Precocious Puberty Flashcards
What is precocious puberty?
Development of secondary sexual characteristics before 8 years in females and 9 years in males’
When does precocious puberty occur in girls?
Before the age of 8
When does precocious puberty occur in males?
Before the age of 9
What are the 2 classifications of Precocious puberty?
Gonadotrophin dependent ('central', 'true')
Gonadotrophin independent ('pseudo', 'false')What is Gonadotrophin dependent (‘central’, ‘true’) due to?
Premature activation of the hypothalamic-pituitary-gonadal axis
FSH & LH raised
What will be raised in gonadotrophin dependent precocious puberty?
FSH and LH
What are possible causes of gonadotrophin dependent precocious puberty?
- Idiopathic (>90%)
- Brain neoplasms
- Cranial radiotherapy
- Cranial disability conditions such as hydrocephalus, cerebral palsy or post-infection (meningitis)
- Traumatic head injury
What is Gonadotrophin independent (‘pseudo’, ‘false’) due to?
Excess sex hormones
What will be low in Gonadotrophin independent precocious puberty?
FSH and LH
What are the Ovarian causes of Gonadotrophin independent precocious puberty?
- Follicular cysts of the ovary
- Granulosa cell tumours
- Leydig’s cell tumours
- Gonadoblastoma.
What are the testicular causes of gonadotrophin independent precocious puberty?
Leydig’s cell tumours and a defect of luteinising hormone (LH) receptor function
What are the Adrenal causes of gonadotrophin independent precocious puberty?
21-hydroxylase congenital adrenal hyperplasia (CAH) in males results in GIPP.
Congenital adrenal hyperplasia
McCune-Albright syndrome (MAS)
What does congenital adrenal hyperplasia cause?
Affects females
Presents with signs of virilisation but no breast development.
What is bilateral enlargement of the testes in males due to?
Gonadotrophin release from intracranial lesion
What is unilateral enlargement of the testes in males due to?
Gonadal tumour
