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Precocious puberty: who to treat?
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M RazaghiAzar   |
| , emazar@iums.ac.ir |
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Abstract: (71656 Views) |
| Following the use of GnRH analogues for treatment of precocious puberty and their effect on preserving final height, physicians are more encouraged to treat the idiopathic type of this entity. In 1999, a study reported about 20 girls with slowly progressive and unsustained precocious puberty with mean age of 4.1±0.2 years who achieved normal final height without any treatment. Appearance of first signs of puberty in 95% of the population or 2 standard deviations below the mean age of puberty in normal girls is the definition of age limit of normal puberty. In 1997 a study conducted in Pediatric Research Network, based on pubertal staging of over 17000 girls between 3-12 years of age indicated that breast development occurred at 9.96±1.82 years of age in white girls and at 8.87±1.93 years in African American girls, about 1 year earlier in white girls and 2 years earlier in African American girls than what previous studies had shown. On the other hand, treatment of precocious puberty is based on suppression of hypothalamo-pituitary-gonadal axis with GnRH analogue, so this axis needs to be activated first. The interpretation of LH and FSH levels depends on laboratory methods of assessment, the latest being ICMA (immunochemiluminometric assay) which is more sensitive than older methods like radioimmunoassay. With the new ICMA method, basal LH>0.3 IU/L and with post GnRH test, peak LH>5 IU/L are diagnostic. The younger the age at onset of puberty, the longer the duration of puberty that results in a more prolonged pubertal growth spurt. The mean increase in stature after menarche is about 10 cm for girls with early menarche and about 5 cm for those with delayed menarche. Hence in this article, clinical and laboratory criteria and the age limit for defining precocious puberty are reviewed to distinguish those requiring treatment. |
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| Keywords: Precocious pubety, Age of puberty, GnRH, Hypothalamo-pituitary-gonadal axis. |
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Full-Text [PDF 484 kb]
(62244 Downloads)
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Type of Study: Review |
Subject:
Endocrinology
Received: 2006/11/21 | Published: 2002/06/15
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