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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.
The parents of a 6-year-old girl bring her to a pediatrician because of breast development. Her medical history is unremarkable. The parents are of average height, and the mother reports first menstruating when she was 11 years old. At physical examination, the girl is 125 cm tall (in the 97th percentile for her age), weighs 28 kg, and has a body-mass index
The Clinical Problem
Strategies and Evidence
Evaluation
Additional Testing
Bone Age
Hormonal Measurements
Pelvic or Testicular Ultrasound Scans
Brain Magnetic Resonance Imaging
Management
Central Precocious Puberty
Peripheral Precocious Puberty
Areas of Uncertainty
Guidelines
Conclusions and Recommendations
Source Information
From the Department of Pediatric Endocrinology and Diabetology, INSERM Unité 690, and Centre de Référence des Maladies Endocriniennes de la Croissance, Robert Debré Hospital and University of Paris 7 — Denis Diderot, Paris (J.-C.C., J.L.).
An audio version of this article is available at www.nejm.org.
Address reprint requests to Dr. Carel at Endocrinologie Diabétologie Pédiatrique and INSERM U690, Hôpital Robert Debré, 48, Blvd. Sérurier, 75935 Paris CEDEX 19, France, or at jean-claude.carel@inserm.fr.
This article has been cited by other articles:
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