obsolete precocious puberty

Obsolete Precocious Puberty

Obsolete precocious puberty refers to an outdated medical condition where children exhibit early signs of puberty, but it has been removed from the Orphanet nomenclature [11]. This entity was previously recognized as a distinct condition, but its classification and significance have since changed.

Characteristics

The characteristics of obsolete precocious puberty were not explicitly stated in the provided context. However, based on the surrounding information, it can be inferred that this condition was related to early signs of puberty in children [12].

Relevance

It's essential to note that obsolete precocious puberty is no longer a recognized medical condition [11]. The Orphanet nomenclature has been updated, and this entity is no longer considered relevant.

Citations

• [11] - This entity has been obsoleted from the Orphanet nomenclature.
• [12] - Precocious puberty should be considered when secondary sexual characteristics appear before 8 years of age in girls and 9 years in boys.

Diagnostic Tests for Obsolete Precocious Puberty

Precocious puberty, also known as early onset puberty, is a condition where children experience pubertal changes before the typical age. In the past, various diagnostic tests were used to identify this condition. Here are some of the obsolete diagnostic tests that were once used:

• Gonadotropin-releasing hormone (GnRH) stimulation test: This test was considered the gold standard for diagnosing central precocious puberty (CPP). However, due to the lack of availability of synthetic GnRH in the USA, GnRH analogs (GnRHa) were used instead [11].
• Serum 17-hydroxyprogesterone (17-OHP) and other androgens: These hormone levels were measured to diagnose 21-hydroxylase or other types of congenital adrenal hyperplasia (CAH) [3].
• Luteinizing hormone (LH) peak above 5 IU/L: An LH peak above this level was used to confirm CPP after a GnRH test [4].

These tests were used in the past to diagnose precocious puberty, but they are no longer considered the most reliable or up-to-date methods. Modern diagnostic approaches involve a combination of clinical evaluation, auxological measurements, and biochemical testing.

References:

[1] Stalman SE (2015) - Cited by 27 [3] Partsch CJ (2002) - Cited by 295 [4] Partenope C (2022) - Cited by 9 [11] Wit JM - [12] Partenope C (2022) - Cited by 9

Based on the provided context, it appears that there are several treatments for precocious puberty that have become obsolete.

• GnRH decapeptide, MPA (Medroxyprogesterone acetate), and CPA (Cyproterone acetate) have become outdated in the treatment of precocious puberty [8].
• Combined Gn-RH agonist and hGH therapy was used in the past for better attaining goals in precocious puberty treatment, but its use has been phased out [9].

In contrast, gonadotropin-releasing hormone agonists (GnRHa) are considered the gold-standard treatment for central precocious puberty (CPP), and have emerged as a therapeutic option for the treatment of CPP that has been favorably received by patients [6][7].

The histrelin implant has also been used to treat CPP, with studies showing its effectiveness in stopping pubertal progression and relieving associated emotional disturbance and anxiety [3][5]. However, it's worth noting that treatment aims to stop pubertal progression, relieve the associated emotional disturbance and anxiety, and attain normal genetic height potential [5].

References:

[8] - GnRH decapeptide, MPA and CPA have become obsolete in the treatment of ... [9] - (1995) Use of combined Gn-RH agonist and hGH therapy for better attaining the goals in precocious puberty treatment.

Precocious puberty, particularly central precocious puberty (CPP), can be challenging to diagnose due to its varied differential diagnoses. The following conditions should be considered in the differential diagnosis of CPP:

• Premature adrenarche: This condition is characterized by the early development of pubic hair and body odor in children, typically before the age of 8 in girls and 9 in boys [2].
• Premature thelarche: Also known as breast budding, this condition involves the early development of breast tissue in girls, usually before the age of 8 [2].
• Prepubertal vaginal bleeding: This is a condition where girls experience vaginal bleeding before the onset of puberty, which can be a sign of precocious puberty or other underlying conditions [2].
• Leydig cell tumors: These rare tumors produce androgens, leading to early development of secondary sexual characteristics in boys [3].
• Idiopathic central precocious puberty (ICPP): This is the most common cause of CPP, accounting for approximately 80-90% of cases. The exact cause remains unknown, but it is believed to be related to genetic and environmental factors [15].

It's essential to note that a comprehensive evaluation, including physical examination, laboratory tests, and imaging studies, is necessary to rule out these differential diagnoses and confirm the diagnosis of CPP.

References:

[2] Jun 4, 2024 — Precocious Puberty Differential Diagnoses · Diagnostic Considerations · Premature adrenarche · Premature thelarche · Prepubertal vaginal bleeding. [3] by J Brämswig · 2009 · Cited by 99 — Leydig cell tumors must also be considered in the differential diagnosis of precocious pseudopuberty. Physical examination often, though not always, reveals a ... [15] CENTRAL PRECOCIOUS PUBERTY (CPP) CPP is due to early maturation of the HPG axis. The frequency of CPP ranges between 1/5000-1/10,000. 2, 3 It is more common in girls. Female/male ratio changes between 3/1 and 23/1. 4 It is reported to be more frequent in adopted children in developed countries. 5 Although the large majority of CPP is idiopathic, organic lesions as well as environmental factors ...