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Symptoms and Signs – Differential Diagnosis of Precocious Puberty
• GnRH-independent precocious puberty: congenital adrenal hyperplasia, adrenocortical tumors (males), McCune-Albright syndrome (females), gonadal tumors, ectopic human chorionic gonadotropin (hCG)–secreting tumors (chorioblastoma, hepatoblastoma), exposure to exogenous sex steroids, severe hypothyroidism
• Gonadotropin hormone–releasing hormone (GnRH)–dependent precocious puberty: idiopathic, CNS tumors, hypothalamic hamartomas, neurofibromatosis, tuberous sclerosis, hydrocephalus, post acute head injury, ventricular cysts, post CNS infection
• Most common diagnoses to consider: premature thelarche and premature adrenarche
• GnRH-independent precocious puberty: congenital adrenal hyperplasia, adrenocortical tumors (males), McCune-Albright syndrome (females), gonadal tumors, ectopic human chorionic gonadotropin (hCG)–secreting tumors (chorioblastoma, hepatoblastoma), exposure to exogenous sex steroids, severe hypothyroidism
• Gonadotropin hormone–releasing hormone (GnRH)–dependent precocious puberty: idiopathic, CNS tumors, hypothalamic hamartomas, neurofibromatosis, tuberous sclerosis, hydrocephalus, post acute head injury, ventricular cysts, post CNS infection
• Most common diagnoses to consider: premature thelarche and premature adrenarche
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