b.思春期早発症の系統的診断法(1.内分泌)

概要

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Precocious puberty is a symptom that second sexual characteristics develop at younger age. Occurrence of precocious puberty is dominant in girls. Most frequent etiology of precocious puberty in girls is idiopathic, whereas it is organic in boys. Diagnostic procedure is important to examine and treat the cause of the symptom. At first, partial precocious puberty such as premature thelarche, premature adrenarche and premature menarche can be differentiated by growth velocity, bone age, and sex steroid determination. Sometimes it is difficult to differentiate autonomous ovarian follicular cysts from true precocious puberty. LHRH test can differentiate gonadotropin-dependent precocious puberty from gonadotropin-independent precocious puberty. Gonadotropin-independent precocious puberty should be evaluated carefully, since it is caused by organic diseases such as adrenal tumor and hCG-producing tumor, or genetic diseases such as McCune-Albright syndrome and testotoxicosis. Gonadotropin-dependent precocious puberty should be evaluated by brain MRI to differentiate idiopathic precocious puberty from organic disorders such as germinoma, hamartoma, and hydrocephalus.
社団法人日本産科婦人科学会の論文
2002-08-01