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Question |
My daughter is 7 year 9 months old. She has achieved thelarchy eight to ten months back. She has PV white discharge ( spots) since last fifteen days. she has no other secondary sexual characters developed. Her height is 128cm and her weight is 25kg. Paretns heights- mother- 148cm , father - 5'4" ) Her invistegatons were done recently TSH - 5.50mIU/L Prolactin 20.0 ng/ML Estradiol - 16.5 pg/ml Sonography Report - Uterine and ovarian morpholgy Length of corpus 3.2cm Length of the cervix - 1.8cm AP of fundus - 1.2cm AP of cervix - 0.6cm Uterus is pear shaped Right ovarian volume - 1.4X 0.9 X 1.2 = 0.7 Small folicides are seen in the right ovary and the largest measures .6cm . No adrenal mass. Her X-ray wrist suggests bone age 10 years. MRI – brain scan is normal . Pl. suggest proper treatment
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Answer |
This girl has idiopathic true precocious puberty and needs treatement by GnRh analogue such as Decapeptyl or Lupride depot montly injections. In the first two months she needs Medroxyprogesterone acetate to stop pv bleeding. Depending upon the final height prognosis she may also need Growth hormone therapy.
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