Precocious puberty: Difference between revisions
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==External links== |
==External links== |
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* [http://www.med.umich.edu/1libr/yourchild/puberty.htm University of Michigan] |
* [http://www.med.umich.edu/1libr/yourchild/puberty.htm University of Michigan] |
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*[http://www.center4research.org/children11.html When Little Girls Become Women: Early Onset of Puberty Among Girls] |
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{{Endocrine pathology}} |
{{Endocrine pathology}} |
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Revision as of 01:45, 11 March 2007
| Precocious puberty | |
|---|---|
| Specialty | Endocrinology  |
Precocious puberty refers to an unusually early onset of puberty.
Types and causes
Early pubic hair, breast, or genital development may result from natural early maturation or from several other conditions.
- Early puberty which is natural in every way except age is termed idiopathic central precocious puberty. It may be partial or transient. Central puberty can also occur prematurely if the inhibitory system of the brain is damaged, or a hypothalamic hamartoma produces pulsatile gonadotropin-releasing hormone (GnRH).
- Secondary sexual development induced by sex steroids from other abnormal sources (gonadal or adrenal tumors, congenital adrenal hyperplasia, etc.) is referred to as peripheral precocious puberty or precocious pseudopuberty.
Clinical significance
Early sexual development deserves evaluation because it may:
- induce early bone maturation and reduce eventual adult height,
- cause significant social problems, or
- indicate the presence of a tumor or other serious problem.
Central precocious puberty can be caused by intracranial neoplasm, infection, trauma, hydrocephalus, and Angelman syndrome. [1]
High levels of beta-hCG in serum and cerebospinal fliud observed in 9-year old boy suggest a pineal gland tumour. The tumour is called a chronic gonadotropin secreting pineal tumour. Radiography and chemotherapy reduced tumour and beta-hCG levels normalized.[2]
Measures
No single age limit reliably separates normal from abnormal processes, but the following age thresholds for evaluation will minimize the risk of missing a significant problem:
- Pubic hair or genital enlargement in boys with onset before 9 years.
- Breast development in boys before appearance of pubic hair and testicular enlargement.
- Pubic hair before 8 or breast development in girls with onset before 7 years.
- Vaginal bleeding in girls before 10 years.
Suggested causes: Environmental estrogens, sedentary lifestyle, and obesity.
Other notes
Medical evaluation is sometimes necessary to recognize the few children with serious conditions from the majority who have entered puberty early but are still medically normal.
Children (esp. girls) who are obese are more likely to physically mature earlier. Precocious puberty can make a child able to conceive when very young. Both sexes have become parents before age 10. The youngest mother on record is Lina Medina, who gave birth at the age of 5 years, 7 months and 21 days. An 8 year old boy had early puberty caused by a malignant intracranial germ cell tumour. Chemotherapy cures most intracranial tumours.[3]
The role of the pineal gland in reproduction of other species of vetebrate suggest that the pineal gland does have significance indevelopement and function of human reproductive axis.[4] In a study using neonatal melatonin on rats, results suggest that elevated melatonin could be responsible for some cases of early puberty.[5]
See also
References
- ^ Dickerman R, Stevens Q, Steide J, Schneider S (2004). "Precocious puberty associated with a pineal cyst: is it disinhibition of the hypothalamic-pituitary axis?". Neuro Endocrinol Lett. 25 (3): 173–5. PMID 15349080.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Kuo H, Sheen J, Wu K, Wei H, Hsiao C. "Precocious puberty due to human chorionic gonadotropin-secreting pineal tumor". Chang Gung Med J. 29 (2): 198–202. PMID 16767969.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Massie R, Shaw P, Burgess M (1993). "Intracranial choriocarcinoma causing precocious puberty and cured with combined modality therapy". J Paediatr Child Health. 29 (6): 464–7. PMID 8286166.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Cavallo A (1993). "Melatonin and human puberty: current perspectives". J Pineal Res. 15 (3): 115–21. PMID 8106956.
- ^ Esquifino A, Villanúa M, Agrasal C (1987). "Effect of neonatal melatonin administration on sexual development in the rat". J Steroid Biochem. 27 (4–6): 1089–93. PMID 3121932.
{{cite journal}}: CS1 maint: multiple names: authors list (link)(4-6):1089-93
External links
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