Central Precocious Puberty: Update on Diagnosis and Treatment

Abstract

Central precocious puberty (CPP) is characterized by the same biochemical and physical features as normally timed puberty but occurs at an abnormally early age. Most cases of CPP are seen in girls, in whom it is usually idiopathic. In contrast, ∼50 % of boys with CPP have an identifiable cause. The diagnosis of CPP relies on clinical, biochemical, and radiographic features. Untreated, CPP has the potential to result in early epiphyseal fusion and a significant compromise in adult height. Thus, the main goal of therapy is preservation of height potential. The gold-standard treatment for CPP is go-nadotropin-releasing hormone (GnRH) analogs (GnRHa). Numerous preparations with a range of delivery systems and durations of action are commercially available. While the outcomes of patients treated for CPP have generally been favorable, more research about the psychological aspects, optimal monitoring, and long-term effects of all forms of GnRHa treatment is needed. Several potential therapeutic alternatives to GnRHa exist and await additional investigation.

One-Year Follow-Up of Girls with Precocious Puberty and Their Mothers: Do Psychological Assessments Change over Time or with Treatment?

“…GnRH analogs (GnRHa) are the gold-standard treatment of CPP and are highly effective in suppressing the HPG axis [10]. While the primary medical reason for the treatment of CPP is to preserve adult height potential, a second frequently cited reason is to alleviate psychological distress associated with early pubertal development [11].…”

Central precocious puberty: From genetics to treatment

“…LH concentrations <0.3 mIU/L are in the prepubertal range whereas levels >0.3 mIU/L are usually indicative of puberty [10]. However, these levels need to be taken in context as children with slowly or intermittently progressive CPP can have levels in the pubertal range as can young girls under the age of 2 years who are in the mini-puberty have not yet been determined for many hormones [25,27]. Regardless, suppressed gonadotropins and elevated sex steroids would indicate that a form of peripheral, rather than CPP is present [25].…”

“…In 2009, 30 international experts convened to address topics surrounding CPP, with brain imaging as one such area. They determined that without clinical neurological findings or rapid pubertal progression, the incidence of pathological brain findings in girls decreases with age An additional option for imaging in girls is pelvic ultrasound which can provide useful information if clinical and biochemical features are equivocal [27].…”

The Therapeutic Effect of Shugan Xiehuo Formula in Female Rat Model with Central Precocious Puberty

“…Central precocious puberty (CPP) is caused by premature activation of the hypothalamic-pituitary-gonad (HPG) axis, which ultimately leads to the premature development of secondary sexual characteristics in children [1][2][3]. According to report, 1 out of every 5000 to 10,000 children develops CPP, and in general, the incidence of CPP in girls is much higher than that in boys [4].…”