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Precocious puberty is when the first signs of puberty are detected in girls before the age of 8 and before the age of 9-10 in boys. The consequence is a decrease in height in adulthood, in addition, it also causes psychological disorders for children because of abnormal changes in the body compared to peers. There are many ways to diagnose precocious puberty in children, one of which is to measure serum gonadotropin levels.
1. How is early puberty in children classified?
If based on Gonadotropin-Releasing hormone (GnRH), precocious puberty is divided into 2 types:
Central precocious puberty (GnRH dependent) Peripheral precocious puberty (GnRH independent) Precocious GnRH dependent precocious puberty more common in girls in particular and children in general than in the non-GnRH-independent type. Activation of the anterior hypothalamus due to precocious puberty in this case would lead to enlargement and maturation of the gonads. At the same time, development of secondary sexual characteristics and the development of eggs or sperm. On the other hand, peripheral precocious puberty is less common with secondary sexual characteristics due to circulating estrogen and androgens levels without influence of hypothalamic-pituitary axis activity.
Another classification is precocious puberty with gonadal development or precocious puberty with adrenocortical development:
Gonadal development: in girls it will be breast development, muscle habits growth of the uterus and appearance of menstruation, in boys testicular growth, penile growth and appearance of pubic, face, and armpit hair, adult body odor . Adrenal cortex growth in both sexes is associated with more body hair growth, body odor, and acne. However, there are cases of children with precocious adrenocortical maturation that is not associated with precocious puberty but is indicative of hyperandrogenism. Watch now: The role of ultrasound, X-ray and other imaging means in the diagnosis of precocious puberty
2. What is the reason for early puberty in children?
For GnRH-dependent precocious puberty in children, it is often not possible to determine the cause in affected girls. But in boys, up to 60% of cases are found with potential lesions such as intracranial tumors, particularly in the hypothalamus or pineal region, including hamartomas, gliomas, germinomas and adenomas. In addition, neurofibromatosis and several other rare disorders are also associated with precocious puberty. Surgery, radiation therapy, or ischemic chemotherapy may also be responsible for central precocious puberty.
Precocious puberty that is not GnRH dependent is often due to the influence of sex hormones (estrogens or androgens) causing physical changes that are often markedly different from normal pubertal development. :
Tumor of the adrenal gland or pituitary gland that secretes estrogen or testosterone. McCune-Albright syndrome Exposure to external sources of estrogen or testosterone such as creams or ointments. Girls may be related to ovarian tumors or cysts. Boys may be related to tumors in sperm-making or testosterone-producing cells, a defect in a gene that causes premature production of testosterone. >>See more: LH testing and puberty in children - Article written by MSc Tran Quynh Trang - Doctor of Biochemistry, Laboratory Department - Vinmec Times City International Hospital
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3. Diagnosis of precocious puberty in children by GnRH . stimulation test
The diagnosis of precocious puberty in children is often based mainly on clinical and laboratory tests such as X-rays of the left hand and wrist to check for bone maturation, and GnRH stimulation testing has not been performed. a lot of. However, since GnRH stimulation tests can help differentiate children with central precocious puberty, they are of great value.
GnRH stimulation test is a test used to diagnose central precocious puberty, considered the gold standard for detecting early hypothalamic-pituitary-gonadal axis activity in patients with precocious puberty. center. Besides, they are also the basis for differential diagnosis between central precocious puberty and peripheral precocious puberty. Normally, GnRH is controlled and secreted in a rhythmic manner in the anterior pituitary gland, regulating the secretion of gonadotropic hormones LH and FSH, stabilizing the concentration according to each period of the child. When the concentration is raised suddenly without rhythm, it will cause GnRH to be continuously stimulated, leading to increased sex hormone secretion and these values can be measured in the blood. The GnRH stimulation test is positive when the peak LH response is above 5 IU/L and is the criterion for diagnosing precocious puberty in children.
If your baby is having problems with height growth and pubertal sex development, you should take your baby to a reputable medical facility for early examination for timely intervention. Currently, Vinmec Times City International Hospital and Pediatric Endocrinology Clinic - Vinmec Central Park International General Hospital are reputable and quality addresses for treating precocious puberty in children in Vietnam. . With in-depth expertise, extensive teaching and treatment experience and equipped with modern facilities, it will bring optimal treatment results, helping children to develop normally according to the right age.
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