Management of central isosexual precocity: diagnosis, treatment, outcome

The diagnosis of central isosexual precocity, a condition much more common in girls than in boys, is currently viewed as a spectrum of disorders betwe en isolated premature thelarche and borderline early puberty. in some count ries, a trend may be seen toward onset of puberty at earlier ages, integrat ion of the clinical findings with bone age, pelvic echography, and hormonal data as well as follow-up ascertainment of progression of development is c ritical to define which patients should be proposed for therapy, The use of long-acting forms of gonadotropin-releasing hormone (GnRH) agonists may no t be indicated in slowly progressive variants or borderline early puberty b ecause they do not affect final height. Preservation of height potential is particularly obvious in precocious puberty starting at young ages. In some selected patients, associated growth hormone therapy may increase adult he ight but further studies are warranted. The psychosocial and behavioral cor relates of precocious puberty are an important and underinvestigated area. Curr Opin Pediatr 2000, 12:394-399 (C) 2000 Lippincott Williams & Wilkins, Inc.