Peripheral Precocious Puberty: Interventions to Improve Growth

  • Nadine G. Haddad
  • Erica A. Eugster


Precocious puberty is usually defined as the onset of secondary sexual characteristics prior to age 7 1/2–8 in girls and prior to age 9 in boys. Although sex steroids cause growth acceleration and tall stature in the short term, the potential for a significant loss of ultimate adult height is a central concern in all children with pathologic forms of early puberty. Unlike central precocious puberty (CPP), which refers to early activation of the hypothalamic-pituitary-gonadal axis, peripheral precocious puberty (PPP) arises from abnormal sex steroid exposure from other sources. These may be endogenous or exogenous, congenital, or acquired. The clinical presentation will depend on the underlying process and on the class of sex steroids (estrogens or androgens) involved. Although many different causes of PPP exist, the most common are congenital adrenal hyperplasia (CAH), familial male-limited precocious puberty (FMPP), and McCune Albright syndrome (MAS). The pathophysiology and clinical characteristics of each of these will be described. A variety of factors are known to influence growth in these disorders. The impact of primary and adjuvant treatment on growth and ultimate height in children with these conditions will be discussed. Data regarding the long-term outcome of established clinical management as well as preliminary findings from investigational approaches will also be summarized.


Congenital Adrenal Hyperplasia Adult Height Precocious Puberty Cyproterone Acetate Central Precocious Puberty 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Aromatase inhibitor


Congenital adrenal hyperplasia


Central precocious puberty


Familial male-limited precocious puberty




Gonadotropin-releasing hormone




Luteinizing hormone


McCune Albright syndrome


Non-classical congenital adrenal hyperplasia


Peripheral precocious puberty


Salt-wasting congenital adrenal hyperplasia


Simple virilizing congenital adrenal hyperplasia


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Section of Endocrinology and DiabetologyIndiana University School of Medicine, Riley Hospital for ChildrenIndianapolisUSA

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