Desarrollo sexual precoz en la niña

ESCOBAR DE LAZZARI ME; ROPELATO MG

Avances en Endocrinología Ginecológica y Reproductiva. Sociedad Argentina Endocrinología Ginecológica y Reproductiva

Editorial Ascune Hnos

Año: 2012; p. 144 - 160

Precocious puberty is a condition which produces parental anxiety and a profound emotional impact in the affected children. It is defined as the appearance of secondary sex characteristics before the age of 8 years in girls and 9 years in boys, although this criteria might be redefined taking into account the early occurrence of sexual development observed in the lasts decades. Central Precocious Puberty (CPP) results from premature activation of the hypothalamic – pituitary- gonadal axis. As a consequence of the accelerated growth and skeletal maturation CPP leads to an early epiphysial fusion and in most cases compromises final height. Biochemical diagnosis of CPP is based on the presence of elevated sex steroids levels and the demonstration of the GnRH- dependence of its secretion. The “gold standard” for diagnosis is the gonadotropin pubertal response to a GnRH challenge. Imaging as radiological evaluation of bone age, ultrasonography for assessment of internal genitalia characteristics and MRI for detection of intracranial tumours or malformations are of particular importance in the diagnosis. Agonists analogues of GnRH have became the treatment of choice for CPP. The regression of sex development and  the decrease in height velocity and bone maturation are the main objectives of treatment . The optimal outcome should be to achieve a final height according to the genetical child potential and a good psychosocial adjustment.