Diagnóstico de pubertad precoz: Guía de práctica clínica para el diagnóstico y el tratamiento de la pubertad precoz

Abstract

The Mexican Society of Pediatric Endocrinology developed a clinical practice guide for the diagnosis and treatment of precocious puberty. This document presents recommendations related to the diagnosis of precocious puberty. The detailed description of the methodology for the development of this guide and the grading system, as well as the synthesis of the evidence on which it is based can be accessed in this same supplement.

Auxological and Metabolic Parameters of Children Undergoing the Gonadotropin-Releasing Hormone Stimulation Test: Correlations with the Final Diagnosis of Central Precocious Puberty in a Single-Center Study

“…However, the performance and interpretation of the results can be difficult due to the different cut-off values suggested by scientific societies. Most recommendations consider LH above 5 IU/L or LH/FSH ratio above 1 (or 0.6, depending on the guidelines used) after a GnRH test as the most appropriate seal for the diagnosis of precocious puberty in children [ 12 ], although Italian recommendations consider even a peak above 3.3 IU/L useful [ 4 ].…”

Metodología para la elaboración de la Guía de práctica clínica para el diagnóstico y el tratamiento de la pubertad precoz

“…Se generaron 43 recomendaciones en total: 12 recomendaciones sobre el diagnóstico de PP 7 , siete sobre el diagnóstico de causas secundarias 8 , ocho sobre intervenciones para la inhibición de la pubertad 9 , cinco sobre otras intervenciones en PP 10 y 14 para la monitorización del tratamiento y el seguimiento de estos pacientes 11 . Las recomendaciones y su sustento se detallan en el resto de los siguientes artículos de este suplemento, así como las tablas de evidencia de las tres revisiones sistemáticas que se realizaron.…”

Clinical Management and Therapy of Precocious Puberty in the Sapienza University Pediatrics Hospital of Rome, Italy

“…PPP is characterized by an increase in adrenal and gonadal sex steroids in the absence of HPG axis activation; the pubertal characteristics may be valid for the child's sex (isosexual) or inappropriate, with virilization of girls and feminization of boys (contrasexual) [29]. It can be congenital, with the most frequent forms represented by congenital adrenal hyperplasia and McCune-Albright syndrome, or acquired, mainly related to hormone-secreting endocrine tumors [2,11,30].…”

“…Puberty is the transitional period from childhood to adulthood characterized by major physical and psychological modifications leading to the development of secondary sexual characteristics, the maturation of the gonads and the achievement of reproductive capacity [1]. Puberty is a complex process characterized by environmental, genetic, geographical and metabolic factors [2]. The mechanism underlying pubertal activation remains unknown, although the following have been identified as possible causes: adrenal activation, physical and psychological stress, an abundance of adipose tissue and the inflammation of the intestinal tract [3,4].…”

“…LH and FSH act on the gonads, promoting gametogenesis [10]. Pubertal development is considered physiological when it begins between the ages of 8 and 13 in females and between 9 and 14 years in males, although it is a variable process within each individual, lasting on average between 3 and 5 years [2,10].…”