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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
نسخه الکترونیک
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Central (gonadotropin-dependent) precocious puberty

Central (gonadotropin-dependent) precocious puberty
Etiology Clinical features Bone age Additional evaluation
Idiopathic
  • 80 to 90% of females with CPP
  • 25 to 80% of males with CPP
 Early progressive pubertal development, but proceeds in normal sequence. ↑↑

Increased ovarian and uterine volumes on ultrasound may help differentiate females with CPP from those with premature thelarche.

Contrast-enhanced MRI to rule out CNS abnormality.
Secondary to CNS lesions
(eg, hypothalamic hamartomas, other CNS tumors and lesions, cranial radiation)
  • 20 to 75% of males with CPP
  • 10 to 20% of females with CPP

Early progressive pubertal development that usually proceeds in normal sequence, but abnormal tempo or sequence can be seen with CNS lesions.

CPP secondary to a CNS lesion occurs more commonly in males and younger children. 		↑↑
Post-early exposure to sex steroids
(after treatment for peripheral precocity)

History of treatment of peripheral precocity.

Progressive pubertal development with breast development in females and testicular enlargement in males. 		↑↑ Basal and stimulated LH concentrations are pubertal.
CPP is characterized by basal LH concentrations >0.2 to 0.3 mIU/L and/or stimulated LH concentration post-GnRH or GnRH agonist of >3.3 to 5.0 mIU/L.
↑↑: significantly advanced for chronologic age (eg, ≥2 standard deviations); CPP: central precocious puberty; MRI: magnetic resonance imaging; CNS: central nervous system; LH: luteinizing hormone; GnRH: gonadotropin-releasing hormone.
Courtesy of Jennifer Harrington, MBBS, PhD, and Mark R Palmert, MD, PhD.
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