In the world of medicine, precocious puberty is puberty that occurs at a very young age. In many cases, the process is normal in every aspect except for a very young age, and represents only normal developmental variations. In a minority of children, early development is triggered by diseases such as tumors or brain injury. Even when there is no illness, unusual early puberty can have adverse effects on social behavior and psychological development, can reduce the potential for adult height, and may shift some lifetime health risks. Early middle puberty can be treated by suppressing the pituitary hormones that induce the production of sex steroids. The opposite is delayed puberty.
This term is used with some slightly different meanings that are usually seen from the context. In the broadest sense, and often simplified as early puberty , "prematurely puberty" sometimes refers to the effects of any physical sex hormone, for whatever reason, occurs earlier than usual, is being considered. as a medical issue. Higher "speed" definitions may refer only to central puberty that begins before a statistically determined age based on the percentile in the population (eg 2.5 standard deviations below the population average), on the recommendation of an aged expert in which there is more than one opportunities that are ignored. find abnormal causes, or based on opinions about the age at which early puberty may have adverse effects. The general definition for medical purposes is onset before 8 years in girls or 9 years in boys.
Video Precocious puberty
Cause
Puberty praecox is a Latin term used by doctors in the 19th century. Genital, breast, or early genital development may result from natural early maturation or from some other conditions.
Middle
If the cause can be traced to the hypothalamus or pituitary, the cause is considered central. Other names for this type are complete or precocious puberty .
The causes of precocious puberty may include:
- damage the brain's inhibition system (due to infection, trauma, or irradiation),
- hypothalamus hamartoma produces pulsatile gonadotropin release hormone (GnRH),
- Langerhans cell histiocytosis cell, or
- McCune-Albright syndrome.
Early midline puberty can be caused by intracranial neoplasms, infection (especially the central nervous system of tuberculosis especially in developing countries), trauma, hydrocephalus, and Angelman syndrome. Puberty prematurely is associated with advances in bone age, leading to early fusion of epiphyses, resulting in reduced high end and short stature.
Puberty prematurely can make the child become fertile when very young, with the youngest mother recorded is Lina Medina, who gave birth at the age of 5 years, 7 months and 17 days, in one report and at 6 years and 5 months in another.
"Middle premature puberty (CPP) is reported in some patients with suprasellar arachnoid cyst (SAC), and SCFE (derailed in femoral epiphysis) occurs in patients with CPP due to rapid growth and changes in growth hormone secretion."
If no cause can be identified, it is considered idiopathic or constitutional.
Peripherals
Secondary sexual development caused by sex steroids from other abnormal sources is referred to as precocious peripheral puberty or pseudopuberty prematurely. Usually appears as a severe form of illness in children. Symptoms are typically as residual symptoms of adrenal insufficiency (due to a first-ever more common deficiency of 21-hydroxylase or 11-beta hydroxylase deficiency), which includes but are not limited to hypertension, hypotension, electrolyte abnormalities, ambiguous genitalia in women, virilization signs on woman. Blood tests will usually reveal high androgen levels with low levels of cortisol.
The causes could include:
- Endogenous sources
- gonad tumor (such as arrhenoblastoma),
- adrenal tumor,
- germ cell tumor,
- congenital adrenal hyperplasia,
- McCune-Albright syndrome,
- Exogenous hormones
- Exogenous environment hormone,
- As a treatment for other conditions.
Isosexual and heterosexual
Generally, patients with premature puberty develop appropriate secondary characteristics of the phenotype. This is called isosexual precocity.
Sometimes the patient may progress in the opposite direction. For example, men can develop breasts and other feminine characteristics, while women can develop deepened facial sounds and hair. This is called heterosexual or contrastexual forecasts. It is very rare compared to isosexual precocity and is usually the result of unusual circumstances. For example, children with a very rare genetic condition called excess aromatase syndrome in which estrogen levels are very high circulating usually develop into adulthood prematurely. Men and women experience hyperememinization by syndrome.
Research
Many of the causes of early puberty are somewhat unclear, although girls who have high-fat diets and are physically inactive or obese are more likely to physically mature earlier. "Girl obesity, defined as at least 10 kilograms (22 pounds) overweight, has an 80 percent chance of developing breasts before the ninth birthday and begins to menstruate before the age of 12 years - the western average for menstruation is about 12.7 years. " Exposure to chemicals that mimic estrogens (known as xenoestrogens) is a likely cause of early puberty in girls. Bisphenol A, xenoestrogen found in hard plastic, has been shown to affect sexual development. "Factors other than obesity, however, may be genetic and/or environmental, necessary to explain the prevalence of higher early puberty in black and white girls." While more girls are getting into puberty at a younger age, new research shows that some boys actually start later (puberty is delayed). "Increasing obesity rates and overweight children in the United States may contribute to the onset of puberty in boys, say researchers at the University of Michigan Health System."
The high levels of beta-hCG in serum and cerebrospinal fluid observed in 9-year-old boys showed a pineal gland tumor. This tumor is called a chorionic secreting gonadotropin pine. Radiotherapy and chemotherapy reduce normalized levels of tumor and beta-hCG.
In a study using melatonin in neonatal mice, the results showed that high melatonin can be responsible for some cases of early puberty.
The idiopathic central precocious puberty (ICPP) family case has been reported, leading researchers to believe there is an ICPP specific genetic modulator. Mutations in genes such as LIN28, and LEP and LEPR, which encode leptin and leptin receptors, have been associated with puberty prematurely. The relationship between LIN28 and puberty timings was experimentally validated in vivo, when it was found that mice with ectopic overexpression of LIN28 showed an extended period of pre-puberty growth and a significant delay in puberty.
Mutations in kisspeptin (KISS1) and its receptors, KISS1R (also known as GPR54), are involved in GnRH secretion and onset puberty, also considered a cause for ICPP However, this is still a controversial field of research, and some researchers have found no mutation the LIN28 and KISS1/KISS1R genes became the underlying common cause of ICPP.
The MKRN3 gene, which is a maternally printed gene, was first cloned by Jong et al in 1999. MKRN3 was originally named Zinc finger protein 127. It lies on the human chromosome 15 on the long arm in the critical region of Prader-Willi syndrome2, and since then has been identified as a cause of early sexual development or CPP. The identification of mutations in MKRN3 leading to sporadic CPP cases has contributed significantly to better understand the mechanism of puberty. MKRN3 seems to act as a "brake" in access of the central hypothalamus-pituitary. Thus, loss of the function of the mutation of the protein allows the initial activation of the GnRH pathway and causes phenotypic CPP. Patients with MKRN3 mutations all showed classic signs of CCP including early development of the breast and testes, increased bone aging and elevated levels of GnRH and LH hormones.
Maps Precocious puberty
Diagnosis
Studies show that breast development in girls and the appearance of pubic hair in girls and boys start earlier than in previous generations. As a result, "early puberty" in children, especially girls, as young as 9 and 10 is no longer considered abnormal, although it may be disruptive to parents and may harm physically adult children when they are mentally immature.
There is no age that reliably separates the normal from abnormal processes in children, but the following age limit for evaluation is considered to minimize the risk of losing significant medical problems:
- Breast development in boys before the appearance of pubic hair or testicular enlargement,
- Genital hair or genital enlargement (gonadarche) in boys with onset before 9.5 years,
- Pubic hair before 8 or threecry in girls with onset before 7 years,
- Menstruation (menarche) in girls before 10 years.
Medical evaluation is sometimes necessary to recognize some children with serious conditions of the majority who have entered puberty early but medically normal. Early sexual development requires evaluation as possible:
- induces early bone maturation and reduces adult height,
- indicates a tumor or other serious problem,
- causes a child, especially a girl, to be the object of adult sexual attraction.
Prognosis
Early puberty is believed to place girls at a higher risk of sexual abuse, unrelated to pedophilia because the child has developed secondary sex characteristics; however, the causal relationship still can not be concluded. Early puberty also places girls at higher risk for teasing or bullying, mental health disorders and short stature as adults. Helping children control their weight is recommended to help delay puberty. Early puberty also places girls at a much "greater risk" for later breast cancer. Girls as young as 8 are getting started menstruating, developing breasts and growing pubic hair and underarms; This "biological milestone" usually occurs only at the age of 13 years or older in the past. African-American girls are particularly vulnerable to early puberty. There are theories that debate the tendency of early puberty, but the exact cause is unknown.
Although boys face fewer problems in puberty earlier than girls, early puberty is not always positive for boys; Early sexual maturity in boys can be accompanied by increased aggressiveness due to hormonal spikes that affect them. Because they look older than their peers, pubescent boys can face increasing social pressure to adapt to adult norms; people can see them as more emotionally advanced, though their cognitive and social development may lag behind their appearance. Studies have shown that older boys tend to be more sexually active and more likely to participate in risky behavior.
Treatment
One possible treatment is with anastrozole. Histrelin acetate (Supprelin LA), triptorelin or leuprolide, any GnRH agonist, may be used. The use of non-continuous GnRH agonists stimulates the pituitary gland to release follicle stimulating hormone (FSH) and luteinizing hormone (LH). However, when used regularly, GnRH agonists cause decreased release of FSH and LH. Long-term use has the risk of causing osteoporosis. After stopping the GnRH agonist, pubertal changes continue within 3 to 12 months.
See also
- Puberty pending
- List of youngest birth moms
- Early menopause and premature ovarian failure
References
External links
- Your Child - Puberty by University of Michigan
- PSM by Yayasan Anak Pertumbuhan
- Great Central Pub
Source of the article : Wikipedia
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