US EPA

7436888 

Journal Article 

Precocious Puberty 

Zhu, Jia; , 

2021 

Springer International Publishing 

Cham 

Endocrine Conditions in Pediatrics 

253-258 

10.1007/978-3-030-52215-5_43 

http://link.springer.com/10.1007/978-3-030-52215-5_43
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Precocious puberty is the development of secondary sexual characteristics at an age 2–2.5 standard deviations earlier than the population mean. The etiology of precocious puberty varies significantly and can indicate a critical underlying medical condition or represent a normal variation of development. Broadly, causes of precocious puberty can be divided into the following three categories each with distinct clinical features and pathophysiology: central precocious puberty, peripheral precocity, and variants of pubertal development, such as premature thelarche and premature adrenarche. In all cases of precocious puberty, the initial management is to assess for a malignant or benign tumor that could have emergent life-threatening complications. The long-term management depends on the underlying etiology, and a referral to a pediatric endocrinologist is routinely indicated for consideration of treatment and monitoring for long-term consequences. In this chapter, the etiology, key pathophysiology, and distinguishing clinical features of precocious puberty are reviewed, and recommendations regarding initial management and considerations for a referral to a pediatric endocrinologist are provided.