Idiopathic Gonadotropin-dependent Precocious Puberty in Boy who Attain Normal Final Adult Height without GnRH agonist Treatment
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Abstract
Gonadotropin-dependent precocious puberty in boy is characterized by the onset of secondary sexual characteristics before age of 9. This condition is resulting from early activation hypothalamic-pituitary-gonadal axis and most of cases cause from central nervous system lesions. Boys with gonadotropin-dependent precocious puberty result in impaired adult height due to premature epiphyseal growth plate closure unless treatment with gonadotropin releasing hormone agonist (GnRHa). Here we report a case of 9-year-10-month old boy presents with accelerated growth, facial acne, body odor and penile enlargement at age of 9.5 years. Physical examination reveals testicular volume 12 mL, Tanner III genital and pubic hair and normal neurological examination. Serum gonadotropins were in pubertal level and correlated with his pubertal status. MRI of brain and pituitary gland were unremarkable. He was diagnosed of idiopathic gonadotropin-dependent precocious puberty. However, his predicted adult height at the time of diagnosis was not impaired when compared with his target adult height despite the evidence of advance bone age. The patient was follow up examination without GnRHa treatment. After 5 years of follow up, he reached final adult height of 175 cm, which better than his target adult height, at age of 14.5 years. Idiopathic gonadotropin-dependent precocious puberty in boy has been increasingly report in recent years and result in normal adult height. GnRHa treatment should consider in those who has compromise adult height.
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References
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