Early maturing children

Patient's question:

Child
Patient Age: 11
Detailed Condition and Purpose of Consultation: Half a month ago, the child mentioned some pain in the nipple and felt slightly hard when touched. The hospital examination revealed that it was developing, but it was more than a year ahead of the same age group. It was recommended to exercise more and eat less hormone-containing foods, such as fried foods, KFC, and similar items.
Duration of Current Illness: Half a month
Current General Condition: No discomfort.
Medical History: No history
Previous Diagnoses, Treatments, and Outcomes: First discovery

Doctor's answer:

1. Isolated premature thelarche
This refers to a subset of central precocious puberty (PICPP), where FSH levels significantly increase after GnRH stimulation (they also rise in normal prepubertal girls), but LH levels do not rise markedly (most cases), and the FSH/LH ratio is >1. However, it is important to note that PICPP can transform into CPP without any clinical signs. Therefore, regular follow-up is necessary after diagnosing PICPP, especially for cases with recurrent breast enlargement or persistent enlargement, with repeated stimulation tests if needed.
2. CPP resulting from non-central precocious puberty
Such as congenital adrenal hyperplasia, McCune-Albright syndrome, etc., it is essential to monitor for CPP during the treatment of the primary disease.
3. Precocious puberty associated with congenital hypothyroidism
This is a special type of precocious puberty. Early-stage patients have elevated basal LH levels, but these do not increase after GnRH stimulation, and it takes a prolonged course before they develop into true CPP. Short stature is a key characteristic.