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Precocious puberty (true)

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

True precocious puberty is where the puberty is early but the pattern is normal.

It would be expected that the lesion is one of early adrenarche, and a central cause is usually suspected. It is gonadotrophin dependent.

  • is gonadotropin-dependent and involves the premature activation of the hypothalamic-pituitary-gonadal (HPG) axis

Precocious puberty is commonly defined as puberty that starts before age 8 in girls and 9 in boys (1)

  • thelarche and increased growth velocity before age 8 in girls and genital development in boys before age 9 suggests precocious puberty

  • precocious puberty in boys represents a substantial risk of underlying pathology
    • this scenario requires urgent referral to a paediatric endocrinologist

  • many cases of precocious puberty in girls over 6 have benign causes, but precocious puberty can indicate serious pathology in some cases

  • " idiopathic" precocious puberty is the commonest cause of gonadotrophin releasing hormone (GnRH) (gonadotrophin dependent precocious puberty or GDPP)
    • GDPP and is more commonly seen in girls than boys

Reference:

  • Muir A.Precocious puberty. Pediatr Rev 2006;27:373-81.
  • Bradley S et al. Precocious puberty. BMJ 2020; 368:16597

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