influence puberty will be useful in providing adequate nutritional recommendations to prevent PP and related complications.

A 10-Month-Old Infant Presenting With Signs of Precocious Puberty Secondary to a Sclerosing Stromal Tumor of the Ovary in the Absence of Hormonal Elevation

2018 ◽  
Vol 22 (4) ◽  
pp. 375-379 ◽  
Author(s):  
Anthony I Squillaro ◽  
Shengmei Zhou ◽  
Stefanie M Thomas ◽  
Eugene S Kim
Keyword(s):  
Precocious Puberty ◽  
Hair Growth ◽  
Soft Tissue Mass ◽  
Pubic Hair ◽  
Stromal Tumor ◽  
Growth Spurt ◽  
Pediatric Endocrinology ◽  
Tissue Mass ◽  
Sclerosing Stromal Tumor ◽  
Cut Surface

Precocious puberty in an infant is an alarming and infrequent finding, making the differential diagnosis difficult for practitioners. Precocious puberty secondary to a sclerosing stromal tumor (SST) of the ovary is rare. We present a case of a child that began precocious puberty at 3 months of age including development of breast buds, pubic hair, growth spurt, and menarche 5 days prior to presenting to pediatric endocrinology at 10 months. She underwent right salpingo-oophorectomy which demonstrated a soft tissue mass occupying almost the entire ovary with a tan-pink fleshy cut surface. Histological examination confirmed a variant of SST. This case represents an extremely young onset of precocious puberty secondary to a variant of SST without hormonal elevation.

scholarly journals Early life household intactness and timing of pubertal onset in girls: a prospective cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sara Aghaee ◽  
Julianna Deardorff ◽  
Louise C. Greenspan ◽  
Charles P. Quesenberry ◽  
Lawrence H. Kushi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Early Life ◽  
Pubertal Development ◽  
Pubic Hair ◽  
Interval Censoring ◽  
Early Puberty ◽  
Pubertal Onset ◽  
Increased Risk

Abstract Background Girls who experience early-life familial stress may have heightened risk of early puberty, which has adverse implications for adolescent and adult health. We assessed the association between household intactness and pubertal onset using a racially/ethnically diverse cohort of girls from Northern California. Methods A prospective cohort study of 26,044 girls born in 2003-10. Girls living with both parents from birth up to 6 years were considered to come from “intact” households while others constituted “non-intact” households. Pubertal development was measured using pediatrician-assessed Tanner staging for breast and pubic hair. Pubertal onset was defined as the transition from Tanner Stage 1 to 2+ for breast (thelarche) and pubic hair (pubarche). Menarche data was collected from routine well-child questionnaires. Weibull regression models accommodating left, right, and interval censoring were used to determine risk of earlier thelarche and pubarche, and logistic regressions were used to assess the risk of early menarche (age < 12). Results Girls exposed to non-intact households before age 2 years were at increased risk for earlier thelarche and pubarche with significant effect modification by race/ethnicity, compared with girls from intact households. The associations were strongest among Black girls (adjusted hazard ratio [HR]: 1.60, 95% confidence interval [CI]: 1.29,1.98; HR: 1.42, 95%CI: 1.15,1.77 for thelarche and pubarche, respectively). There were no significant associations among Asian/Pacific Islanders. Girls who lived in non-intact households before age 2 years were also at increased risk for earlier menarche, but without race/ethnic interaction. Adjustment for prepubertal obesity did not change these associations. Associations between living in non-intact households after age 2 years and early puberty were weaker but still significant. Conclusions Exposure to a non-intact household early in life may increase the risk of early puberty in girls. Future psychosocial interventions focused on improving family cohesiveness and efforts to reduce childhood stress among families that are non-intact may mitigate these negative associations, thereby preventing future adverse health effects of early puberty and health disparities.

Gonadotropin- and Adrenocorticotropic Hormone-Independent Precocious Puberty of Gonadal Origin in a Patient with Adrenal Hypoplasia Congenita Due to DAX1 Gene Mutation – A Case Report and Review of the Literature: Implications for the Pathomechanism

2018 ◽  
Vol 91 (5) ◽  
pp. 336-345 ◽  
Author(s):  
Stella A. Nagel ◽  
Michaela F. Hartmann ◽  
Felix G. Riepe ◽  
Stefan A. Wudy ◽  
Martin Wabitsch
Keyword(s):  
Gene Mutation ◽  
Precocious Puberty ◽  
Adrenocorticotropic Hormone ◽  
Pubertal Development ◽  
Hypogonadotropic Hypogonadism ◽  
Bone Age ◽  
Pubic Hair ◽  
Adrenal Hypoplasia Congenita ◽  
Body Odour ◽  
Adrenal Hypoplasia

Background/Aims: Mutations in the DAX1 gene cause X-linked adrenal hypoplasia congenita (AHC) classically associated with hypogonadotropic hypogonadism. Unexpectedly, precocious puberty (PP) has been reported in some cases, its mechanism remaining unclear. Methods: We longitudinally studied a boy with AHC due to DAX1 gene mutation who developed peripheral PP at age 4.5 years. Initially he presented pubic hair, penile enlargement, advanced bone age and elevated testosterone levels. PP progressed with acne, body odour and ejaculations. In addition, we summarized reported findings of patients with DAX1 mutations and PP in the literature in a structured manner providing a basis to discuss possible pathomechanisms of PP in DAX1 patients. Results: In our patient, hydrocortisone treatment was increased to 20 mg/m2/day as suggested in similar published cases. However, despite the suppression of adrenocorticotropic hormone (ACTH), this remained without clinical effect or change in laboratory results. The progression of symptoms of pubertal development was well suppressed under cyproterone acetate treatment. Twenty-four-hour steroid urine excretion rate measurements excluded an effect of adrenal androgens and showed a prepubertal rise of excreted testosterone. Testes size remained small. GnRH testing showed peripheral PP. Conclusion: We hypothesize that an intrinsic, gonadotropin- and ACTH-independent activation of steroidogenesis in the DAX1 deficient testes leads to PP in AHC patients with DAX1 mutations.

scholarly journals Precocious Puberty – A Case Report

2016 ◽  
Vol 30 (2) ◽  
pp. 109-112
Author(s):  
Poly Begum ◽  
Dipti Rani Saha ◽  
Md Kamrul Hassan
Keyword(s):  
Precocious Puberty ◽  
Pubertal Development ◽  
Tanner Stage ◽  
Central Precocious Puberty ◽  
Female Child ◽  
Pubic Hair ◽  
Breast Development ◽  
Average Height ◽  
Hypothalamic Pituitary Axis ◽  
Hair Development

The parents of a 04-year-old girl bring her to a Gynaecologist because of breast development, appearance of pubic hair and periodic per vaginal bleeding. Her medical history is unremarkable. The parents are of average height, and the mother reports first menstruating when she was 11 years old. At physical examination, the girl is 100 cm tall , weighs 17 kg, and has a bodymass index of 17. Her pubertal development is classified as Tanner stage 3 breast development and Tanner stage 2 pubic hair development. She was diagnosed as a case of precocious puberity. Appearance of secondary sexual development before the age of 9 in a male child and before the age of 8 in a female child is called precocious puberty. When the cause of precocious puberty is premature activation of the hypothalamic-pituitary axis, it is called central or complete precocious puberty and she was a case of central precocious puberty. After proper consult she was treated by GnRHa suppressor of pituitary till 11 years of age.Bangladesh J Obstet Gynaecol, 2015; Vol. 30(2) : 109-112

scholarly journals Etiology of Increased Referrals for Evaluation of Early Puberty in a Tertiary Care Center in Turkey: True Precocious Puberty, Obesity, or Parental Anxiety and Lack of Knowledge?

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110090
Author(s):  
Ayse Pinar Cemeroglu ◽  
Damlanur Kaval ◽  
Ozan Ozcan
Keyword(s):  
Precocious Puberty ◽  
Care Center ◽  
Pubertal Development ◽  
Tertiary Care ◽  
Parental Anxiety ◽  
Adrenal Hyperplasia ◽  
Pediatric Endocrinology ◽  
Early Puberty ◽  
Classic Congenital Adrenal Hyperplasia ◽  
Timing Of Puberty

There has been a global increase in pediatric endocrinology referrals for the concerns of early puberty. The objective of this study was to determine the reasons behind this increase. A retrospective cross-sectional study was designed to analyze the clinical characteristics of patients seen for the concerns of early puberty in pediatric endocrinology clinic of a tertiary care center (Study A). Additionally, a prospective questionnaire study was designed to assess the knowledge and concerns of the mothers regarding the timing of puberty in girls (Study B). In study A, of the 305 girls, 42.9% were overweight/obese, 68.5% either had normal pubertal development for age or were prepubertal, 1 had non-classic congenital adrenal hyperplasia, and 2 had central precocious puberty. Of the 36 boys, 56% were overweight/obese, 64% either had normal pubertal development for age or were prepubertal, and 1 had non-classic congenital adrenal hyperplasia. In study B, 95% of the participants thought the girls have been developing earlier, over 10% considered the first sign of puberty to be normal after the age 14 years and 12.4% considered menarche to be normal after age 14 years. The common sources of anxiety for the participants regarding the earlier timing of puberty were psychosocial issues and short final height. In conclusion, many parents had wrong beliefs/information about the normal timing of puberty and were concerned about precocious puberty in girls. Education of parents about the normal timing of puberty may help avoiding unnecessary referrals, parental anxiety, and financial burden to the society.

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