Extremely variable clinical course. Puberty may
occur before 3 years of age. Affected children may complete sexual
maturation rapidly or slowly. Adult height is reduced as the increased rate
of ossification results in early closure of the epiphyses. Dental age and
mental development are usually compatible with chronologic age.
Hypothyroidism is occasionally accompanied by precocious puberty and thyroid function
should be checked and if it is the case, treatment should be administered in these patients.
Otherwise, treatment consists mainly of psychological support of the patient and family.
Sexual precocity, fibrous dysplasia, and patchy pigmentation
occur in McCune-Albright syndrome where hyperthyroidism is common. Precocious puberty may
also result from organic brain lesions such as hypothalamic hamartomas. Signs of
increased intracranial pressure may surface years later. Computed tomography scan of the head is
indicated in all boys with true precocious puberty when no specific cause can be found.
In boys, other causes of the precocity should be evaluated, including adrenogenital
syndrome, Leydig cell tumor, and gonadotropin-producing hepatoma.