Puberdade precoce

Autores

  • Isabel R. Madeira Departamento de Pediatria. Faculdade de Ciências Médicas. Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.

DOI:

https://doi.org/10.12957/rhupe.2016.28241

Resumo

O objetivo do presente artigo é apresentar informações relevantes a respeito de puberdade precoce e de seu diagnóstico diferencial. Foi realizada revisão de literatura científica utilizando busca bibliográfica eletrônica no Medline com as palavras-chave “precocious puberty”, “adrenarche” e “gynecomastia” e livros textos contendo dados atualizados relevantes sobre o tema. Foi também consultada a portaria nacional que trata do protocolo clínico e diretrizes terapêuticas em puberdade precoce central. Além da revisão, especialmente no que se refere ao diagnóstico das causas subjacentes e ao diagnóstico diferencial, o artigo apresenta a conduta terapêutica de puberdade precoce verdadeira. A pesquisa de uma causa subjacente está sempre indicada em meninos. Deve ser realizada em meninas com puberdade precoce progressiva, principalmente quando as manifestações se iniciam antes dos seis anos de idade ou naquelas com risco para causas orgânicas, aventadas em função de condições pré-existentes ou sinais e sintomas neurológicos.

Descritores: Puberdade precoce; Adrenarca; Ginecomastia.

Biografia do Autor

Isabel R. Madeira, Departamento de Pediatria. Faculdade de Ciências Médicas. Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.

Departamento de Pediatria. Faculdade de Ciências Médicas. Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.

Referências

Rosenfield RL, Cooke DW, Radovick S. Puberty and its disorders in the female. In: Sperling MA (ed.). Pediatric Endocrinology. 4th ed. Philadelphia: Elsevier, Sauders;2014.p.569-663.

Sabchez-Garrido MA, Tena-Sempere M. Metabolic control of puberty: roles of leptina and kisspeptins. Horm Behav. 2013;64:187-94. http://doi.org/10.1016/j.yhbeh.2013.01.014

Abreu AP, Kaiser UB. Pubertal development and regulation. Lancet Diabetes Endocrinol. 2016;4:254-64. http://doi.org/10.1016/S2213-8587(15)00418-0

Livadas S, Chrousos GP. Control of the onset of puberty. Curr Opin Pediatr. 2016;28:551-8. http://doi.org/ 10.1097/MOP.0000000000000386

Rosenfiel RL, Bordini B, Yu C. Comparison of detection of normal puberty in girls by a hormonal sleep test and a gonadotropin-releasing hormone agonist test. J Clin Endocrinol Metab. 2013;98:1591-601. http://doi.org/10.1210/jc.2012-4136

Halan WR, Grillo GP, Cornoni-Huntley J, et al. Secondary sex characteristics of boys 12 to 17 years of age: the U.S. Health Examination Survey. J Pediatr. 1979;95:293-7.

Marshall W, Tanner J. Variations in pattern of pubertal changes in girls. Arch Di Child. 1969;44:291-8.

Mart-Henneberg C, Vizmanos B. The duration of puberty in girls is related to the timing of its onset. J Pediatr. 1997;131:618-21.

Glass AR. Gynecomastia. Endocrinol Metab Clin North Am. 1994;23:825-37.

Parent AS, Teilmann G, Juul A, et al. The timing of normal puberty and the age limits of sexual precocity: variations around the world, secular trends, and changes after migration. Endocr Rev. 2003;24:668-93. http://doi.org/10.1210/er.2002-0019

Winter JSD, Hughes IA, Reyes FL, et al. Pituitary-gonadal relations in infancy: patterns of serum gonadal steroid concentrations in man from birth to two years of age. J Clin Endocrinol Metab 1976;42:679-86. http://doi.org/10.1210/jcem-42-4-679

Palmert MR, Dunkel L, Witchel SF. Puberty and its disorders in the male. In: Sperling MA (ed.). Pediatric Endocrinology. 4th ed. Philadelphia: Elsevier, Sauders; 2014. p.697-733.

Carel JC, Eugster EA, Rogol A, et al. Consensus statement on the use of gonadotropin-releasing hormone analogs in children. Pediatrics. 2009;123:e752-62. http://doi.org/10.1542/peds.2008-1783

Chalumeau M, Hadjiathanasiou CG, Ng SM, et al. Selecting girls with precocious puberty for brain imaging: validation of European evidence-based diagnosis rule. J Pediatr. 2003:143:445-50. http://doi.org/10.1067/S0022-3476(03)00328-7

Cisternino M, Arrigo T, Pasquino AM, et al. Etiology and age incidence of precocious puberty in girls: a multicentric study. J Pediatr Endocrinol Metab. 2000;13:695-701.

Brauner R, Adan L, Malandry E, et al. Adult hight in girls with idioptic true precocious puberty. J Clin Endocrinol Metab. 1994;79:415-20. http://doi.org/ 10.1210/jcem.79.2.8045957

Rosenfield RL, Lipoton RB, Drum ML. Thelarche, pubarche, and menarche attainment in children with normal and elevated body mass index. Pediatrics. 2009;123:84-8. http://doi.org/10.1542/peds.2008-0146

De Sanctis V, Corrias A, Rizzo V, et al. Etiology of central precocious puberty in males: the results of the Italian Study Group for Physiopathology of Puberty. J Pediatr Endocrinol Metab. 2000;13:687-93.

Junier MP, Wolff A, Hoffman G, et al. Effect of hypothalamic lesions that induce precocious puberty on the morphological and functional maturation of the luteinizing hormone-releasing hormone neuronal system. Endocrinology. 1992;131:787-98. http://doi.org/10.1210/endo.131.2.1639024

Carel JC, Leger J. Clinical practice: precocious puberty. N Engl J Med. 2008;358:2366-77. http://doi.org/10.1056/NEJMcp0800459

Nathan BN, Palmer MR. Regulation and disorders of pubertal timing. Endocrinol Metab Clin North Am. 2005;34:617-41. http://doi.org/10.1016/j.ecl.2005.04.015

Pescovitz OH, Comite E, Cassorla E, et al. True precocious puberty complicating congenital adrenal hyperplasia: treatment with a luteinizing hormone-releasing hormone analog. J Clin Endocrinol Metab. 1984;58:857-64. http://doi.org/10.1210/jcem-58-5-857

Gazolla FM, Rodrigues GC, Alencar RC, et al. Perfil de uma amostra de precocidade sexual acompanhada em um ambulatório de endocrinologia pediátrica. Arq Bras Endocrinol Metab. 2007;51:S757-S64.

Clayton PE, Cianfarani S, Czernichow P, et al. Management of the child born small for gesational age through to adulthood: a consensus statement of the International Societies of Pediatric Endocrinology and the Growth Hormone Research Society. J Clin Endocrinol Metab. 2007;92:804-10. http://doi.org/10.1210/jc.2006-2017

Marchall WA, Tanner JM. Variations in the pattern of pubertal changes in girls and boys. Arch Dis Child. 1969;44:291-303.

Greulich WW, Pyle SI. Radiographic atlas of skeletal development of the hand and wrist. 2nd ed. Stanford: Stanford University Press; 1959. 255p.

Rosenfield RL Normal and almost normal variants of precocious puberty: premature pubarche and premature thelarche revisited. Horm Res. 1994;41:7-13.

Kraiter M, Cara J, Rosenfield R. Modifying the outcome of complete precocious puberty: to treat or not to treat. In Grave G, Cutler G (ed). Sexula Precocity: Etiology, Diagnosis, and Management. New York: Haven Press;1993. p. 109-120.

de Vries L, Horev G, Schwrtz M, et al. Ultrassonographic and clinical parameters for early differentiation between precocious puberty and premature thelarche. Eu J Endocrinol. 2006:154:891-8. http://doi.org/10.1530/eje.1.02151

Haber HP, Wollmann HA, Ranke MB. Pelvic ultrasonography: early differentiation between isolated premature thelarche and central precocious puberty. Eur J Pediatr. 1995;154:182-6.

Salardi S, Orsini L, Cacciari E, et al. Pelvic ultrassonography in girls with precocious puberty, congenital adrenal hyperplasia, obesity, or hirsutism. J Pediatr 1988;112:880-7.

Balassi C, Navarro OM, Daneman A. Adrenal masses in children. Radiol Clin North Am. 2011;49:711-27. http://doi.org/10.1016/j.rcl.2011.05.001

Grunt JA, Midyett LK, Simon SD, el al. When should cranial magnetic resonance imaging be used in girls with early sexual development? J Pediatr Endocrinol Metab. 2004;17:775-80.

Resende EA, Lara BH, Reis JD, et al. Assessment of basal and gonadotropin-releasing hormone-stimulated gonadotropins by immunochemiluminometric and immunofluorometric assays in normal children. J Clin Endocrinol Metab. 2007;92:1424-9. http://doi.org/10.1210/jc.2006-1569

Neely EK, Wilson DM, Lee PA, et al. Spontaneous serum gonadotropin concentrations in the evaluation of precocious puberty. J Pediatr. 1995;127:47-52.

Speiser PW, Azziz R, Baskin LS, et al. Congenital adrenal hyperplasia due to steroid 21-hydroxylase deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2010;95:4133-60. http://doi.org/10.1210/jc.2009-2631

Van Wyk J, Grumbach M. Syndrome of precocious menstruation and galactorrhea in juvenile hypothyroidism: an example of hormonal overlap in pituitary feedback. J Pediatr. 1960;57:416-23.

Völkl TMK, Dörr HG. McCune-Albright syndrome: clinical picture and a natural history in children and adolescents. J Pediatr Endocrinol Metab. 2006;19:551-9.

Shenker A, Laue L, Kosugi S, et al. A constitutively activating mutation of the luteinizing hormone receptor in familial male precocious puberty. Nature. 1993;365:652-54. http://doi.org/10.1038/365652a0

Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Portaria Nº 111, de 23 de abril de 2010. Protocolo Clínico e Diretrizes Terapêuticas. Puberdade Precoce Central.

http://bvsms.saude.gov.br/bvs/saudelegis/sas/2010/prt0111_23_04_2010_rep.html. Acesso em: 22/3/2016.

Brito VN, Spinola-Castro AM, Kochi C, et al. Central precocious puberty: revising the diagnosis and therapeutic management. Arch Endocrinol Metab. 2016;60:163-72. http://doi.org/10.1590/2359-3997000000144

Liu S, Liu Q, Cheng X, et al. Effects and safety of combination therapy with gonadotropin-releasing hormone analogue and growth hormone in girls with idiopathic central precocious puberty: a meta-analysis. J Endocrinol Invest. 2016. [Epub ahead of print]. http://www.ncbi.nlm.nih.gov/pubmed/27225286. Acesso: 04/9/2016.

Downloads

Publicado

2016-06-19

Edição

Seção

Artigos