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Central precocious puberty — RACP Paediatrics MCQ

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HardEndocrinology and growthCentral precocious pubertyRACP Paediatrics

A 7-year-old girl has progressive breast development and pubic hair over six months. Her height velocity has increased and bone age is advanced by two years; there is no virilisation. What is the most appropriate investigation?

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Correct answer: E — Basal gonadotrophins with GnRH stimulation testing and pelvic ultrasound

Progressive puberty before age 8 with growth acceleration and advanced bone age suggests central precocious puberty, assessed with gonadotrophins/GnRH stimulation and pelvic ultrasound. Reassurance is inappropriate because the tempo is progressive and early. The pearl is that growth velocity and bone age distinguish true progressive puberty from isolated premature thelarche.

Reference: RCH Clinical Practice Guidelines; Therapeutic Guidelines (eTG): Endocrinology