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Precocious Puberty, Pediatric

Reviewed 10/2018
 


BASICS

DESCRIPTION

  • In most populations, the mean ages of onset of puberty are 10.5 years in girls and 11.5 years in boys.

    • Girls: The first sign of puberty is most commonly breast development (thelarche)...

DIAGNOSIS

Signs and symptoms 
  • Careful history focusing on chronology: physical changes, growth spurt, onset of menses

  • Neurologic, visual, or behavioral changes suggest a CNS lesion.

HISTORY

  • Family history...

TREATMENT

MEDICATION

  • Central precocious puberty: GnRH agonists (leuprolide depot injection or histrelin acetate implant) are treatment of choice. Adjunctive therapy with growth hormone may be needed to...

ONGOING CARE

  • When to expect improvement:

    • Depends on cause. For example, sexual changes of McCune-Albright syndrome are due to autonomously functioning ovarian cysts, which regress variably over time.

    • Tr...

ADDITIONAL READING

  • Carel JC, Eugster EA, Rogol A, et al; for ESPE-LWPES GnRH Analogs Consensus Conference Group. Consensus statement on the use of gonadotropin-releasing hormone analogs in children. P...

CODES

ICD9

  • 259.1 Precocious sexual development and puberty, not elsewhere classified

  • 253.1 Other and unspecified anterior pituitary hyperfunction

ICD10

  • E30.1 Precocious puberty

  • E22.8 Other hyperfunction of...

FAQ

  • Q: If my child is treated with a GnRH agonist, will he or she go through puberty when we stop the medication?

  • A: Yes. Children on GnRH agonist treatment proceed through normal puberty when the medi...

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