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Precocious puberty
Classification and external resources
ICD-10 E30.1, E22.8
ICD-9 259.1
OMIM 176400
DiseasesDB 10519
MedlinePlus 001168
eMedicine ped/1882 
MeSH D011629

Precocious puberty (La:pubertas praecox) is an unusually early onset of puberty, the process of sexual maturation triggered by the brain, which usually begins in late childhood and results in reproductive maturity and completion of growth. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The International Statistical Classification of Diseases and Related Health Problems 10th Revision ( ICD -10) is a coding of diseases and signs symptoms abnormal findings E00-E35 - Endocrine diseases (E00-E07 Thyroid gland / Thyroid hormone ( Congenital iodine-deficiency syndrome ( E00-E35 - Endocrine diseases (E00-E07 Thyroid gland / Thyroid hormone ( Congenital iodine-deficiency syndrome ( The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. The Mendelian Inheritance in Man project is a Database that catalogues all the known Diseases with a genetic component, and—when possible—links them The Diseases Database is a free Website that provides information about the relationships between medical conditions Symptoms, and Medications. MedlinePlus, with the MedlinePlus Medical Encyclopedia, is a website network containing Health information from the world's largest medical Library eMedicine is an online clinical medical knowledge base that was founded in 1996 by Scott Plantz and Richard Lavely two medical doctors Medical Subject Headings ( MeSH) is a huge Controlled vocabulary (or metadata system for the purpose of indexing journal articles and books Early puberty may be a variation of normal development, or may be a result of a disease or abnormal hormone exposure. Human variability, or human variation, is the range of possible values for any measurable characteristic physical or mental of human beings Human development is the process of Growing to maturity In biological terms this entails growth from a one-celled Zygote to an adult Human being A disease is an abnormal condition of an organism that impairs bodily functions and can be deadly Hormones (from Greek ὁρμή - "impetus" are chemicals released by cells that affect cells in other parts of the body In some contexts, the term is used more broadly to describe the early appearance of any of the physical features of puberty even if the complete brain-directed process is not occurring.

Contents

Types and causes

Early pubic hair, breast, or genital development may result from natural early maturation or from several other conditions. Pubic hair is Hair in the frontal Genital area the crotch, and sometimes at the top of the inside of the legs these areas form the pubic region The breast is the upper Ventral region of an animal’s Torso, particularly that of Mammals including Human beings. A sex organ, or primary sexual characteristic, as narrowly defined is any of the anatomical parts of the body which are involved in sexual reproduction and constitute

a.    Early puberty which is natural in every way except age is termed idiopathic central precocious puberty. It may be partial or transient. Central puberty can also occur prematurely if the inhibitory system of the brain is damaged, or a hypothalamic hamartoma produces pulsatile gonadotropin-releasing hormone (GnRH). Hypothalamic hamartoma (abbreviated as HH is a congenital condition consisting of a mass of disorganized neuronal or glial tissue on or near the Hypothalamus. Gonadotropin-releasing hormone ( GNRH) also known as Luteinizing-hormone releasing hormone ( LHRH) is a tropic Peptide Hormone

b.    Secondary sexual development induced by sex steroids from other abnormal sources (gonadal or adrenal tumors, congenital adrenal hyperplasia, etc. Sex steroids, also known as gonadal steroids, are Steroid hormones that interact with Vertebrate Androgen or Estrogen receptors The gonad is the organ that makes Gametes The gonads in males are the Testes and the gonads in Females are the Ovaries. In Mammals the adrenal glands (also known as suprarenal glands) are the triangle-shaped Endocrine glands that sit on top of the Kidneys their See also Cancer A tumor or tumour is the name for a swelling or lesion formed by an abnormal growth of cells (termed neoplastic Congenital adrenal hyperplasia ( CAH) refers to any of several Autosomal Recessive Diseases resulting from Mutations ) is referred to as peripheral precocious puberty or precocious pseudopuberty.

Clinical significance

Early sexual development deserves evaluation because it may:

  1. induce early bone maturation and reduce eventual adult height
  2. indicate the presence of a tumor or other serious problem

Central precocious puberty can be caused by intracranial neoplasm, infection, trauma, hydrocephalus, and Angelman syndrome. Bone age is a way of describing the degree of maturation of a child's Bones As a person grows from fetal life through childhood Puberty, and finishes growth Angelman syndrome (AS is a neuro- Genetic disorder characterized by intellectual and Developmental delay, sleep disturbance Seizures, jerky movements [1]

Case Study

High levels of beta-hCG in serum and cerebrospinal fluid observed in a 9-year old boy suggest a pineal gland tumor. Cerebrospinal fluid ( CSF) Liquor cerebrospinalis, is a clear Bodily fluid that occupies the Subarachnoid space and the Ventricular system The tumor is called a chronic gonadotropin secreting pineal tumor. Gonadotropins are Protein Hormones secreted by Gonadotrope cells of the Pituitary gland of Vertebrates Gonadotropin is sometimes The pineal gland (also called the pineal body, epiphysis cerebri, or epiphysis) is a small endocrine gland in the vertebrate Brain Radiography and chemotherapy reduced tumor and beta-hCG levels normalized. [2] "Central precocious puberty (CPP) was reported in some patients with suprasellar arachnoid cysts(SAC) [3], and SCFE occurs in patients with CPP because of rapid growth and changes of growth hormone secretion. "[3]

Bones can be considered older in individuals with early puberty beyond actual age of individual. Early puberty is marked by growth hormone problems resulting from various brain disorders.

Measures

Studies indicate that breast development in girls and pubic hair in girls and boys are starting earlier than in previous generations. As a result, "early puberty" in children as young as 9 and 10 is no longer considered abnormal, although it may be upsetting to parents.

No single age limit reliably separates normal from abnormal processes in children today, but the following age thresholds for evaluation will minimize the risk of missing a significant medical problem:

Suggested causes:
  1. endocrine disorder
  2. familial associations
  3. abnormalities in the ovaries, testicles, or adrenal glands
  4. structural problems in the brain
  5. tumors that release hormones (estrogen, testosterone, etc. )

(For Suggested Causes and epidemiology of central form, see: Antoniazzi, F. ; Zamboni, G. ; "Central Precocious Puberty - Current Treatment Options;" Pediatric Drugs 2004, Vol. 6, No. 4, pp. 211-231)

Other notes

Medical evaluation is sometimes necessary to recognize the few children with serious conditions from the majority who have entered puberty early but are still medically normal.

Girls who are obese are more likely to physically mature earlier. Obesity is a condition in which excess Body fat has accumulated to such an extent that health may be negatively affected Precocious puberty can make a child able to conceive when very young; the youngest mother on record is Lina Medina, who gave birth at the age of 5 years, 7 months and 21 days. Lina Medina (born September 27 1933) is the youngest confirmed mother in medical history, giving birth at the age of 5 years 7 months and 21 days An 8 year old boy had early puberty caused by a malignant intracranial germ cell tumor. [4]

The role of the pineal gland in reproduction of other species of vertebrate suggest that the pineal gland does have significance in development and function of human reproductive axis. [5] In a study using neonatal melatonin on rats, results suggest that elevated melatonin could be responsible for some cases of early puberty. [6]

See also

References

  1. ^ Dickerman R, Stevens Q, Steide J, Schneider S (2004). Puberty is described as delayed when a boy or girl has passed the usual age of onset of Puberty with no physical or hormonal signs that it is beginning "Precocious puberty associated with a pineal cyst: is it disinhibition of the hypothalamic-pituitary axis?". Neuro Endocrinol Lett 25 (3): 173-5. PMID 15349080.  
  2. ^ Kuo H, Sheen J, Wu K, Wei H, Hsiao C. "Precocious puberty due to human chorionic gonadotropin-secreting pineal tumor". Chang Gung Med J 29 (2): 198-202. PMID 16767969.  
  3. ^ European Journal of Pediatrics;March2005,Vol. 164 Issue 3, p173-174,2p,1 graph
  4. ^ Massie R, Shaw P, Burgess M (1993). "Intracranial choriocarcinoma causing precocious puberty and cured with combined modality therapy". J Paediatr Child Health 29 (6): 464-7. PMID 8286166.  
  5. ^ Cavallo A (1993). "Melatonin and human puberty: current perspectives". J Pineal Res 15 (3): 115-21. doi:10.1111/j.1600-079X.1993.tb00517.x. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 8106956.  
  6. ^ Esquifino A, Villanúa M, Agrasal C (1987). "Effect of neonatal melatonin administration on sexual development in the rat". J Steroid Biochem 27 (4-6): 1089-93. PMID 3121932.  (4-6):1089-93

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