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Pediatrics in Review Feb 1990The child with premature sexual development requires a thorough history, physical, and appropriate laboratory evaluation. The physician and other medical staff should... (Review)
Review
The child with premature sexual development requires a thorough history, physical, and appropriate laboratory evaluation. The physician and other medical staff should remain sensitive to the family's concerns and the child's emotional adaptation. Counseling and open discussion of the psychosocial and sexual issues may greatly assist both the child and family. Making the correct diagnosis is critical to the selection of the appropriate form of therapy. Fortunately, in most cases in which therapy is warranted, it is extremely effective. In the remaining conditions, promising new forms of therapy are being investigated.
Topics: Adolescent; Child; Female; Humans; Male; Puberty; Puberty, Precocious
PubMed: 2181420
DOI: 10.1542/pir.11-8-229 -
Best Practice & Research. Clinical... Sep 2021Sexual maturation in humans is characterized by a unique individual variability. Pubertal onset is a highly heritable polygenic trait but it is also affected by... (Review)
Review
Sexual maturation in humans is characterized by a unique individual variability. Pubertal onset is a highly heritable polygenic trait but it is also affected by environmental factors such as obesity or endocrine disrupting chemicals. The last 30 years have been marked by a constant secular trend toward earlier age at onset of puberty in girls and boys around the world. More recent data, although more disputed, suggest an increased incidence in idiopathic central precocious puberty. Such trends point to a role for environmental factors in pubertal changes. Animal data suggest that the GnRH-neuronal network is highly sensitive to endocrine disruption during development. This review focuses on the most recent data regarding secular trend in pubertal timing as well as potential new epigenetic mechanisms explaining the developmental and transgenerational effects of endocrine disrupting chemicals on pubertal timing.
Topics: Animals; Endocrine Disruptors; Female; Humans; Male; Obesity; Puberty; Puberty, Precocious; Sexual Maturation
PubMed: 34563408
DOI: 10.1016/j.beem.2021.101579 -
Archivos Argentinos de Pediatria Jun 2023
Topics: Humans; Puberty, Precocious; COVID-19; Argentina
PubMed: 36893338
DOI: 10.5546/aap.2023-03028.eng -
Przeglad Lekarski 2014Precocious puberty in boys is defined as the onset of puberty before the age of 9 years. It is divided into two categories: central precocious puberty, characterized by... (Review)
Review
Precocious puberty in boys is defined as the onset of puberty before the age of 9 years. It is divided into two categories: central precocious puberty, characterized by the premature activation of the hypothalamic-pituitary-gonadal axis, and peripheral precocious puberty presents when premature sexual development is dependent on steroid production regardless of gonadotropin secretion. Although precocious puberty occurs more frequently in girls, in the case of boys it is more often associated with identifiable organic disorders of the central nervous system, adrenal glands or testes. The diagnosis should include detailed anamnesis and clinical examination, measurement of pituitary and sex hormones, assessment of bone age, and imaging of the hypothalamus, pituitary gland, adrenal glands and testes. Indications for treatment are based on the type of precocious puberty and its progression rate, advancement of bone age, predicted adult height and psychological evaluation. The purpose of this article was to discuss the etiopathogenesis of precocious puberty in boys and to provide the approach to its diagnosis, differentiation and treatment.
Topics: Adrenal Gland Diseases; Causality; Central Nervous System Diseases; Child; Child, Preschool; Comorbidity; Female; Humans; Male; Men's Health; Puberty, Precocious; Sex Distribution; Testicular Diseases
PubMed: 25826980
DOI: No ID Found -
Pediatrics in Review Oct 2006
Review
Topics: Breast; Child; Child, Preschool; Diagnosis, Differential; Female; Gonadal Steroid Hormones; Gonadotropin-Releasing Hormone; Hamartoma; Humans; Hypothalamo-Hypophyseal System; Male; Ovary; Physical Examination; Pituitary-Adrenal System; Prognosis; Puberty; Puberty, Precocious; Testis; United States
PubMed: 17012487
DOI: 10.1542/pir.27-10-373 -
Endokrynologia Polska 2009The term precocious puberty is defined as the appearance of secondary sex characteristics before the age of 8 in girls and 9 in boys. There are two major forms of... (Review)
Review
The term precocious puberty is defined as the appearance of secondary sex characteristics before the age of 8 in girls and 9 in boys. There are two major forms of premature sexual maturation: gonadotrophin-dependent (central, or 'true' precocious puberty) and gonadotrophin- independent precocious puberty. The latter, also called peripheral precocious puberty, is characterized by increased production of sex steroids, causing the typical physical changes of puberty, in the absence of reactivation of the hypothalamic-pituitary axis. It may result from several different disorders including testotoxicosis, McCune-Albright syndrome, congenital adrenal hyperplasia, adrenal and gonadal tumours. The accumulation of knowledge regarding the pathogenesis of symptoms and the development of safe, effective treatment modalities have led to earlier intervention in patients with peripheral precocious puberty to prevent the decline in their psychosocial wellbeing, adult height and quality of life. We review the ethiopathogenesis, clinical picture, diagnosis and treatment of various disorders causing peripheral precocious puberty and provide the reader with current recommendations concerning approach to the patient with this health problem.
Topics: Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Adult; Child; Female; Fibrous Dysplasia, Polyostotic; Gonadal Disorders; Growth Disorders; Humans; Male; Puberty, Precocious
PubMed: 20041371
DOI: No ID Found -
Ginekologia Polska Apr 2011Precocious puberty is an early sexual maturation before the age of 8 in case of girls and 9 in boys. There are two types: isosexual precocious puberty--characteristic... (Review)
Review
Precocious puberty is an early sexual maturation before the age of 8 in case of girls and 9 in boys. There are two types: isosexual precocious puberty--characteristic are appropriate for the child's genetic and gonadal sex; and heterosexual precocious puberty--sexual characteristic are inappropriate for the genetic sex (feminizing syndrome in boys or virilizing syndrome in girls). Precocious puberty is an important problem in childhood gynecology pediatrics, endocrinology and psychology.
Topics: Androgens; Child; Female; Humans; Hypothalamo-Hypophyseal System; Male; Menarche; Pituitary Hormone-Releasing Hormones; Puberty, Precocious; Sex Characteristics; Sexual Maturation
PubMed: 21735696
DOI: No ID Found -
Clinical Obstetrics and Gynecology Sep 1987
Review
Topics: Androgens; Child; Child, Preschool; Estrogens; Female; Gonadotropins; Humans; Infant; Male; Puberty, Precocious
PubMed: 3308259
DOI: 10.1097/00003081-198709000-00026 -
Endocrine Development 2016There are many etiologies of peripheral precocious puberty (PPP) with diverse manifestations resulting from exposure to androgens, estrogens, or both. The clinical... (Review)
Review
There are many etiologies of peripheral precocious puberty (PPP) with diverse manifestations resulting from exposure to androgens, estrogens, or both. The clinical presentation depends on the underlying process and may be acute or gradual. The primary goals of therapy are to halt pubertal development and restore sex steroids to prepubertal values. Attenuation of linear growth velocity and rate of skeletal maturation in order to maximize height potential are additional considerations for many patients. McCune-Albright syndrome (MAS) and familial male-limited precocious puberty (FMPP) represent rare causes of PPP that arise from activating mutations in GNAS1 and the LH receptor gene, respectively. Several different therapeutic approaches have been investigated for both conditions with variable success. Experience to date suggests that the ideal therapy for precocious puberty secondary to MAS in girls remains elusive. In contrast, while the number of treated patients remains small, several successful therapeutic options for FMPP are available.
Topics: Adolescent; Female; Fibrous Dysplasia, Polyostotic; Humans; Male; Puberty, Precocious
PubMed: 26680582
DOI: 10.1159/000438895 -
Human Reproduction Update 2004Precocious puberty results mostly from the precocious activation of the gonadotropic axis. Although the age limits have recently been discussed, most physicians consider... (Review)
Review
Precocious puberty results mostly from the precocious activation of the gonadotropic axis. Although the age limits have recently been discussed, most physicians consider that onset of pubertal development before the age of 8 years in a girl or 9 years in a boy warrants at least a clinical and bone age evaluation by a paediatric endocrinologist. The major concern in precocious puberty is the underlying condition, and central nervous system or gonadal neoplasm have to be formally excluded as a first step in the diagnosis. A secondary concern is height, since precocious puberty leads to accelerated growth, accelerated bone maturation and ultimately reduced stature. Precocious puberty is heterogeneous and strict criteria should be used to define it, both in terms of age and in terms of potential for progression. Depot forms of GnRH agonists are now the standard treatment for progressive central precocious puberty and aim at alleviating the clinical symptoms of early pubertal development, their psychological consequences and the effects on growth. Here, we review the consequences of both central and gonadotropin-independent precocious puberty on adult stature and the information available on outcomes using the therapeutic regimens currently available. In girls with progressive precocious puberty, all published evidence indicates a gain of adult height over height predicted before treatment or over untreated historical controls. However, the apparent height gain (derived from the comparison of predicted and actual heights) is very variable, in large part due to the inaccuracy of height prediction methods. In girls with onset of puberty at the lower half of the normal age (8-10 years) distribution, trials using GnRH agonists have given negative results (no benefit of treatment). In boys, precocious puberty is rare and fewer results are available but point in the same direction. The most appropriate time for interrupting the treatment is still controversial. In conclusion, GnRH agonists restore adult height in children when it is compromised by precocious puberty.
Topics: Adolescent; Adult; Body Height; Child; Child Development; Female; Gonadotropin-Releasing Hormone; Gonadotropins; Human Growth Hormone; Humans; Male; Puberty; Puberty, Precocious; Reference Values; Treatment Outcome
PubMed: 15073143
DOI: 10.1093/humupd/dmh012