PRECOCIOUS AND DELAYED PUBERTY Flashcards
(21 cards)
What is the definition of precocious puberty in females?
Sexual maturation takes place before the age of 8.
9 in males
What does the term thenarche mean?
First stage of breast development
What does the term adrenarche mean?
First stage of pubic hair development
What is the most common cause of precocious puberty in females?
Idiopathic in 74% of cases
What are the four organs/systems that may be affected where there is a non-idiopathic cause of precocious puberty?
CNS
Thyroid
Adrenals
Ovary
What are the CNS causes of precocious puberty?
Infection - meningitis, encephalitis, abscess
Tumours - gliomas, neurofibromas, ependymoma, hamartoma
Head trauma
Hydrocephaly
Does hyper or hypothyroidism cause precocious puberty?
Hypothyroidism
What are the adrenal causes of precocious puberty?
Congenital adrenal hyperplasia
Adrenal tumours
What are the ovary related causes of precocious puberty?
Oestrogen secreting tumours especially granulose cell tumours
Premature oestrogen secretion eg McCune-Albright syndrome
What is McCune-Albright syndrome?
A complex genetic disorder affecting the bone, skin, and endocrine systems that is associated with hyperfunctioning endocrine disease, fibrous dysplasia and café au lait macules.
What are the management options for someone with precocious puberty?
Endocrinologist referral - suppression of oestrogen and androgen production by GnRH analogues.
Psychological support
Surgical removal of tumour
What is the definition of delayed puberty in females?
No signs of secondary sexual development by the age of 13.
What is the most common cause of delayed puberty in females?
Gonadal failure
What are the categories of causes of delayed puberty?
Idiopathic CNS Thyroid Adrenal Ovary Genetic Chronic illness
What are the CNS causes of delayed puberty?
Infection - meningitis, encephalitis, abscess
Tumours - pituitary, destructive
Head trauma
Does hyper or hypothyroidism cause delayed puberty?
Hypothyroidism
What are the adrenal causes of delayed puberty?
Congenital adrenal hyperplasia
What are the ovary related causes of delayed puberty?
Gonadal failure
PCOS
Resistant ovary syndrome
What are the genetic diseases associated with delayed puberty?
Turner syndrome Prader-Willi syndrome Laurence-Moon-Biedl syndrome Androgen insensitivity syndrome Gonadal dysgenesis Kalmann's syndrome
What chronic illnesses can lead to delayed puberty?
Anorexia nervosa
Diabetes mellitus
Renal disease
Cystic fibrosis
What investigations would you do in someone with delayed puberty?
Full endocrine profile - LH, FSH, Prolactin, TFT, 17-OH progesterone
Chromosomal analysis
Bone age studies
Imaging - CT or MRI head
