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Peripheral Precocious Puberty: Interventions to Improve Growth

  • Nadine G. Haddad
  • Erica A. Eugster
Chapter

Abstract

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.

Keywords

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.

Abbreviations

AI

Aromatase inhibitor

CAH

Congenital adrenal hyperplasia

CPP

Central precocious puberty

FMPP

Familial male-limited precocious puberty

GC

Glucocorticoid

GnRH

Gonadotropin-releasing hormone

17OHP

17-Hydroxyprogesterone

LH

Luteinizing hormone

MAS

McCune Albright syndrome

NCCAH

Non-classical congenital adrenal hyperplasia

PPP

Peripheral precocious puberty

SWCAH

Salt-wasting congenital adrenal hyperplasia

SVCAH

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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