A Fictional Educational Case of Central Precocious Puberty in a 7-Year-Old Girl

Central precocious puberty (CPP) is a condition in which the normal hypothalamic–pituitary–gonadal axis activates earlier than expected. In practice, this means that secondary sexual characteristics and the pubertal growth spurt appear before age 8 in girls or before age 9 in boys. If CPP is not recognized and treated, it can lead to loss of adult height and emotional or social stress. In this fictional educational case, a 7-year-old girl is brought to the clinic with early breast development, recent pubic hair, and a clear increase in height over a short period of time. Hormonal tests show a pubertal luteinizing hormone (LH) response after gonadotropin-releasing hormone (GnRH) stimulation. Bone age is advanced compared to chronological age. Pelvic ultrasound shows estrogen effect on the uterus and ovaries, and brain magnetic resonance imaging (MRI) is normal. Taken together, these findings support a diagnosis of idiopathic central precocious puberty. Treatment with a GnRH analog is started to slow puberty and protect final adult height. The case is presented in a simple and practical way to illustrate how a typical case of CPP is evaluated, how the diagnosis is made, which alternative diagnoses should be considered, how treatment is organized, and how the family can be guided and supported.