Central Precocious puberty

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Definition

Secondary sexual development in girls <8 or boys<9

Cause

Premature activation of HPG axis, tumors (esp. in boys)

Presentation

Premature adrenarche (axillary and pubic hair), premature telarche (breast), premature menarche, advanced bone age

Diagnosis

High LH (at baseline or after GnRH stimulation)

  1. Bone age (advanced)
  2. Basal LH (high or low)
  3. GnRH stimulation (high)
  4. Brain MRI w/ contrast

Treatment

GnRH agonist therapy to prevent epiphyseal fusion