Evaluation and Referral of Children With Signs of Early Puberty
| Autor: | Paul, Kaplowitz, Clifford, Bloch, Kupper A, Wintergerst |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Pediatrics Referral Puberty Precocious 030209 endocrinology & metabolism Palpation 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Humans Medicine Sexual maturity Child Referral and Consultation Gynecology Breast development medicine.diagnostic_test business.industry Adrenarche Age Factors Bone age Pubic hair medicine.anatomical_structure Pediatrics Perinatology and Child Health Female business Penis |
| Zdroj: | Pediatrics. 137 |
| ISSN: | 1098-4275 0031-4005 |
| DOI: | 10.1542/peds.2015-3732 |
| Popis: | Concerns about possible early pubertal development are a common cause for referral to pediatric medical subspecialists. Several recent studies have suggested that onset of breast and/or pubic hair development may be occurring earlier than in the past. Although there is a chance of finding pathology in girls with signs of puberty before 8 years of age and in boys before 9 years of age, the vast majority of these children with signs of apparent puberty have variations of normal growth and physical development and do not require laboratory testing, bone age radiographs, or intervention. The most common of these signs of early puberty are premature adrenarche (early onset of pubic hair and/or body odor), premature thelarche (nonprogressive breast development, usually occurring before 2 years of age), and lipomastia, in which girls have apparent breast development which, on careful palpation, is determined to be adipose tissue. Indicators that the signs of sexual maturation may represent true, central precocious puberty include progressive breast development over a 4- to 6-month period of observation or progressive penis and testicular enlargement, especially if accompanied by rapid linear growth. Children exhibiting these true indicators of early puberty need prompt evaluation by the appropriate pediatric medical subspecialist. Therapy with a gonadotropin-releasing hormone agonist may be indicated, as discussed in this report. |
| Databáze: | OpenAIRE |
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