Precocious puberty


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Precocious puberty


Adrenal gland disorders

Congenital adrenal hyperplasia

Primary adrenal insufficiency

Waterhouse-Friderichsen syndrome


Adrenal cortical carcinoma

Cushing syndrome

Conn syndrome

Thyroid gland disorders

Thyroglossal duct cyst


Graves disease

Thyroid eye disease (NORD)

Toxic multinodular goiter

Thyroid storm


Euthyroid sick syndrome

Hashimoto thyroiditis

Subacute granulomatous thyroiditis

Riedel thyroiditis

Postpartum thyroiditis

Thyroid cancer

Parathyroid gland disorders





Pancreatic disorders

Diabetes mellitus

Diabetic retinopathy

Diabetic nephropathy

Pituitary gland disorders


Pituitary adenoma






Growth hormone deficiency

Pituitary apoplexy

Sheehan syndrome


Constitutional growth delay

Diabetes insipidus

Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

Gonadal dysfunction

Precocious puberty

Delayed puberty

Premature ovarian failure

Polycystic ovary syndrome

Androgen insensitivity syndrome

Kallmann syndrome

5-alpha-reductase deficiency

Polyglandular syndromes

Autoimmune polyglandular syndrome type 1 (NORD)

Endocrine tumors

Multiple endocrine neoplasia

Pancreatic neuroendocrine neoplasms

Zollinger-Ellison syndrome

Carcinoid syndrome



Opsoclonus myoclonus syndrome (NORD)

Endocrine system pathology review

Adrenal insufficiency: Pathology review

Adrenal masses: Pathology review

Hyperthyroidism: Pathology review

Hypothyroidism: Pathology review

Thyroid nodules and thyroid cancer: Pathology review

Parathyroid disorders and calcium imbalance: Pathology review

Diabetes mellitus: Pathology review

Cushing syndrome and Cushing disease: Pathology review

Pituitary tumors: Pathology review

Hypopituitarism: Pathology review

Diabetes insipidus and SIADH: Pathology review

Multiple endocrine neoplasia: Pathology review

Neuroendocrine tumors of the gastrointestinal system: Pathology review


Precocious puberty


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Precocious puberty

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USMLE® Step 1 style questions USMLE

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A 6-year-old boy is referred to an endocrinologist by his pediatrician due to concerns about the child’s development. The patient’s parents report that he has had pubic, axillary and chest hair growth over the past six months. They note that the child also gained several inches in height over the same period. Currently, the patient is at the 89th percentile for height and 76th percentile for weight. Physical examination reveals coarse pubic, chest and axillary hair. The testes are markedly enlarged without evidence of extra-seminal masses. Which of the following findings is most likely to be found on further evaluation?  

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Pediatric patients

precocious puberty in p. 55, 338

Precocious puberty

adrenal steroids and p. 338

leuprolide p. 680

McCune-Albright syndrome p. 55, 714

pinealoma p. 546


precocious p. 55, 338



Jennifer K. Gates

Amanda J. Grieco, Ph.D.

Sarah Clifford, BMBS, BSc (Hons)

Sam Gillespie, BSc

Marisa Pedron

Puberty is the time in an individual’s life when they physically become sexually mature and able to have children. Precocious refers to puberty occurring at an earlier age than the average age among an individual’s peers. Generally, puberty is considered precocious if it begins before the age of 8 in females and the age of 9 in males.

The hypothalamic-pituitary-gonadal axis is a system of hormone signaling between the hypothalamus, pituitary gland, and gonads, either the testes or ovaries, to control sexual development and reproduction. Gonadotropin-releasing hormone is released by the hypothalamus into the hypophyseal portal system, which is a network of capillaries connecting the hypothalamus to the hypophysis, or the pituitary.  When gonadotropin-releasing hormone reaches the pituitary gland, it stimulates cells in the anterior pituitary, called gonadotrophs, to release gonadotropin hormones — luteinizing hormone and follicle-stimulating hormone — into the blood. These gonadotropin hormones then stimulate the gonads to produce specific steroids, sex hormones

Beginning at puberty, the Leydig cells of the testes respond to the luteinizing hormone by converting more cholesterol into testosterone. In addition, the Sertoli cells of the testes respond to follicle-stimulating hormone by producing more sperm


Precocious puberty, also known as early puberty, refers to the occurrence of secondary sexual characteristics in children before the age of 8 in girls and before the age of 9 in boys. In some children, early development is triggered by a disease such as a tumor or injury of the brain. Precocious puberty can also be a result of other pathologies such as pinealoma, McCune-Albright syndrome, and 21-hydroxylase deficiency. Treatment for precocious puberty usually involves hormone therapy or medications to suppress the early activation of the hypothalamic-pituitary-gonadal axis.


  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  5. "Central Precocious Puberty" Pediatric Drugs (2004)
  6. "<i>LIN28B</i>polymorphisms are associated with central precocious puberty and early puberty in girls" Korean Journal of Pediatrics (2012)

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