Central precocious puberty — MRCPCH FOP MCQ

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HardEndocrinology and growthCentral precocious pubertyMRCPCH FOP

A 6-year-old girl has breast development, pubic hair and rapid height acceleration. Bone age is advanced by two years and basal LH is pubertal. What is the most appropriate investigation?

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Correct answer: A — MRI brain with paediatric endocrine referral

Pubertal development before age 8 with growth acceleration, advanced bone age and pubertal LH suggests central precocious puberty, needing endocrine assessment and brain MRI. Reassurance is inappropriate because the age and investigations are abnormal. The oral contraceptive pill would not address the underlying activation of the hypothalamic-pituitary-gonadal axis. The pearl is that tempo and bone age help distinguish benign variants from true precocious puberty.

Reference: British Society for Paediatric Endocrinology and Diabetes guidance; NICE CKS Puberty