Precocious Puberty: A Case Report

Anna Felita, Ivanna Sarahfebi, Anastasia Nadya, P. Anjali, Chandni P. Daryanani
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Abstract

Background Puberty is a transitional period in children with acceleration of growth and development of secondary sexual characteristics. When this period appears before the age of 8 to 9 years in children, it is called precocious puberty.  Depending on the primary source of the hormonal production, precocious puberty may be classified as central (gonadotropin dependent or true) or peripheral (gonadotropin independent or precocious pseudo-puberty). Case presentation We herein report a case of precocious puberty in a 7,5-year-old girl who has shown early sign of secondary sexual development. Patients complained pain on her nipple, her breasts began to grow in size, and changes in her body odour, but had no complaints about her pubic hair growth and any vaginal discharge. Laboratory findings shown high level in fertility hormones and level of bone age is equal to 10-year-old girl. Patient then had begun to receive monthly therapy of Leuprolide. Conclusion Detailed history taking on chronological order of thelarche, pubarche, menarche, and adrenarche, followed by assessment on family history, nutritional history, child developmental history, medication history, and neurological complaints should be done in order to diagnose precocious puberty. Physical examination and other examination of bone age determination, Luteinizing Hormone and Follicle-Stimulating Hormone level, and pelvic ultrasound are essentials in defining the diagnosis and treatment. Leuprolide is indicated for Central Precocious Puberty patient who have advanced bone age at the time of initial evaluation. As a clinician, it is necessary to diagnose precocious puberty as soon as possible to have good prognosis for the patient.
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性早熟1例报告
青春期是儿童第二性征生长和发育加速的过渡时期。当这一时期出现在8至9岁之前的儿童,它被称为性早熟。根据激素产生的主要来源,性早熟可分为中枢性(促性腺激素依赖性或真性)或外周性(非促性腺激素依赖性或假性性早熟)。我们在此报告一例性早熟的7,5岁的女孩谁已经显示出第二性发育的早期迹象。患者抱怨她的乳头疼痛,乳房开始变大,她的体味也发生了变化,但没有人抱怨她的阴毛生长和阴道分泌物。实验室结果显示,生育激素水平高,骨龄水平与10岁女孩相当。随后,患者开始接受每月一次的Leuprolide治疗。结论对性早熟的诊断应进行详细的病史调查,包括年龄、青春期、月经初潮、肾上腺素初潮的时间顺序,以及家族史、营养史、儿童发展史、用药史和神经系统疾病的评估。体格检查及骨龄测定、促黄体生成素和促卵泡激素水平、盆腔超声检查是确定诊断和治疗的必要条件。Leuprolide适用于在初始评估时骨龄较高的中枢性性早熟患者。作为临床医生,尽早诊断性早熟对患者有良好的预后是必要的。
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