Pediatria pre prax 6/2019
Precocious puberty – physiological and pathological variants
Puberty is considered precocious when it occurs in girls before 8 years and in boys before 9 years of age. Complete precocious puberty is defined when all clinical symptoms simultaneously are present, in incomplete form we observe its isolated signs. Most often we meet isolated thelarche. In girls less than 4 years of age it is mostly benign phenomenon. Girl with isolated thelarche before 8 years of age should be examined by a pediatric endocrinologist who evaluates growth spurt, bone age and laboratory findings. Premature adrenarche may not always be a benign phenomenon. It represents the spectrum of clinical condition of adrenal diseases with androgen overproduction. Premature central puberty with slowly or rapidly progressing clinical features, including growth spurt, is a pathological condition. This paper emphasizes the cooperation of the general practitioner for children and adolescents in the evaluation of clinical signs of puberty and the timing of the correct indication of endocrinological examination.
Keywords: precocious puberty, thelarche, adrenarche
