Symptoms of precocious puberty in girls

Nowadays, children are exposed to various electronic devices from birth. In addition, parents want their children to win at the starting point, which leads some parents to send their children who are only a few months old to early education centers. Being exposed to new knowledge from an early age, children's ability to comprehension is enhanced, and their precocious maturity becomes more and more obvious. We will find that some little girls say things that are comparable to those of a little adult. What are the symptoms of precocious puberty in girls?

Precocious puberty is a common developmental abnormality of the pediatric endocrine system. It refers to an abnormal disease in which girls show secondary sexual characteristics before the age of 8 and boys before the age of 9. Central precocious puberty (CPP) is caused by the hypothalamus prematurely increasing the secretion and release of gonadotropin-releasing hormone (GnRH), prematurely activating the function of the gonadal axis, leading to gonadal development and secretion of sex hormones, causing the development of internal and external genitalia and the appearance of secondary sexual characteristics. CPP is also known as GnRH-dependent precocious puberty, and the process is progressive until the reproductive system matures.

Causes:

1. Organic lesions of the central nervous system.

2. Transformed from peripheral precocious puberty.

3. Idiopathic CPP (ICPP) has no organic lesions. 80% to 90% of female patients suffer from ICPP; the opposite is true for male patients, with more than 80% suffering from organic disease. It is speculated that these children with precocious puberty are closely related to the stimulation of environmental endocrine disruptors.

Clinical manifestations:

Symptoms in women include breast development, enlargement of the labia minora, estrogen-dependent changes in vaginal mucosal cells, enlargement of the uterus and ovaries, appearance of pubic hair, and menarche. In men, symptoms include enlarged testicles and penis, appearance of pubic hair, developed muscles, and a deeper voice. Both men and women experience accelerated growth and bone maturation, which may ultimately lead to a lifetime height below the target height. When accompanied by central nervous system diseases such as intracranial tumors, there may be headache, vomiting, vision changes or other neurological symptoms and signs.

examine

1. Imaging examination

(1) X-ray examination and wrist bone film are used to check bone age. The bone age is faster than the actual age.

(2) In girls, the ovarian volume is >1 ml and multiple follicles with a diameter >4 mm can be seen under B-ultrasound. In boys, the testicular volume is ≥4 ml and increases progressively with the course of the disease.

2. Laboratory examination

Blood was taken to measure FSH, LH, E2 and testosterone. The LH/FSH ratio is small in the early stage and increases in the middle stage. LH secretion increases, LH/FSH increases, and E2 increases to more than 10pg/ml. Women can also detect an increase in testosterone in their blood. The testosterone level in men's blood can reach 50-100pg/ml.

3. GnRH stimulation test

If necessary, a stimulation test with GnRH or its analogues can be performed.

The treatment goal of CPP is to improve the child's adult height, and attention should also be paid to preventing psychological problems caused by precocious puberty and early menarche. GnRH analogs (GnRHa) are generally used to treat CPP. The sustained-release GnRHa preparations currently available for children in China include triptorelin and leuprorelin acetate.

GnRHa can effectively inhibit the secretion of LH, causing the development of gonads to be suspended and the secretion of sex hormones to return to the pre-pubertal state, thereby delaying the growth and fusion of epiphyses, and achieving the goal of extending the growth years and improving the final adult height as much as possible.