Methods for detecting precocious puberty in children

If your child suffers from precocious puberty, you must take them to the hospital for relevant examinations, because only in this way can you confirm whether your child suffers from precocious puberty and the specific cause of precocious puberty. Only by finding the cause can you prescribe the right medicine, otherwise there is no way to completely cure this disease. So what are the examinations for precocious puberty in children?

People with constitutional precocious puberty may have enlarged ovaries and cystic changes. If adrenal cortical disease is suspected, retroperitoneal pneumatic radiography may be performed. Take anteroposterior and lateral views of the head to observe the size of the sella turcica to exclude tumors, etc.

1. Laboratory examination of precocious puberty in children

A detailed and complete medical history, including sexual development, vaginal bleeding, whether endocrine drugs are taken, etc. The measurement of follicle-stimulating hormone (FSH) and LH in the blood by radioimmunoassay can help distinguish true from false precocious puberty. People with constitutional precocious puberty may have enlarged ovaries and cystic changes. If adrenal cortical disease is suspected, retroperitoneal pneumatic radiography may be performed. Take anteroposterior and lateral views of the head to observe the size of the sella turcica to exclude tumors, etc.

Plasma FSH and LH determination

Examination and types of precocious puberty in healthy babies and children

The basal values ​​of plasma FSH and LH in children with idiopathic precocious puberty may be higher than normal, which is often difficult to judge and requires the use of GnRH stimulation test, also known as luteinizing hormone releasing hormone (LHRH) stimulation test. Generally, Gnrh is injected intravenously at 2.5μg/kg (maximum dose ≤100μg). Serum LH and FSH are measured before injection (basal value) and 30, 60, 90 and 120 minutes after injection. When the HL peak is 15U/L (female) or 25U/L (male); LH/FSH peak is 0.7, and LH peak/basal value is 3, it can be considered that the gonad axis function has been activated.

Bone age determination

Bone age is assessed based on X-rays of the hands and wrists to determine whether bone development is advanced. Children with precocious puberty generally have a bone age that is older than their actual age.

Ultrasound examination

Examination and types of precocious puberty in healthy babies and children

Choose pelvic B-ultrasound to check the development of the ovaries and uterus of girls; for boys, pay attention to the testicles, adrenal cortex and other parts. If the pelvic B-ultrasound shows multiple follicles ≥4mm in the ovaries, it is precocious puberty. If a single follicle with a diameter of ≥9mm is found, it is mostly a cyst. If the ovaries are not large and the uterus is ≥3.5cm in length and endometrial thickening is seen, it is mostly the effect of exogenous androgens.

CT or MRI

If an intracranial tumor or adrenal disease is suspected, a head or abdominal CT or MRI examination should be performed.

Other tests

Other tests can be further selected based on the child's clinical manifestations. For example, if hypothyroidism is suspected, T3, T4, and TSH can be measured. Gonadal tumors have increased testosterone and estradiol concentrations. Children with congenital adrenal hyperplasia have significantly increased blood 17-hydroxyprogesterone (17-OHP) and urinary 17-ketosteroid (17-KS).

To sum up, we have learned about the examinations for precocious puberty in children. Usually, it requires B-ultrasound examination or CT examination. These are the most routine examination items for people, but they can show the type of precocious puberty of your child. The most important thing is to measure the bone age.