What are the symptoms of precocious puberty?

When the disease of precocious puberty occurs, you will find that your child's physical age is much older than his mental age, and even excessive breast development will occur during childhood. If it is a boy, you will find that the testicles are developing. This is a phenomenon that only occurs during puberty, but it appears too early in childhood. This is not a normal situation and must be treated.

1. Central precocious puberty 50% of children with central precocious puberty begin to develop before the age of 6 years. Female symptoms 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. Male symptoms include enlarged testicles and penis, appearance of pubic hair, developed muscles, and a deeper voice. Both men and women have accelerated growth and accelerated bone maturation, which may ultimately lead to a lifetime height below the target height. When accompanied by central nervous system lesions such as intracranial tumors, there may be headaches, vomiting, vision changes or other neurological symptoms and signs.

2. Peripheral precocious puberty Peripheral precocious puberty is also called pseudo-precocious puberty. The clinical manifestations include the appearance of secondary sexual characteristics, but they are not initiated during puberty. It has nothing to do with the activity of the hypothalamus-pituitary-gonadal axis, but is related to the increase in endogenous or exogenous sex hormone levels.

(1) Familial hypertestosteronism: an autosomal dominant hereditary precocious puberty seen only in males. The cause is a mutation in the gene encoding the LH receptor, which causes the LH receptor on the cell membrane to be in a state of continuous activation. The blood testosterone level reaches the adolescent or adult level, but the LH secretion pattern and the LH response in the LHRH stimulation test are pre-pubertal, manifested as bilateral testicular enlargement, accelerated growth and accelerated bone maturation. Testicular biopsy can show maturation of interstitial cells and development of seminiferous tubules.

(2) McCune-Albright syndrome: Typical clinical manifestations include café-au-lait spots on the skin, multiple cystic fibrosis and peripheral precocious puberty. The distribution of café-au-lait spots on the skin usually does not exceed the midline and is located on the same side of the body as the bone lesions. Multiple cystic fibrosis is chronic and progressive. Bone lesions often involve the long bones of the limbs, pelvis, and skull, and may cause pseudocysts, deformations, and fractures. The disease is more common in girls than in boys and may be accompanied by hyperfunction of the thyroid, adrenal glands, pituitary glands, and parathyroid glands, manifesting as nodular goiter, hyperthyroidism, adrenal nodular hyperplasia, and excessive secretion of growth hormone resulting in gigantism or acromegaly.

Precocious puberty in females often begins within 2 years of age, and vaginal bleeding may be seen later. LH and FSH levels are suppressed, and there is a low response to GnRH. Estrogen levels often fluctuate between normal and significantly elevated, often in a cyclical manner, which may be related to changes in the size of ovarian cysts. Ovarian cysts often show alternating enlargement and reduction. Precocious puberty in boys is rare, and their testicles enlarge symmetrically. When the bone age approaches 12 years old, the GnRH impulse source is activated, and true and false precocious puberty overlap.

McCune-Albright syndrome is caused by mutations in the Gas subunit of somatic cells that encodes guanosine triphosphate (GTP)-binding protein, which activates adenylate cyclase. GTP-binding protein is a link in the hormone signal transduction pathway.

(3) Tumors: Adrenal cortical tumors are one of the main causes of pseudo-precocious puberty in both males and females. Adrenal cortical tumors (adenomas, carcinomas) that mainly secrete androgens, as well as adrenal cortical hyperplasia, cause homosexual peripheral precocious puberty in boys and heterosexual precocious puberty in girls. Growth deceleration is what distinguishes this disease from other precocious puberty. Identification of the lesion should rely on adrenal imaging examinations.

The above article introduces to us in detail the manifestations of precocious puberty. After precocious puberty, pubic hair or armpit hair will appear, especially in girls, the symptoms will be more obvious, and menstruation will occur directly, such as vaginal bleeding. This must be restrained, otherwise the harm will be particularly great.