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Central precocious puberty — RACP Paediatrics MCQ

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ModerateEndocrineCentral precocious pubertyRACP Paediatrics

A 6-year-old girl presents with breast development (Tanner stage 3) and pubic hair. Her growth velocity is accelerated with a bone age advanced by 2 years. LH and FSH are in the pubertal range. MRI brain is normal. What is the most likely diagnosis?

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Correct answer: E — Central precocious puberty

Breast development before age 8 in girls with pubertal LH/FSH levels and advanced bone age constitutes central (gonadotrophin-dependent) precocious puberty. With a normal MRI brain (excluding CNS pathology), this is idiopathic central precocious puberty. GnRH agonist therapy is the standard treatment to preserve adult height and address psychosocial concerns.

Reference: RCH Melbourne – 2023 – Precocious Puberty CPG; RACP Paediatric Curriculum – Endocrine