Background The term of precocious puberty signifies the onset of secondary sexual characters before the age of 9 years in the boys and 8 years in the girls. The first step in the clinical reflection is to decide whether the child has central or peripheral form of precocious puberty.
Objective Identify some causes of precocious puberty, expose difficulty of management.
Methods A retrospective study of medical records of children hospitalised in the Paediatric unit at Sahloul hospital in Tunisia.
Results Within a period of 6 years, eight patients were diagnosed with precocious puberty (4 boys and 4 girls). The mean age was 4 years and 3 months. The precocious puberty was isosexual in all cases with accelerated growth velocity. The PP was identify as central in four cases, the investigations showed: hypothalamic hamartoma (2 cases), pituitary adenoma (1 case) and arachnoid cyst (1 case). Peripheral precocious puberty included: congenital adrenal hyperplasia (3 cases) and adrenocortical carcinoma (1 case). The children with central precocious puberty were treated with gonadotrophin releasing hormone agonists, those with congenital adrenal hyperplasia received steroids replacement therapy and surgery was performed for the boy with adrenocortical carcinoma. The clinical and biological evolution of our patients was favourable with a regression of signs of puberty and normal hormone levels after a mean of 5 years.
Conclusion Precocious puberty needs a systematic approach with detailed history and clinical examination. Early treatment contributes to optimise adult height potential. There are still unresolved questions that future studies will need to address. Finally, the behavioural and psychological outcomes of precocious puberty were still poorly evaluated.