SEARCH RESULTS FOR: Precocious-Puberty

Precocious Puberty

Precocious Puberty: Pathogenesis and clinical findings Secondary sex characteristics appearing at age < 8 years in girls and < 9 years in boys. Early growth acceleration Bone age (skeletal maturity determined on x-ray) > chronological age Gonadotropin releasing hormone (GnRH)-dependent causes involve activation of the hypothalamic-pituitary-gonadal (HPG) axis. Also known as central precocious puberty GnRH-independent causes of precocious puberty are related to increased amounts of hormone in the body. Also known as peripheral precocious puberty Neurogenic (previous CNS insult) and CNS tumors (e.g. hypothalamic hamartoma, germinoma, astrocytoma) Idiopathic Tumours causing ↑ hormone levels Exogenous hormones causing ↑ hormone levels Genetics causing ↑ hormone levels 21-hydroxylase enzyme deficiency Growth of ovarian cysts/tumors (ex. germinoma, teratoma, choriocarcinoma) Growth of β-HCG-secreting tumours (e.g. germinomas, dysgerminomas, hepatomas Growth of benign or malignant adrenal tumours (e.g. adenoma, carcinoma) ↑ Estrogen and/or progesterone ↑ Beta-HCG stimulates ↑ testosterone production ↑ Cortisol, androgens, and/or aldosterone Exposure to exogenous sex steroids (e.g. anabolic steroids, topical testosterone, oral contraceptives) Steroid dependent features (e.g. exposure to estrogen creams in males may lead to breast development) Missense mutation in LH receptor gene (male limited) ↑ Activation of LH receptors ↑ Testosterone production Café au lait lesions Polycystic fibrous dysplasia Puberty onset ages 1-4 ↑ Activation and mutation of GNAS1 gene (McCune Albright Syndrome) Various endocrinopathies Growth acceleration Congenital adrenal hyperplasia ↓ Cortisol, ↑ ACTH Bone age > chronological age Absence of testicular enlargement Female ambiguous genitalia Authors: MacKenzie Horn Reviewers: Dasha Mori Michelle J. Chen Dr. Jean Mah* * MD at time of publication Normal variations in hormone production ↑ Sensitivity to estrogen Early adrenal androgen secretion Idiopathic premature thelarche Idiopathic premature adrenarche Unilateral or bilateral breast development No other secondary sex characteristics Bone age = chronological age Development of pubic hair ± axillary hair No other secondary sex characteristics Bone age = chronological age Legend: Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications Published Oct 4, 2024 on www.thecalgaryguide.com