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Precocious pseudopuberty due to ovarian causes
Jeevarathnam Dhivyalakshmi1, Shaila Bhattacharyya, Rajeshwari Reddy
1Departments of Pediatric Endocrinology and *Pediatrics, Manipal Hospital, Bengaluru, India. Correspondence to: Dr J Dhivyalakshmi, C/o Dr. A. Karunagaran, 60/39, Model Hutment Road, CIT Nagar, Nandanam, Chennai 600 035, Tamilnadu, India.
Background:
It is important to differentiate central from peripheral causes of precocious puberty because of distinct management options.
Case Characteristics:
4 girls with discordant pubertal development.
Observations:
All had low basal and GnRHa stimulated FSH and LH level with high estradiol level. Abdominal ultrasonogram helped in diagnosing precocious pseudopuberty- ovarian cyst in 3 children and juvenile granulosa cell tumour in one.
Outcome:
Case 1 and 4 underwent surgery in view of persistent cyst and tumor, respectively. Rest were managed conservatively. Regression of pubertal signs observed in all children during follow-up.
Conclusion:
Precocious pseudopuberty can be differentiated from central precocious puberty by GnRHa Stimulation test, bone age and abdominal ultrasound.
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