Review of precocious puberty: Part III - Premature thelarche and prematureadrenarche. Variations of normal?

It has been recently recommended that puberty be considered early if it beg ins before age 6 in African-American girls and before age 7 in Caucasian gi rls. Although this recommendation is based on a substantial clinical study, concerns re main as to whether the now larger population of girls defined as normal contains individuals with a pathologic process as part of their e arly development. Important questions also arise as to the mechanisms for e arlier puberty and potential health consequences of earlier sexual maturati on. This paper will review the new definitions proposed for the onset of no rmal puberty and will review recent developments regarding the clinical cou rse, potential complications, and proposed molecular mechanisms for prematu re thelarche and adrenarche. While investigators continue to search for the underlying pathophysiology for these clinical findings, it seems prudent t o continue to evaluate girls presenting with early pubertal signs and to pr ovide close clinical follow up for potential long term complications.