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Precocious Puberty

Bency K. Louidor-Paulynice, MD and Ronald N. Adler, MD, FAAFP Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Defined as the appearance of secondary sexual characteristics before the age of 8 years in girls and 9 years in boys

  • Normal puberty occurs between age 8 and 14 years in girls and 9 an...

DIAGNOSIS

Any child with secondary sexual characteristics before the age of 8 years in girls and before the age of 9 years in boys should be evaluated (4)[B]. 

HISTORY

  • Review past medical history, socia...

TREATMENT

GENERAL MEASURES

  • GDPP: The primary reason to treat is to prevent early epiphyseal closure and reduction of adult height.

  • Good candidates are those who present at a younger age with rapidly pro...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

GDPP 
  • Evaluate every 3 to 6 months to assess pubertal growth and development and height velocity to detect abnormal growth spurt (1)[C].

  • Measure bone age every 6 to...

REFERENCES

1
Chauhan A, Grissom M. Disorders of childhood growth and development: precocious puberty. FP Essent.  2013;410:25–31. [View Abstract on OvidMedline]
2
Huffman GB. Reassessing the age lim...

CODES

ICD10

  • E30.1 Precocious puberty

  • E22.8 Other hyperfunction of pituitary gland

ICD9

  • 259.1 Precocious sexual development and puberty, not elsewhere classified

  • 253.1 Other and unspecified anterior pituita...

CLINICAL PEARLS

  • There are three types of precocious puberty: central, peripheral, and incomplete.

  • Most common in girls, and majority of cases represent idiopathic central precocious puberty

  • GnRH agonist...

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