paed_endo_precociousPuberty.md

Puberty Abnormalities

Precocious Puberty (PP)

Definition and Diagnosis

• Girls >= 8ys
  • Menarche usually at end.
  • Thelarche.
• Boys >= ??

Pathway ¹

• Imaging is LAST STAGE
• Divided into
  1. CENTRAL PP
     • aka Consonant PP or Gonadotrophic dependent.
  2. PERIPHERAL PP

Findings ¹

Central PP

Females: 90% idiopathic. Investigate if very young.
Males: <10% idiopathic. Investigate all.

Causes

General	Specific	Notes
A) TUMOURS
	Optic & Hypothalamic Gliomas.	inc Astrocytomas.
	Optic & Hypothalamic Ependymomas.
	Pineal Tumours.
	Hamartomas of Tuber cinerum.	often in very young and 'gelastic epilepsy'
	Craniopharyngiomas	Rare cause!
B) CONGENITAL
	Neurofibromatosis.
C) TRAUMA & IATROGENIC
	Hydrocephalus
	Head Injury
	Meningitis & Encephalitis.
	Surgery.
	Radiotherapy.	But HIGH dose assocd with delay.
D) IDIOPATHIC

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Delayed Puberty

Female Delayed Puberty

Male Delayed Puberty

Footnotes

1. https://bestpractice.bmj.com/topics/en-gb/1127/investigations ↩ ↩²