Central precocious puberty secondary to pituitary microadenoma: A case report
DOI:
https://doi.org/10.59692/jogeca.v33i4.460Keywords:
pituitary microadenoma, precocious puberty, hypothalamic-pituitary-gonadal axis, leuprolide, Tanner stagingAbstract
Background: Precocious puberty is early pubertal development that results in future short stature and psychosocial problems.
Case presentation: A four-and-a-half-year-old presented to the gynecology clinic with a history of two menstrual cycles. She had pubic hair growth and adult body odor six months prior to the occurrence of menses. She complained of on and off headaches
with blurry vision. The wrist radiograph for age assessment revealed that her age corresponded to the female standard number 18; the skeletal age was 10. The magnetic resonance imaging (MRI) of the brain (pituitary protocol) revealed a pituitary microadenoma. A diagnosis of central precocious puberty secondary to pituitary microadenoma was made. She was put on leuprolide 11.25 mg administered intramuscularly every three months with repeat investigations at six months. Her dose of leuprolide was changed to 15 mg three-monthly. Brain MRI two years since the initiation of treatment revealed that the microadenoma had completely resolved.
Conclusion: Central precocious puberty is rare and therefore requires a high index of suspicion. Thorough workup and a multidisciplinary team are essential for its diagnosis and management.
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