PURPOSE: Differential diagnosis of sexual precocity is important. Sexual precocity, defined as the appearance of secondary sexual characteristics before the age of 8 years in girls and 9 years in boys, was studied to evaluate the sex incidence and etiology of sexual precocity. METHODS: We reviewed the etiology and age incidence of precocious puberty in 14 boys and 89 girls examined between 1994. 11. 1-2002. 7. 31 at Samsung Seoul Hospital. All underwent standard anthropometric measures. They were assigned to diagnostic categories on the basis of clinical assessment, endocrine evaluation, radiologic imaging, and pelvic ultrasonography. RESULTS: In 89 girls, 27 had idiopathic precocious puberty, 3 had precocious puberty with organic brain lesion, 12 had gonadotropin-independent precocious puberty, 44 had premature thelarche, 2 had premature menarche, 1 had premature adrenarche. The majority of idiopathic precocious puberty girls(78%) were aged between 7-7.9 years. In 14 boys, 2 had idiopathic precocious puberty, 3 had precocious puberty with organic brain lesion, 6 had gonadotropin-independent precocious puberty, 3 had gynecomastia. CONCLUSION: Sexual precocity occurs more frequently in girls than boys. Premature thelarche is the most common form of sexual precosity. In boys, majority of central precocious puberty had organic brain lesion, so brain imaging study should be performed. In girls, majority of idiopathic precocious puberty were aged between 7-7.9 years. Reexamination of the age limit for defining when puberty should be considered precocious in Korean girls is necessary.
Adolescent ; Adrenarche ; Brain ; Diagnosis, Differential ; Female ; Gynecomastia ; Humans ; Incidence* ; Male ; Menarche ; Neuroimaging ; Puberty ; Puberty, Precocious* ; Seoul ; Ultrasonography

Puberty is the period of first attaining capability of reproduction, and is signed by the appearance of secondary sex characteristics and the occurrence of menarche in females. The timing of puberty is ethnically, sexually and individually variable and is influenced by both genetic and environmental factors. The diagnosis of precocious or delayed puberty is considered when signs of puberty develop before or after 2 standard deviation of the mean age for the onset of puberty. Consequently, a comprehensive understanding of the normal progression of puberty is vital in the evaluation of abnormal pubertal development. In most western countries, the first signs of puberty occur between 8 and 13 years of age. Correspondingly, the recent Korean data have shown that puberty begins in most Korean girls with breast development at the age between 8.7 and 13.9 years. This article reviewed lately published literatures on normal and abnormal pubertal development in Korean adolescent females to delineate features of pubertal disorders in this population.
Adolescent ; Breast ; Female ; Humans ; Korea ; Menarche ; Puberty ; Puberty, Delayed ; Reproduction ; Sex Characteristics

The age of puberty represents a very critical time in the life history of every young woman. The menarche stands as primary indicator of the onset of sexual maturation in females. According to several studies, menarcheal age in Korean girls has dropped from about 15 years of age in 1960s to 13.5 years of age in 1980s. This findings show a pronounced secular trend to earlier maturation. The purpose of this study is to determine (1) the average age at menarche in Korea in present time, (2) the secular trend of menarcheal age, and (3) the geographic regional influence on menarche. The data sampling was obtained from the physical examination cards of women students in Yonsei University who entered from 1983 to 1991. The data which was obtained from the number of 7761 was analysed by dBase III plus and SAS program. The results are as follows: 1) The mean menarcheal age of the subjects was 13.7+/-1.2 years. 2) Age at menarche has been getting earlier by some 7.4 months during the period of recent II years. 3) Comparing to the decreasing secular trend of menarcheal age, the height and weight showed increasing trend. 4) There were significant differences in menarcheal age, height, weight among geographic regions. We conclude that the results indicate an accelerating secular trend in age of menarche in Korea.
Adolescent ; Female ; Humans ; Korea* ; Menarche ; Physical Examination ; Puberty ; Sexual Maturation

A case of a two and a half year old girl with a 6 month history of isosexual precocious puberty (thelarche: Tanner stage 2 breasts and menarche) secondary to an estrogenizing pure Sertoli cell tumor of the left ovary is presented. Pre-operative tumor markers AFP, BhCG and CA-125 revealed normal results. Transabdominal ultrasound with color flow mapping and Doppler interrogation revealed a solid left ovarian mass probably malignant. The patient underwent exploratory laparotomy, left salpingooophorectomy and frozen section revealing sex cord stromal tumor. Paraffin sections stained with Hematoxylin and Eosin revealed a benign Sertoli cell tumor. Immunostains of the tumor reacted positively for inhibin, calretenin and cytokeratin, but negative for epithelial membrane antigen. Total serum estradiol, prolactin, TSH and LH were elevated prior to surgical operation, with LH and prolactin substantially decreasing four weeks later into the normal prepubertal range. TSH and estradiol levels however have remained very slightly elevated. Serum FSH was at prepubertal levels. Breasts size had likewise regressed to prepubertal size four weeks postoperatively, and the menses never recurred. This is the youngest reported occurrence of this rare sex cord stromal neoplasm in the last 10 years in our institution. The prognosis of this extremely rare tumor presenting at this early juvenile stage is uncertain, and it is recommended to keep a close follow-up and regular endocrinologic investigation until prepubertal values are attained.
SERTOLI ; CELL TUMOR ; ISOSEXUAL ; PRECOCIOUS PUBERTY ; MENARCHE, ; THELARCHE

The incidence of small for gestational age (SGA) births is frequent, accounting for 2.3% to 8% of all live births. Several childhood and adult diseases are related to early postnatal growth and birth size, and 10% of children born SGA may have a short stature throughout postnatal life. Additionally, they may have abnormal growth hormone (GH)-insulin like growth factor axis, HPA axis, and gonadal function. Permanent changes are detrimental in an environment of nutritional abundance, and predispose SGA children to an array of diseases in adolescence and adulthood. Such changes may also cause premature pubarche, adrenarche, and precocious puberty. The varying results from clinical studies necessitate more prospective case control studies. Reproductive tract abnormalities and reproductive dysfunction are related to SGA births. GH treatment is required for SGA infants who do not experience catch-up growth.
Accounting ; Adolescent ; Adrenarche ; Adult ; Axis, Cervical Vertebra ; Case-Control Studies ; Child ; Gestational Age ; Gonads ; Growth Hormone ; Humans ; Incidence ; Infant ; Live Birth ; Parturition ; Puberty, Precocious ; Sex Differentiation

Precocious puberty is the onset of pubertal development at an earlier age than is expected based upon established normal standards. The cause of precocious puberty may range from a variant of normal development (eg. premature adrenarche or isolated premature thelarche) to pathologic conditions with significant risk of morbidity and even death (eg. malignant germ-cell tumor or astrocytoma). A case of an 18 month old female presenting with vaginal bleeding following a previously noted breast enlargement was described. Initial assessment based on the patient's history and physical examination is suggestive of precocious puberty. Hormonal studies indicated normal levels of FSH and LH, with an elevation in estradiol. Radiographic analysis showed a normal bone age. Cranial MRI revealed no abnormal masses. Sonographic evaluation showed bilateral cystic masses in the ovaries. A diagnosis of peripheral precocious puberty associated with functional ovarian cysts was made, and the patient was monitored for progression of pubertal development.

Human ; Female ; Infant ; Familial Testotoxicosis ; Puberty, Precocious ; Estradiol ; Adrenarche ; Ovarian Cysts ; Gigantomastia ; Breast ; Hypertrophy ; Astrocytoma ; Neoplasms, Germ Cell And Embryonal ; Uterine Hemorrhage

Approximately 50% of patients with Turner syndrome (TS) have complete loss of one X chromosome, whereas the rest of the patients with TS display mosaicism or structural abnormalities of the X chromosome. Most well-known common features are short stature and gonadal failure. Approximately one third of girls with TS may enter spontaneous puberty, but only half those completed with menarche. However, some atypical features of TS have been described. Many studies have been conducted to verify and delineate proposed loci for genes pertaining to the TS phenotype, and correlations between karyotype and phenotype. A few rare cases of precocious puberty with TS have been described. Here we describe a case of TS with the Xp22.1 deletion presenting with short final stature, early normal onset of spontaneous puberty, and Graves' disease, without short stature during puberty.
Adolescent ; Female ; Gonads ; Graves Disease ; Humans ; Karyotype ; Menarche ; Mosaicism ; Phenotype ; Puberty* ; Puberty, Precocious ; Turner Syndrome* ; X Chromosome

During the past decades, advancement in pubertal maturation in children has been noticed worldwide. Growing evidence indicates that increasing prevalence of obesity in children is a major factor for the secular trend of earlier puberty. In girls, several epidemiologic studies suggest that earlier pubertal onset and earlier menarche might be caused by obesity. On the other hand, in boys, few research reported an association between obesity and pubertal development, and the results are inconsistent; Some studies found a link between obesity and delayed puberty, but others reported a causal relationship between obesity and early puberty. To date, mechanisms linking childhood obesity and earlier puberty remain unclear. In this review, we presented the potential impact of obesity on puberty-related hormones and summarized human studies on potential relationship of childhood adiposity and pubertal development.
Adiposity ; Aluminum Hydroxide ; Carbonates ; Child ; Female ; Hand ; Humans ; Menarche ; Obesity ; Prevalence ; Puberty ; Puberty, Delayed ; Research Report ; Sexual Maturation

Globally, there is a secular trend toward earlier puberty and an increased final height at adulthood. In Korea, there is a trend toward an earlier menarche in girls but insufficient data to evaluate secular trends in boys. A significant increase in height was observed in Koreans aged 0~20 years during 1965~2005. This trend has diminished, but growth maturation has accelerated in infants and young children. Genetic and environmental factors including nutritional status (e.g., obesity) contribute to these changes. Central precocious puberty results from the accelerated activation of the hypothalamic-pituitary-gonadal axis. Although the cut-off age is controversial, clinical evaluations should be conducted on girls with pubertal onset occurring younger than 8 years, and on boys younger than 9 years at least until further prospective studies define the norms for Korea. Management of precocious puberty depends on the underlying etiology, as accelerated puberty can lead to a reduced final adult height. Depot forms of GnRH agonists (GnRHas) are the standard treatment for some patients with central precocious puberty. These agents can help restore the normal adult height in both girls and boys when it might be compromised by rapidly progressive precocious puberty. However, in girls with slowly progressive precocious puberty or with the onset of puberty at 8~9.9 years of age (early normal puberty), GnRHa treatment might offer no benefit for attaining normal height. There is little evidence on whether psychosocial problems are associated with precocious puberty or are improved by GnRHa treatment.
Adult ; Aged ; Axis, Cervical Vertebra ; Child ; Female ; Gonadotropin-Releasing Hormone ; Humans ; Infant ; Korea ; Menarche ; Nutritional Status ; Puberty ; Puberty, Precocious

No abstract available.
Puberty, Delayed*