Should be considered when secondary sexual characteristics appear before 8 years of age in girls and 9 years in boys.
Results in accelerated skeletal development with an impaired final height, and may have a psychosocial impact.
Two forms exist: gonadotropin-dependent (GDPP; due to premature activation of the hypothalamo-pituitary-gonadal axis) and gonadotropin-independent (GIPP; due to autonomous secretion of sex steroids).
History should be directed dependent on whether puberty is consonant or disconsonant (i.e., whether the pattern of endocrine change is the same as in normal puberty or not).
Treatment of GDPP is usually straightforward with gonadotropin-releasing hormone agonists.
GIPP is more difficult to treat; may require ketoconazole, or aromatase inhibitors and antiandrogens.
Treatment should be stopped once an acceptable age of puberty is reached.
Female with GIPP and café au lait hyperpigmented macules in McCune-Albright Syndrome
From the collection of Dr A. Mehta