Patient's question:
The daughter is now 9 years and 10 months old. She suddenly started gaining weight last August and has been 132 cm tall and 31 kg ever since. There are no signs of breast development, no lump or tenderness, but there is one hair on her lower body.Doctor's answer:
Hello.1. It can sometimes be difficult to observe breast development in obese children. Your child's ovarian volume reached a developmental level at the time of her check-up in July of this year when she was under 8 years old, and she now has pubic hair, which is also considered early. Therefore, she is experiencing precocious puberty. Fortunately, her bone age is not advanced by much (there is usually a certain discrepancy between bone age and chronological age in normal children), and her height is still acceptable (I don’t know the parents' height).
2. Her precocious puberty is closely related to obesity. Obesity can also accelerate and advance bone age, as well as lead to early onset of pubic hair. It can be said that obesity is the main cause of her precocious puberty (though specific examinations did not reveal this, and I did not conduct a face-to-face consultation (I don’t remember if you asked me to see you at the time? Besides, with so many patients, I sometimes forget.)), and whether there are other factors is uncertain). Elevated uric acid levels are also a result of obesity.
Therefore, the most important thing you must address is: obesity. The examination should focus on obesity (identifying the cause of obesity, etc.). If it has already been done (I believe if the examination was conducted in our hospital’s pediatric endocrinology department, it should have been comprehensive enough), there is no need to repeat it. Regarding precocious puberty, regular follow-ups of bone age and height are sufficient. It is best to avoid further medication for precocious puberty.