Precocious puberty in a 30-month-old Nigerian girl: A case report

Abstract

The development of secondary sexual characteristics before the expected age and sex is termed precocious puberty. It is usually due to excessive sex steroids production. Cases of precocious puberty are uncommon worldwide with a prevalence of 1/5000-1/10000 per children population and a female to male ratio of 10:1. In Nigeria, the prevalence is unknown with only a few reported cases, probably due to superstitious and religious beliefs. A high proportion of reported cases globally are of the gonadotropin-dependent (central) type. A case is being reported of a 30-month-old female non-identical twin in Cross River State, South-South of Nigeria, who presented with a 6-month history of bleeding per vagina, premature breast development and pubic hair distribution (Tanner stage 3). The patient had appropriate serum concentrations of the pituitary gonadotrophins and gonadal hormones for age. Precocious puberty was not a finding in the family history, and twin and other siblings had normal growth pattern. Radiological and endocrine investigations were diagnostic of precocious puberty. Hence, being proactive with a high index of suspicion is required of clinicians to be able to identify endocrine abnormalities that are increasing in prevalence and are going unnoticed in our environment, among the pediatric age group.

Precocious puberty in a 24 month old Nigerian girl: case report

“…There was no radiological feature of CNS abnormality or intracranial tumor suggestive of hypothalamic harmatoma which is common in her age group and has been reported by previous authors. 2,4 There was also no periodic fluctuations in the size of the breasts as commonly seen in premature thelache. Premature thelache is often diagnosed in female infants (infantile mammoplasia) or a girl up to the age of three years, who has breast enlargement without other signs of puberty and is growing at a normal pre-pubertal growth velocity.…”

“…1,2 The incidence of precocious puberty in Nigeria is not known as there are few reported cases from this part of the world. 3,4 The cause of precocious puberty in girls is unknown in 90% of cases while 8-10% of girls and 25-75% of boys with precocious pu-berty may have structural central nervous system abnormality. 5 Aetiologically, precocious puberty is broadly classified into central and peripheral causes.…”