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Chapter-090b Precocious Puberty

BOOK TITLE: ESI Manual of Clinical Endocrinology

Author
1. Bansal Naresh
2. Singh SK
ISBN
9789351526476
DOI
10.5005/jp/books/12535_112
Edition
2/e
Publishing Year
2015
Pages
8
Author Affiliations
1. Sir Ganga Ram Hospital, New Delhi, India, Institute of Medical Sciences, Varanasi, Uttar Pradesh, India, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
2. Institute of Medical Sciences (IMS), Banaras Hindu University (BHU), Varanasi, Postgraduate Institute of Medical Education and Research, Chandigarh, India, Institute of Medical Sciences, Banaras Hindu University, Varanasi (UP), India, Institute of Medical Sciences, Varanasi, Uttar Pradesh, India, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
Chapter keywords
Precocious puberty, gonadotropin-dependent PP, gonadotropin-independent PP, GnRH agonist, hypothalamic–pituitary–gonadal axis, anastrozole, letrozole

Abstract

Precocious puberty the onset of secondary sexual development before age 8 years in girls and 9 years in boys. It can be classified into incomplete PP, gonadotropin-dependent PP (GDPP) and gonadotropin-independent PP (GIPP). Gonadotropin-dependent precocious puberty is caused by early maturation of hypothalamic–pituitary–gonadal axis. Gonadotropin-independent precocious puberty is caused by excess secretion of sex hormones derived either from the gonads or adrenal glands or from exogenous sources. Initial evaluation is based on medical history, physical examination and puberty staging. Further evaluation is on the basis of bone age, hormonal measurements, Pelvic or testicular ultrasound scans and Brain magnetic resonance imaging. GDPP can be treated by long-acting GnRH agonist analogs, gonadal steroid levels and growth hormone treatment. GIPP can be treated by surgery, progestational drugs, antiandrogen agents, anastrozole and letrozole and antiestrogen agents.

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