Idiopathic central precocious puberty, a rare entity in boys: A case report

Abstract

Precocious puberty is defined as the appearance of clinical signs of puberty before the age of 8 years in girls and 9 years in boys. The central origin is due to a premature activation of the hypothalamic-pituitary-gonadal axis from which a central tumor pathology must be eliminated in each case. It is distinguished from early puberty of peripheral origin which is independent of hypothalamic-pituitary stimulation of adrenal or gonadal origin. In boys, precocious puberty is most often of central origin and there is a high risk of hypothalamic lesion in 40%. The diagnosis is first of all clinical, then radiological by the realization of a bone age and an abdomino-pelvic or testicular ultrasound sometimes even a pituitary MRI, and biological by the GnRH stimulation test, which allows to confirm the premature activation of the hypothalamic-pituitary gonadal axis. Its management is discussed in case of growth acceleration, significant advance of bone maturation, and ultrasound signs of estrogenic impregnation of the internal genitalia or frank activation of the gonadotropic axis.