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För tidig pubertet

Senast reviderad:
Sakkunnig:
Definition:
Begynnande bröstutveckling hos flickor under 8 år, pubertal testisvolym hos pojkar under 9 år. Kan ha central eller perifer orsak. Hos flickor ses främst idiopatisk central orsak.
Förekomst:
Normal pubertetstart varierar med etnicitet. "Äkta" för tidig pubertet ses egentligen relativt sällan. Central pubertas precox av okänd orsak är vanligast.
Symtom: 
Kontaktorsak kan variera: begynnande bröstutveckling, ökad behåring, svettlukt. 
Kliniska fynd:
Låg födelsevikt predisponerar, särskilt hos flickor. Den kliniska undersökningen bör kartlägga pubertetstecken och tillväxt.
Diagnostik:
Växtdata, FSH, LH. östradiol/testosteron. Röntgen för skelettåldersbestämning. Fortsatt utredning utöver det bör bedömas inom pediatriken. 
Behandling:
Individuell bedömning. Vid okänd orsak blir målet att öka slutlängden och säkra en god psykosocial utveckling. Eventuellt GnRH-analog i utvalda fall. Eventuellt kirurgi vid perifer orsak. 
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  • Athena Adeli, legitimerad läkare, Karolinska Institutet

Tidigare sakkunniga

  • Otto Westphal, docent och överläkare, Centrum för pediatrisk tillväxtforskning, Sahlgrenska akademin, Göteborgs universitet