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Central Precocious Puberty
Gonadotropin-Dependant Precocious Puberty

Presentation

Extensive imaging of the CNS for patients presenting with CPP is recommended. [thejns.org]

We present here a rare case of a 7-month-old infant girl with CPP and HH who was successfully treated with depot gonadotropin-releasing hormone (GnRH) analogue is presented. [ncbi.nlm.nih.gov]

Case presentation. We present the case of a 15-month-old Asian male baby who presented with precocious puberty associated with hepatoblastoma. [mdanderson.elsevierpure.com]

Entire Body System

  • Precocious Puberty

    1–3 with implications for the definition of precocious puberty. [touchendocrinology.com]

    Heterosexual precocious puberty causes signs of masculine characteristics in girls and feminization in boys. Cerebral precocious puberty differs in cause but mimics true precocious puberty. [healthcentral.com]

    […] idiopathic precocious puberty isosexual precocious puberty male-limited precocious puberty peripheral precocious puberty General Discussion Precocious puberty means an abnormally early onset of puberty. [rarediseases.org]

    Treatments Treatments Treatment of precocious puberty depends on if your child is diagnosed with central precocious puberty or peripheral precocious puberty: Central precocious puberty. [rileychildrens.org]

    Precocious puberty. N Engl J Med. 2008;358(22):2366-2377. 4 Antoniazzi F, Zamboni G. Central precocious puberty: current treatment options. Paediatr Drugs. 2004;6:211-231. 5 Partsch CJ, Sippell WG. Treatment of central precocious puberty. [prnewswire.com]

  • Accelerated Growth

    At the age of 1 year, our patient presented with increased testicular volume for his age, bone age advancement and growth acceleration. [ncbi.nlm.nih.gov]

    […] of 9: Penile enlargement Testicular development Increased muscle development Voice change Growth of body hair Accelerated growth There are two types of precocious puberty: Central precocious puberty (CPP). [rileychildrens.org]

    Affected individuals may encounter psychological problems due to their accelerated growth and may feel alienated from their peers. They may exhibit increased aggressiveness and hyperactivity. [healthcentral.com]

    Precocious puberty Puberty is a complex biological process involving sexual maturation and accelerated growth. These processes normally initiate when pulsatile secretion of gonadotropin-releasing hormone (GnRH) from the hypothalamus begins. [imprinting-disorders.eu]

  • Weakness

    In both boys and girls, the adrenal glands, small glands that sit on top of the kidneys, can start producing weak male hormones called adrenal androgens at an early age, causing pubic and/or axillary hair and body odor before age 8, but this situation [healthychildren.org]

    Like Derricott, Ward said she sees a carousel of medical specialists for excruciating muscle and bone pain, depression, weakness, and fatigue. The symptoms mystify each woman’s doctors. [statnews.com]

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Gastrointestinal

  • Diarrhea

    There was history of frequent episodes of ill health withcough, fever, diarrhea and off and on vomiting. [sciedupress.com]

    Other less frequent side effects include diarrhea, edema, fatigue, hypertension, constipation, pain, pneumonitis, as well as asymptomatic CPK elevation. [mdpi.com]

Musculoskeletal

  • Bone Pain

    It can present with bone pain, fractures and deformities [ 13 ]. A study by Hart et al. [ 14 ] revealed that clinically significant bone lesions in FD are detectable at an age of 10 years. [alliedacademies.org]

    There was no clitoral enlargement, neck swelling, pigmented skin marks, bone pain/fractures. Parents could not comment on any recent height gain. She had no significant medical illness or radiation exposure in the past. [ijem.in]

    Those reports frequently note injection-site pain but also include dozens of cases of bone problems, such as pain or disorders, and the inability to walk. [statnews.com]

  • Osteoporosis

    Then came another diagnosis: osteoporosis. The condition would come as little surprise to anyone familiar with Lupron’s use in adults. [statnews.com]

    Prolonged use has a risk of causing osteoporosis. After stopping GnRH agonists, pubertal changes resume within 3 to 12 months. [en.wikipedia.org]

Psychiatrical

  • Fear

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Urogenital

  • Pelvic Pain

    Patients with HWW syndrome usually present symptoms such as dysmenorrhea, abdominal pain, pelvic mass, and purulent vaginal discharge. [chikd.org]

  • Dysmenorrhea

    Patients with HWW syndrome usually present symptoms such as dysmenorrhea, abdominal pain, pelvic mass, and purulent vaginal discharge. [chikd.org]

Neurologic

  • Headache

    The most common side effects from this study were injection-site pain, weight gain, headache, altered mood and injection-site swelling. The three-month formulation is expected to be available in late August. [news-medical.net]

    No history of headache, blurring of vision, seizures, cranial irradiation, perinatal trauma, past encephalitis, exogenous exposure to sex steroids, mucocutaneous hyperpigmentation, salt wasting crisis, lump abdomen, scrotal mass, bony pains, bony deformities [casereports.bmj.com]

    He had no history of headache, seizures, visual problems, behavioural changes or neurological deficits. There was no history of head trauma or surgery or prolonged drug intake. Family history and perinatal history was unremarkable. [ncbi.nlm.nih.gov]

  • Confusion

    Listening can help them express their worries and confusion and reinforce that they are not alone. [pubertytooearly.com]

    They may be mistaken for a much older age, and this can be confusing or embarrassing. If your child has been diagnosed with precocious puberty, treatment can slow down or delay puberty, allowing your child to grow to a more normal height. [rileychildrens.org]

    They are expected to act as old as they look and this is confusing for children. This in combination with other factors leads to a time of great stress. We are here to help parents! [magicfoundation.org]

    The terminology is often confusing as these are also referred to by some authors as incomplete precocious puberty. Precocious puberty can occur in several forms. [rarediseases.org]

    For example, girls with precocious puberty may be confused or embarrassed about physical changes such as getting their periods or having enlarged breasts well before any of their peers. [kidshealth.org]

  • Stroke

    There may be a slightly increased risk of diabetes, heart disease, or stroke. However, these risks are confounded by the fact that obesity is linked to both early puberty and to all three health conditions. [verywell.com]

    Among men who take Lupron, its label warns of increased risk of heart attacks, strokes and sudden death. Drug labels are developed jointly by the FDA and the companies involved. [statnews.com]

  • Insomnia

    Women have reported to the FDA hundreds of cases of insomnia, depression, joint pain, and more than 100 cases of blurred vision. About 900 reports cite side effects that children below age 13 have suffered, mostly within months of taking Lupron. [statnews.com]

Workup

When should you start a workup? What should you order and when do you refer to endocrinology? We discuss these things and more with our pediatric endocrine consultant. [hippoed.com]

Laboratory workup revealed Serum Sodium 138 mmol/L (Ref Values: 135-145), Serum Potassium 4.1 mmol/L (Ref Values: 3.5-5.0), Serum Chloride 101 mmol/L (Ref Values: 97-106). [sciedupress.com]

Subsequent laboratory workup demonstrated highly elevated hormone levels: LH = 1.38 mIU/ml (normal < 0.7), and testosterone = 164 ng/dl (normal < 9.0). Additionally, bone age was advanced, at 11 years. [thejns.org]

Footnotes Contributors: PKS and KSGS contributed to the clinical diagnosis, initial laboratory workup and treatment. [ncbi.nlm.nih.gov]

Serum

  • Hyperprolactinemia

    In addition, while 2 (3.2%) of the patients had hyperprolactinemia before treatment, 11 (17.7%) patients developed hyperprolactinemia at different time points during treatment. [ncbi.nlm.nih.gov]

    Cardio-facio-cutaneous syndrome with precocious puberty, growth hormone deficiency and hyperprolactinemia. J Clin Res Pediatr Endocrinol. (2014) 6:55–8. doi: 10.4274/Jcrpe.1151 PubMed Abstract | CrossRef Full Text | Google Scholar 46. [frontiersin.org]

Treatment

Gonadotropin-releasing hormone agonists are the standard treatment for progressive CPP. Keywords Precocious puberty, treatment, outcome Disclosure Juliane Léger and Jean-Claude Carel have no conflicts of interest to declare. [touchendocrinology.com]

Central precocious puberty: current treatment options. Paediatr Drugs. 2004;6:211-231. 5 Partsch CJ, Sippell WG. Treatment of central precocious puberty. Best Pract Res Clin Endocrinol Metab .2002;16:165-189. [prnewswire.com]

Management of GIPP requires treatment of the underlying disorder. [rarediseases.org]

Sometimes, this treatment may allow a child to be taller than they would have been without treatment. Peripheral precocious puberty. Treatment of PPP varies depending on the cause. [rileychildrens.org]

It is used in the treatment of central precocious puberty and prostate cancer This policy addresses ONLY the use of histrelin acetate for the treatment of central precocious puberty. [bcbst.com]

Prognosis

All previously reported cases in the literature are old and prognosis was grim. Case presentation. We present the case of a 15-month-old Asian male baby who presented with precocious puberty associated with hepatoblastoma. [mdanderson.elsevierpure.com]

The patient did not receive medical care for his precocious pubertal development, because of adequate height prognosis, and reached normal height for both his target height and Klinefelter patients. [ncbi.nlm.nih.gov]

However, in some cases (about one-third of subjects), final stature prognosis may worsen during the progression of puberty, in parallel with the emergence of evident biological signs of oestrogenisation. [touchendocrinology.com]

What is the prognosis of central precocious puberty? Similar to the treatment of central precocious puberty, the prognosis is related to the precise cause of the child's disease. [rxlist.com]

Etiology

Location Indianapolis, IN Subject Area Pharmacy, Health Sciences & Exercise Science Start Date 11-4-2014 8:30 AM End Date 11-4-2014 10:00 AM Description Background: Precocious puberty is a relatively rare disease with little documented information on etiology [digitalcommons.butler.edu]

In the present study, we aimed to evaluate the etiological factors in male CPP cases. METHODS: One hundred male CPP subjects, aged between 9 months and 10.5 years, were included. [ncbi.nlm.nih.gov]

Epidemiology

OBJECTIVES: Precocious puberty seems to be increasing but epidemiological data are scarce. Our objective was to improve the epidemiologic knowledge on this disease. [ncbi.nlm.nih.gov]

Pathogenesis and epidemiology of precocious puberty. Effects of exogenous oestrogens. Human Reproduction Update 2001;7(3):292-302 Parent AS, Teilmann G, Juul A, Skakkebaek NE, Toppari J, Bourguignon JP. [mji.ui.ac.id]

Guillén, Jesús Argente Localización: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP ), ISSN 1695-4033, ISSN-e 1696-4608, Vol. 74, Nº. 5, 2011, pág. 336 Idioma: español Títulos paralelos: Central precocious puberty: epidemiology [dialnet.unirioja.es]

Summary Epidemiology The prevalence of CPP has been evaluated at approximately 1/ 500 girls and 1/ 2,000 boys in Denmark. Girls are more affected than boys, with an overall male to female ratio of at least 1:10. [orpha.net]

Pathophysiology

Reproductive endocrinology:Physiology, pathophysiology and clinical management. 4th ed. Philadelphia:WB Saunders;1999. p.153-190. P.214 掲載の参考文献 3) 伊藤裕ら:ナトリウム利尿ペプチド系の分子生物学と分子薬理. 日本臨牀 1993;51:140-148. 4) 伊藤裕ら:Na利尿ペプチドファミリーとジギタリス様因子の役割は. 矢崎義雄ら編. [molcom.jp]

In addition, we discussed the recent findings on the pathophysiology of OPG development in NF1. [mdpi.com]

Prevention

[…] premature closure of the epiphyseal growth plates, thereby preventing short stature. [ncbi.nlm.nih.gov]

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