Materiały źródłowe

• #1 Precocious Puberty – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK544313/

  Precocious puberty is classified into two major categories based on the etiology […] Central precocious puberty (GnRH dependent) […] Peripheral precocious puberty (GnRH independent) […] This type of precocious puberty represents true pubertal development due to the earlier maturation and activation of the HPG axis. Most of the time, the common cause in females is idiopathic, and in males, there is usually an underlying pathology. It is attributable to a multitude of conditions. […] The most relevant categories include CNS tumors, CNS injury, genetics, syndromes, environmental factors, and familial precocious puberty. […] Precocious development of secondary sexual characteristics independent of the GnRH pulsatile secretion constitutes PPP; this is due to the production of sex steroids from endogenous or exogenous sources. It is less frequent compared to the CPP. Some important causes include congenital adrenal hyperplasia, McCune-Albright syndrome, gonadal tumors, adrenal tumors, familial male-limited precocious puberty, exogenous exposure to sex steroids, and Van Wyk and Grumbach syndrome.

• #2 Definition, etiology, and evaluation of precocious puberty – UpToDate

  https://www.uptodate.com/contents/definition-etiology-and-evaluation-of-precocious-puberty

  Definition, etiology, and evaluation of precocious puberty […] CAUSES OF CENTRAL PRECOCIOUS PUBERTY […] Idiopathic […] Central nervous system lesions […] Genetics […] Previous excess sex steroid exposure […] Pituitary gonadotropin-secreting tumors […] CAUSES OF PERIPHERAL PRECOCITY […] Females […] – Ovarian cysts […] – Ovarian tumors […] Males […] – Leydig cell tumors […] – Human chorionic gonadotropin-secreting germ-cell tumors […] – Familial male-limited precocious puberty […] Both females and males […] – Primary hypothyroidism […] – Exogenous sex steroids and endocrine-disrupting chemicals […] – Adrenal pathology […] – McCune-Albright syndrome […] INTRODUCTION […] Precocious puberty is the onset of pubertal development at an age that is 2 to 2.5 standard deviations (SD) earlier than population norms. The cause of precocious puberty may range from a variant of normal development (eg, isolated premature adrenarche or isolated premature thelarche) to pathologic conditions with significant risk of morbidity and even death (eg, malignant germ-cell tumor or astrocytoma).

• #3 Precocious puberty – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/precocious-puberty/symptoms-causes/syc-20351811

  Precocious puberty is when children’s bodies begin to change into adult bodies too soon. […] The cause of precocious puberty often can’t be found. Rarely, certain conditions, such as infections, hormone issues, tumors, brain issues or injuries, may cause precocious puberty. […] The cause of this type of precocious puberty often isn’t known. […] In rare cases, the following can cause central precocious puberty: A tumor in the brain or spinal cord. A change in the brain that’s present at birth. This could be fluid buildup, known as hydrocephalus, or a tumor that isn’t cancer, known as a hamartoma. Radiation to the brain or spinal cord. Injury to the brain or spinal cord. A rare genetic disease that affects bones and skin color and causes hormonal problems. This condition is called McCune-Albright syndrome. A group of genetic issues, called congenital adrenal hyperplasia, that involve the adrenal gland making atypical hormones. A condition called hypothyroidism in which the thyroid gland doesn’t make enough hormones.

• #4 Precocious Puberty – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK544313/

  Precocious puberty is classified into two major categories based on the etiology […] Central precocious puberty (GnRH dependent) […] Peripheral precocious puberty (GnRH independent) […] This type of precocious puberty represents true pubertal development due to the earlier maturation and activation of the HPG axis. Most of the time, the common cause in females is idiopathic, and in males, there is usually an underlying pathology. It is attributable to a multitude of conditions. […] The most relevant categories include CNS tumors, CNS injury, genetics, syndromes, environmental factors, and familial precocious puberty. […] Precocious development of secondary sexual characteristics independent of the GnRH pulsatile secretion constitutes PPP; this is due to the production of sex steroids from endogenous or exogenous sources. It is less frequent compared to the CPP. Some important causes include congenital adrenal hyperplasia, McCune-Albright syndrome, gonadal tumors, adrenal tumors, familial male-limited precocious puberty, exogenous exposure to sex steroids, and Van Wyk and Grumbach syndrome.

• #5 Precocious Early Puberty | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/precocious-early-puberty

  When a child enters puberty (the process of becoming sexual mature) too early, it’s called precocious puberty, or early puberty. […] In girls, the cause of precocious puberty 90 to 95 percent of the time is idiopathic, or unknown, meaning doctors don’t know for certain why it happens. Boys are more likely to have an underlying identifiable cause. Early puberty and sexual development may be caused by: central nervous system abnormalities, family history of the disorder, certain rare genetic syndromes, tumors of the pituitary gland or brain. […] Peripheral precocious puberty may be caused by: certain rare genetic syndromes, tumors of the ovary or testis, other tumors that secrete human chorionic gonadotropin, disorders of the adrenal gland, severe hypothyroidism. […] The goal of treatment for precocious puberty is to stop, and possibly reverse, the onset of puberty. Treatment will also depend on the type of precocious puberty your child has and the underlying cause, if known.

• #6 Etiology of precocious puberty, 10 years study in Endocrine Reserch Centre (Firouzgar), Tehran

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4163256/

  Precocious puberty, as early physical development and low final height might lead to psychosocial problems. […] To evaluate etiology and clinical feature of precocious puberty in a cohort of Iranian children. […] Patients, concerning etiology of precocious puberty were classified in three categories: 42.6% of patients had central precocious puberty (CPP), including idiopathic CPP (87.5%) and neurogenic CPP (12.5%). 23.3% of patients had peripheral precocious puberty (PPP), including congenital adrenal hyperplasia (CAH) (42.8%), ovarian cysts (28.4%), McCune-Albright syndrome (14.2%) and adrenal carcinoma (14.2%). […] The most common etiology of precocious puberty in girls was idiopathic central precocious puberty and premature thelarche, while in boys they were neurogenic central precocious puberty and CAH.

• #7 Etiology of precocious puberty, 10 years study in Endocrine Reserch Centre (Firouzgar), Tehran

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4163256/

  Precocious puberty, as early physical development and low final height might lead to psychosocial problems. […] To evaluate etiology and clinical feature of precocious puberty in a cohort of Iranian children. […] Patients, concerning etiology of precocious puberty were classified in three categories: 42.6% of patients had central precocious puberty (CPP), including idiopathic CPP (87.5%) and neurogenic CPP (12.5%). 23.3% of patients had peripheral precocious puberty (PPP), including congenital adrenal hyperplasia (CAH) (42.8%), ovarian cysts (28.4%), McCune-Albright syndrome (14.2%) and adrenal carcinoma (14.2%). […] The most common etiology of precocious puberty in girls was idiopathic central precocious puberty and premature thelarche, while in boys they were neurogenic central precocious puberty and CAH.

• #8 Disorders of Puberty: An Approach to Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1101/p590.html

  Precocious puberty is pubertal onset before eight years of age in girls and before nine years of age in boys. […] Among patients with true precocious puberty, or full activation of the hypothalamic-pituitary-gonadal axis, most girls have an idiopathic etiology, whereas it is commonly due to identifiable pathology on imaging in boys. […] Abnormal pubertal timing can adversely affect a child’s physical and psychosocial well-being and may be caused by a range of generally benign or pathologic etiologies. […] Central precocious puberty is approximately 10-fold more common in girls than in boys. […] Although usually idiopathic in girls, it can be incited by head trauma, neoplasm, radiation, or genetic conditions. […] Pathologic causes of central precocious puberty are more common in boys.

• #9

  https://www.archivesofmedicalscience.com/Central-precocious-puberty-etiology-with-particular-consideration-of-neurological,121051,0,2.html

  Central precocious puberty (CPP) is a rare disease of poorly understood etiology. The cause is mostly idiopathic. However, congenital and acquired structural changes in the central nervous system are also involved. […] The etiology of CPP is very diverse. In girls, idiopathic CPP accounts for the vast majority of cases. However, recently the incidence of idiopathic cases has decreased due to the detection of gene mutations that lead to premature activation of the GnRH pulse generator. In boys, however, organic changes in the CNS are much more prevalent (40-75% of cases), which prompts imaging assessment of the CNS in each case of CPP among boys. […] The pathomechanism of CPP in HH patients is not well understood. Currently, several hypotheses are considered: a) HH acts as an ectopic GnRH pulse generator; b) HH is composed of transforming growth factor (TGF-) producing astroglial cells that could cause premature activation of pulsatile GnRH release; c) due to increased CNS pressure associated with the presence of tumor mass, reduced influence of inhibitory neurotransmitters on GnRH neurons in the hypothalamus is observed.

• #10 Precocious puberty – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/precocious-puberty/symptoms-causes/syc-20351811

  Precocious puberty is when children’s bodies begin to change into adult bodies too soon. […] The cause of precocious puberty often can’t be found. Rarely, certain conditions, such as infections, hormone issues, tumors, brain issues or injuries, may cause precocious puberty. […] The cause of this type of precocious puberty often isn’t known. […] In rare cases, the following can cause central precocious puberty: A tumor in the brain or spinal cord. A change in the brain that’s present at birth. This could be fluid buildup, known as hydrocephalus, or a tumor that isn’t cancer, known as a hamartoma. Radiation to the brain or spinal cord. Injury to the brain or spinal cord. A rare genetic disease that affects bones and skin color and causes hormonal problems. This condition is called McCune-Albright syndrome. A group of genetic issues, called congenital adrenal hyperplasia, that involve the adrenal gland making atypical hormones. A condition called hypothyroidism in which the thyroid gland doesn’t make enough hormones.

• #11 Precocious Puberty – Early Puberty: Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/21064-precocious-early-puberty

  Precocious puberty has different causes depending on the type. […] Central precocious puberty occurs when your child’s brain releases GnRH too early, in turn causing their testes or ovaries to release androgens too early. In most cases, the cause of this especially in female children is unknown. Causes may include: Brain trauma, Brain tumors, Brain infections, Brain abnormalities, Radiation treatment. […] Issues with your child’s reproductive organs or adrenal glands cause peripheral precocious puberty. Causes may include: Ovary, testes or adrenal gland tumors, Tumors that release human chorionic gonadotropin (HCG), Genetic conditions, such as McCune-Albright syndrome, Severe hypothyroidism, Adrenal gland disorders, like congenital adrenal hyperplasia. […] Sometimes, exposure to hormones from sources outside your child’s body causes peripheral precocious puberty. For example, exposure to products like creams, medications or supplements containing estrogen, testosterone or androgen.

• #12 Precocious Puberty – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK544313/

  The most common brain lesion causing CPP is hypothalamic hamartoma. […] There have been some reports of familial forms, but the genetic basis is not well understood. Recent years have seen some interesting associations with mutations of kisspeptin (KISS1) and makorin ring finger (MRF3) genes and their receptors. These genes are responsible for the stimulatory and inhibitory signals to the GnRH release. Loss or gain of function mutations in these genes results in CPP.

• #13 Precocious Puberty: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/924002-overview

  Most patients, particularly girls suspected of having CPP, are otherwise healthy children whose pubertal maturation begins at the early end of the normal distribution curve. […] CNS abnormalities associated with precocious puberty include the following: Tumors (eg, astrocytomas, gliomas, germ cell tumors secreting human chorionic gonadotropin [HCG]), Hypothalamic hamartomas, Acquired CNS injury caused by inflammation, surgery, trauma, radiation therapy, or abscess, Congenital anomalies (eg, hydrocephalus, arachnoid cysts, suprasellar cysts). […] A study by Dahl et al indicated that the risk of precocious or early puberty is high in girls who have had shunted infantile hydrocephalus.

• #14 What Is Precocious Puberty?

  https://www.icliniq.com/articles/growth/neurogenic-precocious-puberty

  Attaining puberty at an early age is called precocious puberty. Hypothalamic hamartoma is considered a common cause of the same. The exact cause is not known. Some conditions like infections, tumors, brain defects, and hormone disorders rarely cause precocious puberty. Neurogenic precocious puberty is a neuroendocrine disease that involves hormonal abnormalities. […] In CPP cause may not be pointed out. The majority of children with this condition show normal steps and patterns of the process, except that puberty starts earlier than usual time. These children did not show any underlying medical conditions or other reasons for early puberty. Some causes of CPP in rare conditions include; tumors in the brain or spinal cord, defects in the brain present at birth, like excess fluid buildup (hydrocephalus) or a noncancerous tumor (hamartoma), radiation to the brain or spinal cord, injury to the brain or spinal cord, McCune-Albright syndrome (a rare disorder that affects the bones, skin, and many tissues that produce hormones), congenital adrenal hyperplasia (a group of genetic disorders affecting adrenal glands present above the kidney), hypothyroidism (the thyroid gland does not produce enough hormones or underactive thyroid gland). Other causes of neurogenic CIPP are neuro tuberculosis, pituitary adenoma, hydrocephalus, post-radiotherapy, central nervous system (CNS) tumors, and malformations.

• #15 Precocious Puberty Causes

  https://mobile.fpnotebook.com/Endo/Sex/PrcsPbrtyCs.htm

  Precocious Puberty Causes […] GnRH dependent (True or Central): Complete Isosexual […] Idiopathic […] CNS Lesion (e.g. pituitary tumor) […] Secondary to GnRH independent Precocious Puberty […] Hypothyroidism (unclear cause) […] Chronic Adrenal Insufficiency […] GnRH independent (Peripheral – always abnormal) […] Adrenal Causes […] 21-OH deficiency […] 11-OH deficiency […] Results […] Girls: contrasexual […] Boys: isosexual […] Tumor: Contrasexual OR Isosexual […] Gonadal Cause […] McCune-Albright Syndrome (Isosexual) […] Polyostotic fibrous dysplasia […] Cafe Au Lait spots […] Precocious Puberty […] Associated with Hyperthyroidism, Cushing’s Syndrome […] Familial Male (Testotoxicosis, Isosexual) […] Tumor (Isosexual or Contrasexual) […] Miscellaneous Cause

• #16 Precocious Puberty Causes

  https://mobile.fpnotebook.com/Endo/Sex/PrcsPbrtyCs.htm

  Precocious Puberty Causes […] GnRH dependent (True or Central): Complete Isosexual […] Idiopathic […] CNS Lesion (e.g. pituitary tumor) […] Secondary to GnRH independent Precocious Puberty […] Hypothyroidism (unclear cause) […] Chronic Adrenal Insufficiency […] GnRH independent (Peripheral – always abnormal) […] Adrenal Causes […] 21-OH deficiency […] 11-OH deficiency […] Results […] Girls: contrasexual […] Boys: isosexual […] Tumor: Contrasexual OR Isosexual […] Gonadal Cause […] McCune-Albright Syndrome (Isosexual) […] Polyostotic fibrous dysplasia […] Cafe Au Lait spots […] Precocious Puberty […] Associated with Hyperthyroidism, Cushing’s Syndrome […] Familial Male (Testotoxicosis, Isosexual) […] Tumor (Isosexual or Contrasexual) […] Miscellaneous Cause

• #17 Precocious Puberty: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/924002-overview

  Most patients, particularly girls suspected of having CPP, are otherwise healthy children whose pubertal maturation begins at the early end of the normal distribution curve. […] CNS abnormalities associated with precocious puberty include the following: Tumors (eg, astrocytomas, gliomas, germ cell tumors secreting human chorionic gonadotropin [HCG]), Hypothalamic hamartomas, Acquired CNS injury caused by inflammation, surgery, trauma, radiation therapy, or abscess, Congenital anomalies (eg, hydrocephalus, arachnoid cysts, suprasellar cysts). […] A study by Dahl et al indicated that the risk of precocious or early puberty is high in girls who have had shunted infantile hydrocephalus.

• #18 Central precocious puberty: MedlinePlus GeneticsLock

  https://medlineplus.gov/genetics/condition/central-precocious-puberty/

  Central precocious puberty is a condition that causes early sexual development in girls and boys. […] The cause of central precocious puberty is often unknown. The most common known genetic cause of central precocious puberty is mutations in the MKRN3 gene. Changes in other genes are rare causes of the condition, and researchers suspect that changes in genes that have not yet been identified may also be involved in central precocious puberty. […] The protein produced from the MKRN3 gene plays a role in directing the onset of puberty. Puberty begins when a gland in the brain called the hypothalamus is stimulated to release bursts of a hormone called gonadotropin releasing hormone (GnRH). This hormone triggers the release of other hormones that direct sexual development. […] The MKRN3 gene mutations involved in central precocious puberty are thought to lead to production of a nonfunctional MKRN3 protein.

• #19 Precocious puberty – Wikipedia

  https://en.wikipedia.org/wiki/Precocious_puberty

  Although the causes of early puberty are still somewhat unclear, girls who have a high-fat diet and are not physically active or are obese are more likely to physically mature earlier. […] In addition to diet and exercise habits, exposure to chemicals that mimic estrogen (known as xenoestrogens) is another possible cause of early puberty in girls. […] Familial cases of idiopathic central precocious puberty (ICPP) have been reported, leading researchers to believe there are specific genetic modulators of ICPP. […] Mutations in genes such as LIN28, and LEP and LEPR, which encode leptin and the leptin receptor, have been associated with precocious puberty. […] Mutations in the kisspeptin (KISS1) and its receptor, KISS1R (also known as GPR54), involved in GnRH secretion and puberty onset, are also thought to be the cause for ICPP. […] The gene MKRN3, which is a maternally imprinted gene, has since been identified as a cause of premature sexual development or CPP.

• #20 SciELO Brazil – Central precocious puberty: revisiting the diagnosis and therapeutic management Central precocious puberty: revisiting the diagnosis and therapeutic management

  https://www.scielo.br/j/aem/a/Tpzrbb9PdZR7FcnkJw7C69f/?lang=en

  The main etiologies of CPP are listed in Table 1 (10-15). Idiopathic CPP represents 90% of the cases in girls, whereas organic etiologies are more frequent (60% to 70%) in boys. However, these epidemiological data are currently being revised with the new genetic and imaging diagnostic methods (8). […] In all cases of idiopathic CPP with or without familial history, molecular study of the makorin ring-finger 3 (MKRN3) gene, recently implicated in the genetic etiology of CPP, is indicated and may elucidate the genetic basis of the CPP, with no implication on diagnosis and therapeutic management (26). MKRN3 has a potential inhibitory effect on GnRH secretion and inactivating MKRN3 mutations have been identified in families from several geographical origins (12). In fact, MKRN3 represents the most common genetic cause of CPP (Table 1). In familial CPP, MKRN3 defects were found in about 30% of families (45) while in patients with apparently sporadic CPP, MKRN3 defects were detected in about 8% of cases (12).

• #21 SciELO Brazil – Central precocious puberty: revisiting the diagnosis and therapeutic management Central precocious puberty: revisiting the diagnosis and therapeutic management

  https://www.scielo.br/j/aem/a/Tpzrbb9PdZR7FcnkJw7C69f/?lang=en

  The main etiologies of CPP are listed in Table 1 (10-15). Idiopathic CPP represents 90% of the cases in girls, whereas organic etiologies are more frequent (60% to 70%) in boys. However, these epidemiological data are currently being revised with the new genetic and imaging diagnostic methods (8). […] In all cases of idiopathic CPP with or without familial history, molecular study of the makorin ring-finger 3 (MKRN3) gene, recently implicated in the genetic etiology of CPP, is indicated and may elucidate the genetic basis of the CPP, with no implication on diagnosis and therapeutic management (26). MKRN3 has a potential inhibitory effect on GnRH secretion and inactivating MKRN3 mutations have been identified in families from several geographical origins (12). In fact, MKRN3 represents the most common genetic cause of CPP (Table 1). In familial CPP, MKRN3 defects were found in about 30% of families (45) while in patients with apparently sporadic CPP, MKRN3 defects were detected in about 8% of cases (12).

• #22 Etiology of Central Precocious Puberty | Endocrine Society

  https://www.endocrine.org/journals/endocrine-reviews/etiology-of-central-precocious-puberty

  The etiology of central precocious puberty (CPP) is multiple and heterogeneous, including congenital and acquired causes that can be associated with structural or functional brain alterations. […] Hypothalamic hamartoma (HH) is the most well-known congenital cause of CPP with central nervous system abnormalities. […] The importance of genetic and/or epigenetic factors in the underlying mechanisms of CPP has grown significantly in the last decade, as demonstrated by the evidence of genetic abnormalities in hypothalamic structural lesions (e.g., hamartomas, gliomas), syndromic disorders associated with CPP (Temple, Prader-Willi, Silver-Russell, and Rett syndromes), and isolated CPP from monogenic defects (MKRN3 and DLK1 loss-of-function mutations). […] Genetic and epigenetic discoveries involving the etiology of CPP have had influence on the diagnosis and familial counseling providing bases for potential prevention of premature sexual development and new treatment targets in the future.

• #23 Precocious Puberty – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK544313/

  The most common brain lesion causing CPP is hypothalamic hamartoma. […] There have been some reports of familial forms, but the genetic basis is not well understood. Recent years have seen some interesting associations with mutations of kisspeptin (KISS1) and makorin ring finger (MRF3) genes and their receptors. These genes are responsible for the stimulatory and inhibitory signals to the GnRH release. Loss or gain of function mutations in these genes results in CPP.

• #24 Precocious puberty – Wikipedia

  https://en.wikipedia.org/wiki/Precocious_puberty

  Although the causes of early puberty are still somewhat unclear, girls who have a high-fat diet and are not physically active or are obese are more likely to physically mature earlier. […] In addition to diet and exercise habits, exposure to chemicals that mimic estrogen (known as xenoestrogens) is another possible cause of early puberty in girls. […] Familial cases of idiopathic central precocious puberty (ICPP) have been reported, leading researchers to believe there are specific genetic modulators of ICPP. […] Mutations in genes such as LIN28, and LEP and LEPR, which encode leptin and the leptin receptor, have been associated with precocious puberty. […] Mutations in the kisspeptin (KISS1) and its receptor, KISS1R (also known as GPR54), involved in GnRH secretion and puberty onset, are also thought to be the cause for ICPP. […] The gene MKRN3, which is a maternally imprinted gene, has since been identified as a cause of premature sexual development or CPP.

• #25 Precocious puberty – Wikipedia

  https://en.wikipedia.org/wiki/Precocious_puberty

  Although the causes of early puberty are still somewhat unclear, girls who have a high-fat diet and are not physically active or are obese are more likely to physically mature earlier. […] In addition to diet and exercise habits, exposure to chemicals that mimic estrogen (known as xenoestrogens) is another possible cause of early puberty in girls. […] Familial cases of idiopathic central precocious puberty (ICPP) have been reported, leading researchers to believe there are specific genetic modulators of ICPP. […] Mutations in genes such as LIN28, and LEP and LEPR, which encode leptin and the leptin receptor, have been associated with precocious puberty. […] Mutations in the kisspeptin (KISS1) and its receptor, KISS1R (also known as GPR54), involved in GnRH secretion and puberty onset, are also thought to be the cause for ICPP. […] The gene MKRN3, which is a maternally imprinted gene, has since been identified as a cause of premature sexual development or CPP.

• #26 Central precocious puberty: MedlinePlus GeneticsLock

  https://medlineplus.gov/genetics/condition/central-precocious-puberty/

  Central precocious puberty follows an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder. […] The condition can also occur in people with no family history of the disorder. These cases are called sporadic central precocious puberty. Some apparently sporadic cases are caused by MKRN3 gene mutations inherited from an unaffected father.

• #27 Central precocious puberty: MedlinePlus GeneticsLock

  https://medlineplus.gov/genetics/condition/central-precocious-puberty/

  Central precocious puberty follows an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder. […] The condition can also occur in people with no family history of the disorder. These cases are called sporadic central precocious puberty. Some apparently sporadic cases are caused by MKRN3 gene mutations inherited from an unaffected father.

• #28 Etiology of precocious puberty, 10 years study in Endocrine Reserch Centre (Firouzgar), Tehran

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4163256/

  Precocious puberty, as early physical development and low final height might lead to psychosocial problems. […] To evaluate etiology and clinical feature of precocious puberty in a cohort of Iranian children. […] Patients, concerning etiology of precocious puberty were classified in three categories: 42.6% of patients had central precocious puberty (CPP), including idiopathic CPP (87.5%) and neurogenic CPP (12.5%). 23.3% of patients had peripheral precocious puberty (PPP), including congenital adrenal hyperplasia (CAH) (42.8%), ovarian cysts (28.4%), McCune-Albright syndrome (14.2%) and adrenal carcinoma (14.2%). […] The most common etiology of precocious puberty in girls was idiopathic central precocious puberty and premature thelarche, while in boys they were neurogenic central precocious puberty and CAH.

• #29 Precocious Puberty (Causes, Symptoms, and Treatment)

  https://patient.info/doctor/precocious-puberty-pro

  Precocious puberty is often a benign central process in girls but precocious puberty is rarely idiopathic in boys and early signs of puberty in boys are a particular cause for concern. […] Obesity may also contribute to earlier puberty and may possibly be part of the reason for a general change to earlier puberty. […] Idiopathic (sporadic or familial). No cause is found in 80% of girls and 40% of boys. […] Abnormalities of the central nervous system (CNS) include: Tumours, including gliomas, astrocytomas, hamartomas, pineal tumours and hCG-secreting germ cell tumours. […] This precocious puberty is independent of gonadotrophin release and it accounts for about 20% of cases of precocious puberty; some of the specific causes are rare. […] Causes include: Congenital adrenal hyperplasia (CAH).

• #30 Etiology of precocious puberty, 10 years study in Endocrine Reserch Centre (Firouzgar), Tehran

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4163256/

  Precocious puberty, as early physical development and low final height might lead to psychosocial problems. […] To evaluate etiology and clinical feature of precocious puberty in a cohort of Iranian children. […] Patients, concerning etiology of precocious puberty were classified in three categories: 42.6% of patients had central precocious puberty (CPP), including idiopathic CPP (87.5%) and neurogenic CPP (12.5%). 23.3% of patients had peripheral precocious puberty (PPP), including congenital adrenal hyperplasia (CAH) (42.8%), ovarian cysts (28.4%), McCune-Albright syndrome (14.2%) and adrenal carcinoma (14.2%). […] The most common etiology of precocious puberty in girls was idiopathic central precocious puberty and premature thelarche, while in boys they were neurogenic central precocious puberty and CAH.

• #31 Precocious Pseudopuberty: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/923876-overview

  Certain aromatic oils, such as lavender and tea tree oil, present in some skin creams, hair care products, and aromatherapy oils and sprays, have estrogenic activity. Transdermal estrogen creams or testosterone gels or ingestion of oral contraceptives are other possible exogenous sources of exposure to sex steroid hormones. […] Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders characterized by impaired cortisol synthesis. 21-hydroxylase is the enzyme responsible for the conversion of 17-hydroxyprogesterone to 11-deoxycortisol, and its deficiency accounts for 95% of cases of CAH. 11-hydroxylase deficiency is a second enzyme deficiency leading to CAH. Both 21-hydroxylase and 11-hydroxylase enzyme deficiencies lead to a decrease in cortisol production. This decrease in cortisol production results in chronic stimulation of the adrenal cortex by adrenocorticotropic hormone (ACTH), with an increase in the cortisol precursors. These precursors then are shunted into the androgen pathway, leading to excessive androgen production and, therefore, the signs and symptoms of androgen excess.

• #32 Precocious Pseudopuberty: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/923876-overview

  Certain aromatic oils, such as lavender and tea tree oil, present in some skin creams, hair care products, and aromatherapy oils and sprays, have estrogenic activity. Transdermal estrogen creams or testosterone gels or ingestion of oral contraceptives are other possible exogenous sources of exposure to sex steroid hormones. […] Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders characterized by impaired cortisol synthesis. 21-hydroxylase is the enzyme responsible for the conversion of 17-hydroxyprogesterone to 11-deoxycortisol, and its deficiency accounts for 95% of cases of CAH. 11-hydroxylase deficiency is a second enzyme deficiency leading to CAH. Both 21-hydroxylase and 11-hydroxylase enzyme deficiencies lead to a decrease in cortisol production. This decrease in cortisol production results in chronic stimulation of the adrenal cortex by adrenocorticotropic hormone (ACTH), with an increase in the cortisol precursors. These precursors then are shunted into the androgen pathway, leading to excessive androgen production and, therefore, the signs and symptoms of androgen excess.

• #33 Etiology of precocious puberty, 10 years study in Endocrine Reserch Centre (Firouzgar), Tehran

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4163256/

  Precocious puberty, as early physical development and low final height might lead to psychosocial problems. […] To evaluate etiology and clinical feature of precocious puberty in a cohort of Iranian children. […] Patients, concerning etiology of precocious puberty were classified in three categories: 42.6% of patients had central precocious puberty (CPP), including idiopathic CPP (87.5%) and neurogenic CPP (12.5%). 23.3% of patients had peripheral precocious puberty (PPP), including congenital adrenal hyperplasia (CAH) (42.8%), ovarian cysts (28.4%), McCune-Albright syndrome (14.2%) and adrenal carcinoma (14.2%). […] The most common etiology of precocious puberty in girls was idiopathic central precocious puberty and premature thelarche, while in boys they were neurogenic central precocious puberty and CAH.

• #34 Precocious puberty – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/precocious-puberty/symptoms-causes/syc-20351811

  Estrogen or testosterone being made too soon causes this type of precocious puberty. […] A problem with the ovaries, testicles, adrenal glands or pituitary gland causes the hormone release. […] The following can lead to peripheral precocious puberty: A tumor in the adrenal glands or in the pituitary gland that releases estrogen or testosterone. A rare genetic disease that affects bones and skin color and causes hormonal problems. This condition is called McCune-Albright syndrome. Being exposed to creams or ointments that contain estrogen or testosterone.

• #35 Etiology of precocious puberty, 10 years study in Endocrine Reserch Centre (Firouzgar), Tehran

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4163256/

  Precocious puberty, as early physical development and low final height might lead to psychosocial problems. […] To evaluate etiology and clinical feature of precocious puberty in a cohort of Iranian children. […] Patients, concerning etiology of precocious puberty were classified in three categories: 42.6% of patients had central precocious puberty (CPP), including idiopathic CPP (87.5%) and neurogenic CPP (12.5%). 23.3% of patients had peripheral precocious puberty (PPP), including congenital adrenal hyperplasia (CAH) (42.8%), ovarian cysts (28.4%), McCune-Albright syndrome (14.2%) and adrenal carcinoma (14.2%). […] The most common etiology of precocious puberty in girls was idiopathic central precocious puberty and premature thelarche, while in boys they were neurogenic central precocious puberty and CAH.

• #36 Precocious Pseudopuberty: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/923876-overview

  Potential HCG-secreting tumors may cause Leydig cell stimulation and some testicular enlargement in boys. The locations of HCG-secreting tumors include tumors of the liver (hepatomas, hepatoblastomas) and choriocarcinomas of the gonads, mediastinum, retroperitoneum, or pineal gland. […] Adrenocortical tumors are rare in childhood and their etiology is unknown. Adrenocortical tumors may occur at any age from infancy into adolescence, and the clinical manifestations of these tumors depend on the type of the hormones they secrete. The most frequent hormonal effects are secondary to androgen secretion, resulting in virilization of girls and early puberty in boys. The primary hormonal picture is rarely that of estrogen effects, which lead to feminization in males and precocious pseudopuberty in females.

• #37 Precocious Pseudopuberty: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/923876-overview

  Potential HCG-secreting tumors may cause Leydig cell stimulation and some testicular enlargement in boys. The locations of HCG-secreting tumors include tumors of the liver (hepatomas, hepatoblastomas) and choriocarcinomas of the gonads, mediastinum, retroperitoneum, or pineal gland. […] Adrenocortical tumors are rare in childhood and their etiology is unknown. Adrenocortical tumors may occur at any age from infancy into adolescence, and the clinical manifestations of these tumors depend on the type of the hormones they secrete. The most frequent hormonal effects are secondary to androgen secretion, resulting in virilization of girls and early puberty in boys. The primary hormonal picture is rarely that of estrogen effects, which lead to feminization in males and precocious pseudopuberty in females.

• #38 Precocious puberty – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/precocious-puberty/symptoms-causes/syc-20351811

  Estrogen or testosterone being made too soon causes this type of precocious puberty. […] A problem with the ovaries, testicles, adrenal glands or pituitary gland causes the hormone release. […] The following can lead to peripheral precocious puberty: A tumor in the adrenal glands or in the pituitary gland that releases estrogen or testosterone. A rare genetic disease that affects bones and skin color and causes hormonal problems. This condition is called McCune-Albright syndrome. Being exposed to creams or ointments that contain estrogen or testosterone.

• #39 Precocious Puberty – Early Puberty: Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/21064-precocious-early-puberty

  Precocious puberty has different causes depending on the type. […] Central precocious puberty occurs when your child’s brain releases GnRH too early, in turn causing their testes or ovaries to release androgens too early. In most cases, the cause of this especially in female children is unknown. Causes may include: Brain trauma, Brain tumors, Brain infections, Brain abnormalities, Radiation treatment. […] Issues with your child’s reproductive organs or adrenal glands cause peripheral precocious puberty. Causes may include: Ovary, testes or adrenal gland tumors, Tumors that release human chorionic gonadotropin (HCG), Genetic conditions, such as McCune-Albright syndrome, Severe hypothyroidism, Adrenal gland disorders, like congenital adrenal hyperplasia. […] Sometimes, exposure to hormones from sources outside your child’s body causes peripheral precocious puberty. For example, exposure to products like creams, medications or supplements containing estrogen, testosterone or androgen.

• #40 Precocious Pseudopuberty: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/923876-overview

  Certain aromatic oils, such as lavender and tea tree oil, present in some skin creams, hair care products, and aromatherapy oils and sprays, have estrogenic activity. Transdermal estrogen creams or testosterone gels or ingestion of oral contraceptives are other possible exogenous sources of exposure to sex steroid hormones. […] Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders characterized by impaired cortisol synthesis. 21-hydroxylase is the enzyme responsible for the conversion of 17-hydroxyprogesterone to 11-deoxycortisol, and its deficiency accounts for 95% of cases of CAH. 11-hydroxylase deficiency is a second enzyme deficiency leading to CAH. Both 21-hydroxylase and 11-hydroxylase enzyme deficiencies lead to a decrease in cortisol production. This decrease in cortisol production results in chronic stimulation of the adrenal cortex by adrenocorticotropic hormone (ACTH), with an increase in the cortisol precursors. These precursors then are shunted into the androgen pathway, leading to excessive androgen production and, therefore, the signs and symptoms of androgen excess.

• #41 Precocious Pseudopuberty: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/923876-overview

  Van Wyk-Grumbach syndrome is a rare syndrome characterized by hypothyroidism, precocious puberty with multicystic ovaries, and features of polycystic ovarian disease (PCOD). The exact mechanism for the development of sexual precocity secondary to hypothyroidism is unknown. It is believed to be secondary to the structural similarity between thyroid-stimulating hormone (TSH) and LH.

• #42 Precocious Pseudopuberty: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/923876-overview

  Ovarian tumors can be either feminizing or masculinizing. The most common tumor associated with isosexual precocity is the benign ovarian follicular cyst. The cells lining the cysts are luteinized, leading to estrogen production. […] Granulosa cell tumor is the next most common feminizing neoplasm of the ovary. Juvenile granulosa cell tumors that develop in premenarchal females produce sexual precocity as a consequence of estrogen secretion. This may present as premature breast development or vaginal bleeding. Virilization may also be present. These tumors may also secrete HCG. Sex-cord tumors may have characteristics of both granulosa and Sertoli cells. […] Familial male precocious puberty (FMPP), also called testotoxicosis, is a dominant mutation in the LH receptor gene that results in the production of a receptor that is capable of spontaneous activation in the absence of either LH or HCG.

• #43 Etiology of precocious puberty, 10 years study in Endocrine Reserch Centre (Firouzgar), Tehran

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4163256/

  Precocious puberty, as early physical development and low final height might lead to psychosocial problems. […] To evaluate etiology and clinical feature of precocious puberty in a cohort of Iranian children. […] Patients, concerning etiology of precocious puberty were classified in three categories: 42.6% of patients had central precocious puberty (CPP), including idiopathic CPP (87.5%) and neurogenic CPP (12.5%). 23.3% of patients had peripheral precocious puberty (PPP), including congenital adrenal hyperplasia (CAH) (42.8%), ovarian cysts (28.4%), McCune-Albright syndrome (14.2%) and adrenal carcinoma (14.2%). […] The most common etiology of precocious puberty in girls was idiopathic central precocious puberty and premature thelarche, while in boys they were neurogenic central precocious puberty and CAH.

• #44 Precocious Pseudopuberty: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/923876-overview

  Ovarian tumors can be either feminizing or masculinizing. The most common tumor associated with isosexual precocity is the benign ovarian follicular cyst. The cells lining the cysts are luteinized, leading to estrogen production. […] Granulosa cell tumor is the next most common feminizing neoplasm of the ovary. Juvenile granulosa cell tumors that develop in premenarchal females produce sexual precocity as a consequence of estrogen secretion. This may present as premature breast development or vaginal bleeding. Virilization may also be present. These tumors may also secrete HCG. Sex-cord tumors may have characteristics of both granulosa and Sertoli cells. […] Familial male precocious puberty (FMPP), also called testotoxicosis, is a dominant mutation in the LH receptor gene that results in the production of a receptor that is capable of spontaneous activation in the absence of either LH or HCG.

• #45 Definition, etiology, and evaluation of precocious puberty – UpToDate

  https://www.uptodate.com/contents/definition-etiology-and-evaluation-of-precocious-puberty

  Definition, etiology, and evaluation of precocious puberty […] CAUSES OF CENTRAL PRECOCIOUS PUBERTY […] Idiopathic […] Central nervous system lesions […] Genetics […] Previous excess sex steroid exposure […] Pituitary gonadotropin-secreting tumors […] CAUSES OF PERIPHERAL PRECOCITY […] Females […] – Ovarian cysts […] – Ovarian tumors […] Males […] – Leydig cell tumors […] – Human chorionic gonadotropin-secreting germ-cell tumors […] – Familial male-limited precocious puberty […] Both females and males […] – Primary hypothyroidism […] – Exogenous sex steroids and endocrine-disrupting chemicals […] – Adrenal pathology […] – McCune-Albright syndrome […] INTRODUCTION […] Precocious puberty is the onset of pubertal development at an age that is 2 to 2.5 standard deviations (SD) earlier than population norms. The cause of precocious puberty may range from a variant of normal development (eg, isolated premature adrenarche or isolated premature thelarche) to pathologic conditions with significant risk of morbidity and even death (eg, malignant germ-cell tumor or astrocytoma).

• #46 Precocious Pseudopuberty: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/923876-overview

  Ovarian tumors can be either feminizing or masculinizing. The most common tumor associated with isosexual precocity is the benign ovarian follicular cyst. The cells lining the cysts are luteinized, leading to estrogen production. […] Granulosa cell tumor is the next most common feminizing neoplasm of the ovary. Juvenile granulosa cell tumors that develop in premenarchal females produce sexual precocity as a consequence of estrogen secretion. This may present as premature breast development or vaginal bleeding. Virilization may also be present. These tumors may also secrete HCG. Sex-cord tumors may have characteristics of both granulosa and Sertoli cells. […] Familial male precocious puberty (FMPP), also called testotoxicosis, is a dominant mutation in the LH receptor gene that results in the production of a receptor that is capable of spontaneous activation in the absence of either LH or HCG.

• #47 Precocious Puberty (Causes, Symptoms, and Treatment)

  https://patient.info/doctor/precocious-puberty-pro

  Tumours: HCG-secreting tumours in the liver (hepatomas, hepatoblastomas), choriocarcinomas (of gonads, pineal gland, mediastinum, etc) and adrenal tumours (rare). […] McCune-Albright syndrome (MAS). A genetic condition in which affected individuals are at risk of multiple endocrinopathies, including thyrotoxicosis, Cushing’s syndrome, acromegaly, hyperparathyroidism, etc. […] Testotoxicosis (or familial male precocious puberty). An autosomal dominant condition characterised by progressive pubertal changes, rapid physical growth, skeletal maturation and sexually aggressive behaviour in the first 2-3 years of life. […] Severe hypothyroidism or van Wyk-Grumbach syndrome. Growth is arrested (unusual with precocious puberty) rather than accelerated. […] Exogenous oestrogen or androgen exposure (therapeutic or accidental).

• #48

  https://www.archivesofmedicalscience.com/Central-precocious-puberty-etiology-with-particular-consideration-of-neurological,121051,0,2.html

  The cause of CPP remains undetected among girls in more than 90% of cases (idiopathic precocious puberty). Idiopathic precocious puberty is significantly less prevalent among boys and CPP is mostly the result of lesions in the CNS. […] Long-term exposure to sex steroids (in the case of congenital adrenal hyperplasia, testotoxicosis and sex steroid-producing tumors) can result in secondary CPP. Sex steroids can lead to maturation of CNS centers. The decrease in these hormones during treatment of the primary underlying disorder causes activation of the precociously matured hypothalamic GnRH pulse generator via feedback mechanisms.

• #49 Precocious Puberty

  https://elsevier.health/en-US/preview/precocious-puberty-co

  Rare genetic mutations can result in familial idiopathic central precocious puberty. […] Central nervous system lesions, insults, or abnormalities involving the hypothalamic/pituitary area can disrupt the normal hypothalamic-pituitary-gonadal axis and result in the release of gonadotropins. […] Secondary to longstanding peripheral precocious puberty or long-term exposure to sex steroids (e.g., McCune-Albright syndrome, congenital adrenal hyperplasia). […] Peripheral precocious puberty occurs when sex hormones (estrogen or testosterone) are produced without activation from the hypothalamic-pituitary-gonadal axis or are available from an exogenous peripheral source. […] Common sources of peripheral exogenous estrogen include facial and cosmetic creams, shampoos, hormone-containing herbs (e.g., lavender, tea tree oil), oral contraceptives, and transdermal estrogen creams. […] Congenital adrenal hyperplasia leads to increased testosterone production, resulting in isosexual precocity (peripheral precocious puberty) in boys.

• #50 Precocious puberty – Wikipedia

  https://en.wikipedia.org/wiki/Precocious_puberty

  Although the causes of early puberty are still somewhat unclear, girls who have a high-fat diet and are not physically active or are obese are more likely to physically mature earlier. […] In addition to diet and exercise habits, exposure to chemicals that mimic estrogen (known as xenoestrogens) is another possible cause of early puberty in girls. […] Familial cases of idiopathic central precocious puberty (ICPP) have been reported, leading researchers to believe there are specific genetic modulators of ICPP. […] Mutations in genes such as LIN28, and LEP and LEPR, which encode leptin and the leptin receptor, have been associated with precocious puberty. […] Mutations in the kisspeptin (KISS1) and its receptor, KISS1R (also known as GPR54), involved in GnRH secretion and puberty onset, are also thought to be the cause for ICPP. […] The gene MKRN3, which is a maternally imprinted gene, has since been identified as a cause of premature sexual development or CPP.

• #51 Analysis of risk factors of precocious puberty in children | BMC Pediatrics | Full Text

  https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-023-04265-x

  The purpose of this study is to explore the related factors of precocious puberty in children. […] The multifactor logistic regression analysis shows that the risk factors of children’s precocious puberty included gender (female), bone age (10 years old), and daily exercise time (0.9 h), E2 (66.00pmol/L), FSH (6.00U/L), LH (3.50U/L), leptin (8.00 G/L), mothers menarche time (12 years old), living environment (chemical industry zone), consumption of nutritional supplements (often), consumption of high-protein food (often), and sleep time (10 h). […] In conclusion, children’s gender, bone age, exercise habits, E2, FSH, LH, leptin, mothers menarche time, living environment, eating habits, sleep time and other factors are closely related to precocious puberty in children. […] Therefore, it is necessary to analyze its influencing factors to better prevent the occurrence of precocious puberty.

• #52 Precocious (early) puberty in girls

  https://www.babycenter.com/health/illness-and-infection/precocious-early-puberty-in-girls_68661

  Precocious puberty means that a child is starting puberty early. Experts are studying possible causes of early puberty, including genetics, body fat, and exposure to certain chemicals. […] There’s usually no clear medical cause of puberty, though very occasionally the cause may be linked to a tumor or disorder (such as hypothyroidism or a genetic disorder). Having radiation treatment (for cancer, for example) may also increase the risk of early puberty. […] Researchers are studying risk factors linked to precocious puberty. These include: Family history. There are genetic mutations that may result in early puberty, though it can also happen in children with no family history of it. Overweight or obesity. Body fat plays a role in how the body processes hormones. One study found that obese girls experienced early puberty at higher rates than girls who were normal weight.

• #53 Precocious puberty – Wikipedia

  https://en.wikipedia.org/wiki/Precocious_puberty

  Although the causes of early puberty are still somewhat unclear, girls who have a high-fat diet and are not physically active or are obese are more likely to physically mature earlier. […] In addition to diet and exercise habits, exposure to chemicals that mimic estrogen (known as xenoestrogens) is another possible cause of early puberty in girls. […] Familial cases of idiopathic central precocious puberty (ICPP) have been reported, leading researchers to believe there are specific genetic modulators of ICPP. […] Mutations in genes such as LIN28, and LEP and LEPR, which encode leptin and the leptin receptor, have been associated with precocious puberty. […] Mutations in the kisspeptin (KISS1) and its receptor, KISS1R (also known as GPR54), involved in GnRH secretion and puberty onset, are also thought to be the cause for ICPP. […] The gene MKRN3, which is a maternally imprinted gene, has since been identified as a cause of premature sexual development or CPP.

• #54 Analysis of risk factors of precocious puberty in children | BMC Pediatrics | Full Text

  https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-023-04265-x

  The purpose of this study is to explore the related factors of precocious puberty in children. […] The multifactor logistic regression analysis shows that the risk factors of children’s precocious puberty included gender (female), bone age (10 years old), and daily exercise time (0.9 h), E2 (66.00pmol/L), FSH (6.00U/L), LH (3.50U/L), leptin (8.00 G/L), mothers menarche time (12 years old), living environment (chemical industry zone), consumption of nutritional supplements (often), consumption of high-protein food (often), and sleep time (10 h). […] In conclusion, children’s gender, bone age, exercise habits, E2, FSH, LH, leptin, mothers menarche time, living environment, eating habits, sleep time and other factors are closely related to precocious puberty in children. […] Therefore, it is necessary to analyze its influencing factors to better prevent the occurrence of precocious puberty.

• #55 Precocious (early) puberty in girls

  https://www.babycenter.com/health/illness-and-infection/precocious-early-puberty-in-girls_68661

  Exposure to certain chemicals. Exposure to creams or ointments containing sex hormones (such as estrogen or androgen) may increase the chance of early puberty. And some studies suggest that exposure to endocrine-disrupting chemicals (such as phthalates) may have an effect on puberty. […] Researchers are studying possible reasons for the earlier onset of puberty, including increased incidence of overweight and obesity, decrease in physical activity, stress (including childhood sexual abuse), and exposure to endocrine-disrupting chemicals.

• #56 Analysis of risk factors of precocious puberty in children | BMC Pediatrics | Full Text

  https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-023-04265-x

  The purpose of this study is to explore the related factors of precocious puberty in children. […] The multifactor logistic regression analysis shows that the risk factors of children’s precocious puberty included gender (female), bone age (10 years old), and daily exercise time (0.9 h), E2 (66.00pmol/L), FSH (6.00U/L), LH (3.50U/L), leptin (8.00 G/L), mothers menarche time (12 years old), living environment (chemical industry zone), consumption of nutritional supplements (often), consumption of high-protein food (often), and sleep time (10 h). […] In conclusion, children’s gender, bone age, exercise habits, E2, FSH, LH, leptin, mothers menarche time, living environment, eating habits, sleep time and other factors are closely related to precocious puberty in children. […] Therefore, it is necessary to analyze its influencing factors to better prevent the occurrence of precocious puberty.

• #57 Analysis of risk factors of precocious puberty in children | BMC Pediatrics | Full Text

  https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-023-04265-x

  The purpose of this study is to explore the related factors of precocious puberty in children. […] The multifactor logistic regression analysis shows that the risk factors of children’s precocious puberty included gender (female), bone age (10 years old), and daily exercise time (0.9 h), E2 (66.00pmol/L), FSH (6.00U/L), LH (3.50U/L), leptin (8.00 G/L), mothers menarche time (12 years old), living environment (chemical industry zone), consumption of nutritional supplements (often), consumption of high-protein food (often), and sleep time (10 h). […] In conclusion, children’s gender, bone age, exercise habits, E2, FSH, LH, leptin, mothers menarche time, living environment, eating habits, sleep time and other factors are closely related to precocious puberty in children. […] Therefore, it is necessary to analyze its influencing factors to better prevent the occurrence of precocious puberty.

• #58 Analysis of risk factors of precocious puberty in children | BMC Pediatrics | Full Text

  https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-023-04265-x

  The purpose of this study is to explore the related factors of precocious puberty in children. […] The multifactor logistic regression analysis shows that the risk factors of children’s precocious puberty included gender (female), bone age (10 years old), and daily exercise time (0.9 h), E2 (66.00pmol/L), FSH (6.00U/L), LH (3.50U/L), leptin (8.00 G/L), mothers menarche time (12 years old), living environment (chemical industry zone), consumption of nutritional supplements (often), consumption of high-protein food (often), and sleep time (10 h). […] In conclusion, children’s gender, bone age, exercise habits, E2, FSH, LH, leptin, mothers menarche time, living environment, eating habits, sleep time and other factors are closely related to precocious puberty in children. […] Therefore, it is necessary to analyze its influencing factors to better prevent the occurrence of precocious puberty.

• #59 Analysis of risk factors of precocious puberty in children | BMC Pediatrics | Full Text

  https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-023-04265-x

  The purpose of this study is to explore the related factors of precocious puberty in children. […] The multifactor logistic regression analysis shows that the risk factors of children’s precocious puberty included gender (female), bone age (10 years old), and daily exercise time (0.9 h), E2 (66.00pmol/L), FSH (6.00U/L), LH (3.50U/L), leptin (8.00 G/L), mothers menarche time (12 years old), living environment (chemical industry zone), consumption of nutritional supplements (often), consumption of high-protein food (often), and sleep time (10 h). […] In conclusion, children’s gender, bone age, exercise habits, E2, FSH, LH, leptin, mothers menarche time, living environment, eating habits, sleep time and other factors are closely related to precocious puberty in children. […] Therefore, it is necessary to analyze its influencing factors to better prevent the occurrence of precocious puberty.

• #60 Analysis of risk factors of precocious puberty in children | BMC Pediatrics | Full Text

  https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-023-04265-x

  The purpose of this study is to explore the related factors of precocious puberty in children. […] The multifactor logistic regression analysis shows that the risk factors of children’s precocious puberty included gender (female), bone age (10 years old), and daily exercise time (0.9 h), E2 (66.00pmol/L), FSH (6.00U/L), LH (3.50U/L), leptin (8.00 G/L), mothers menarche time (12 years old), living environment (chemical industry zone), consumption of nutritional supplements (often), consumption of high-protein food (often), and sleep time (10 h). […] In conclusion, children’s gender, bone age, exercise habits, E2, FSH, LH, leptin, mothers menarche time, living environment, eating habits, sleep time and other factors are closely related to precocious puberty in children. […] Therefore, it is necessary to analyze its influencing factors to better prevent the occurrence of precocious puberty.

• #61

  https://www.nbcnews.com/health/womens-health/early-puberty-may-linked-common-chemical-used-personal-care-products-rcna169967

  Combing through 10,000 compounds in a library of licensed pharmaceuticals, environmental chemicals and dietary supplements, the researchers found several that might influence the timing of puberty. […] Musk ambrette, a synthetic form of the fragrance, could latch onto a puberty-related receptor in the hypothalamus, which would lead to the release of GnRH, a hormone involved in the maturation of sexual organs and the production of estrogen, testosterone and progesterone. […] Musk ambrette is widely used in inexpensive or counterfeit fragrances and other scented personal care products, Shaw said. […] The next step for the researchers was to test the impact of musk ambrette on human hypothalamic cells and on zebra fish larvae. […] They found that in both the fish larvae and the human cells, the compound sparked the production of GnRH.

• #62 Disorders of Puberty: An Approach to Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1101/p590.html

  Precocious puberty is pubertal onset before eight years of age in girls and before nine years of age in boys. […] Among patients with true precocious puberty, or full activation of the hypothalamic-pituitary-gonadal axis, most girls have an idiopathic etiology, whereas it is commonly due to identifiable pathology on imaging in boys. […] Abnormal pubertal timing can adversely affect a child’s physical and psychosocial well-being and may be caused by a range of generally benign or pathologic etiologies. […] Central precocious puberty is approximately 10-fold more common in girls than in boys. […] Although usually idiopathic in girls, it can be incited by head trauma, neoplasm, radiation, or genetic conditions. […] Pathologic causes of central precocious puberty are more common in boys.

• #63 Etiology of precocious puberty, 10 years study in Endocrine Reserch Centre (Firouzgar), Tehran

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4163256/

  Normal variant was considered as the second common cause (43.2%) of puberty in girls with dominancy of premature thelarche. […] The most common etiology of precocious puberty in boys was NCPP (25%) and CAH (37.5%). […] This is because when CPP occurs in boys, it is more likely to be the result of a demonstrable CNS lesion.

• #64 Disorders of Puberty: An Approach to Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1101/p590.html

  Precocious puberty is pubertal onset before eight years of age in girls and before nine years of age in boys. […] Among patients with true precocious puberty, or full activation of the hypothalamic-pituitary-gonadal axis, most girls have an idiopathic etiology, whereas it is commonly due to identifiable pathology on imaging in boys. […] Abnormal pubertal timing can adversely affect a child’s physical and psychosocial well-being and may be caused by a range of generally benign or pathologic etiologies. […] Central precocious puberty is approximately 10-fold more common in girls than in boys. […] Although usually idiopathic in girls, it can be incited by head trauma, neoplasm, radiation, or genetic conditions. […] Pathologic causes of central precocious puberty are more common in boys.

• #65 Etiology of precocious puberty, 10 years study in Endocrine Reserch Centre (Firouzgar), Tehran

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4163256/

  Normal variant was considered as the second common cause (43.2%) of puberty in girls with dominancy of premature thelarche. […] The most common etiology of precocious puberty in boys was NCPP (25%) and CAH (37.5%). […] This is because when CPP occurs in boys, it is more likely to be the result of a demonstrable CNS lesion.

• #66 What is Central Precocious Puberty? – Little a Little Longer

  https://littlealittlelonger.tolmar.com/what-is-cpp/

  Central precocious puberty (CPP) is a condition that causes early sexual development in children. CPP leads the brain to release pulses of GnRH, the puberty-inducing hormone, as early as age 2. CPP is a treatable, non-lifelong condition, with no underlying medical problem causing it in most cases. […] For most children diagnosed with CPP, it arises as an idiopathic condition with no underlying medical problem causing it. […] Children with precocious puberty produce high levels of sex steroid hormones at a much younger age. The same hormones that cause breast or testicular development and pubic hair growth also cause rapid bone and muscle growth, as well as changes in body shape and size. […] When childrens bones mature more quickly than expected, they experience early fusion of growth plates, which causes their bones to stop growing earlier than they should. So after an initial growth spurt, kids with CPP reach their adult height much earlier than their peers and their final adult height is shorter than would be expected.

• #67 Precocious Early Puberty | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/precocious-early-puberty

  When treating children with central precocious puberty, we often use synthetic luteinizing-hormone-releasing hormone (LHRH). This hormone appears to stop sexual maturation brought on by the disorder by stopping the pituitary gland from releasing gonadotropin. […] In addition to showing physical signs of early puberty, children with precocious puberty often have low self-esteem linked to the feeling of being different than their peers. Other people, including children and adults, may assume children with precocious puberty are older than they actually are and may expect them to behave beyond their maturity level. […] Early puberty will cause your child’s body to change much sooner than his peers. This sense of being different, coupled with the hormonal change-induced emotional mood swings, may make him feel self-conscious.

• #68 What is Central Precocious Puberty? – Little a Little Longer

  https://littlealittlelonger.tolmar.com/what-is-cpp/

  If CPP is left untreated, the child will likely not reach their predicted adult height which is based on how tall their parents are. For example, most boys with CPP will not grow taller than 5 feet 2 inches, and girls often do not grow taller than 5 feet, as opposed to the national height averages of 5 feet 9 inches for males and 5 feet 3.5 inches for females.

• #69 Precocious Early Puberty | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/precocious-early-puberty

  When treating children with central precocious puberty, we often use synthetic luteinizing-hormone-releasing hormone (LHRH). This hormone appears to stop sexual maturation brought on by the disorder by stopping the pituitary gland from releasing gonadotropin. […] In addition to showing physical signs of early puberty, children with precocious puberty often have low self-esteem linked to the feeling of being different than their peers. Other people, including children and adults, may assume children with precocious puberty are older than they actually are and may expect them to behave beyond their maturity level. […] Early puberty will cause your child’s body to change much sooner than his peers. This sense of being different, coupled with the hormonal change-induced emotional mood swings, may make him feel self-conscious.

• #70 Precocious Puberty and Why it Matters | Columbia University Irving Medical Center

  https://www.cuimc.columbia.edu/news/precocious-puberty-and-why-it-matters

  Puberty that starts earlier than these age ranges is called precocious puberty. […] Precocious puberty occurs 10 to 20 times more frequently among girls than boys. […] In boys, however, its more common to have central nervous system tumors (abnormal growths) or disease cause the early start of puberty. […] Earlier puberty has been associated with deleterious long-term health outcomes. […] Several studies show an increase in new diagnoses of precocious puberty in Italy following lockdown and months at home.

• #71 Etiology of precocious puberty, 10 years study in Endocrine Reserch Centre (Firouzgar), Tehran

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4163256/

  Precocious puberty, as early physical development and low final height might lead to psychosocial problems. […] To evaluate etiology and clinical feature of precocious puberty in a cohort of Iranian children. […] Patients, concerning etiology of precocious puberty were classified in three categories: 42.6% of patients had central precocious puberty (CPP), including idiopathic CPP (87.5%) and neurogenic CPP (12.5%). 23.3% of patients had peripheral precocious puberty (PPP), including congenital adrenal hyperplasia (CAH) (42.8%), ovarian cysts (28.4%), McCune-Albright syndrome (14.2%) and adrenal carcinoma (14.2%). […] The most common etiology of precocious puberty in girls was idiopathic central precocious puberty and premature thelarche, while in boys they were neurogenic central precocious puberty and CAH.

• #72

  https://link.springer.com/article/10.1007/BF02752439

  Puberty occurring before the age of 8 years in girls and 9 years in boys is considered precocious. The numerous causes of precocity can be classified as central or peripheral. Central or true precocious puberty (CPP) is due to premature activation of the hypothalamopituitary-gonadal axis and is isosexual. Peripheral or pseudoprecocious puberty (PPP) results from the production of sex steroids independent of the H-P-G axis and may be isosexual or heterosexual. […] Hypothalamic hamartoma is the most common tumour causing CPP especially in boys. Adrenal causes, particularly CAH, are the commonest cause of PPP in boys whereas ovarian causes are more likely in girls.

• #73 Analysis of risk factors of precocious puberty in children | BMC Pediatrics | Full Text

  https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-023-04265-x

  The results of this study showed that the risk factors of precocious puberty in children were sex (female), bone age (10 years old), daily exercise time (0.9 h), E2 (66.00pmol/L), FSH (6.00U/L), LH (3.50U/L), leptin (8.00 G/L), mothers menarche time (12 years old), living environment (chemical industry zone), consumption of nutritional supplements (often), consumption of high-protein food (often), and sleep time (10 h). […] Therefore, clinicians should pay attention to children’s gender, bone age, exercise habits, E2, FSH, LH, leptin, mothers menarche time, living environment, eating habits, sleep time and other factors to alert the occurrence of precocious puberty.

• #74 Etiology of Central Precocious Puberty | Endocrine Society

  https://www.endocrine.org/journals/endocrine-reviews/etiology-of-central-precocious-puberty

  The etiology of central precocious puberty (CPP) is multiple and heterogeneous, including congenital and acquired causes that can be associated with structural or functional brain alterations. […] Hypothalamic hamartoma (HH) is the most well-known congenital cause of CPP with central nervous system abnormalities. […] The importance of genetic and/or epigenetic factors in the underlying mechanisms of CPP has grown significantly in the last decade, as demonstrated by the evidence of genetic abnormalities in hypothalamic structural lesions (e.g., hamartomas, gliomas), syndromic disorders associated with CPP (Temple, Prader-Willi, Silver-Russell, and Rett syndromes), and isolated CPP from monogenic defects (MKRN3 and DLK1 loss-of-function mutations). […] Genetic and epigenetic discoveries involving the etiology of CPP have had influence on the diagnosis and familial counseling providing bases for potential prevention of premature sexual development and new treatment targets in the future.

• #75 SciELO Brazil – Central precocious puberty: revisiting the diagnosis and therapeutic management Central precocious puberty: revisiting the diagnosis and therapeutic management

  https://www.scielo.br/j/aem/a/Tpzrbb9PdZR7FcnkJw7C69f/?lang=en

  The treatment of choice for CPP is GnRHa (15,44), a synthetic decapeptide that binds to the GnRH receptor in the pituitary with more stability and duration, and is resistant to protease degradation, which prolongs its half-life. GnRHa acts on the anterior pituitary, competing for GnRH receptor with endogenous GnRH, promoting endocytosis and reducing the amount of GnRH receptors (down-regulation) (46-48). Initially, GnRHa stimulates the synthesis and secretion of LH and FSH but when it is administered chronically, GnRHa suppresses the production of these hormones, which in turn suppress the production of sex steroid hormones by the gonads (28,48).

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