Precocious Puberty in a 24-Month-Old Nigerian Girl: Case Report
August 2020
in “
Nigerian journal of paediatrics
”
precocious puberty breast development pubic hair growth vaginal secretion Tanner stage bone age serum gonadotrophins cranial CT ultrasonography enlarged uterus dominant follicle idiopathic female precocious puberty endocrine disorder early puberty breast growth pubic hair vaginal discharge Tanner scale bone maturity hormone levels CT scan ultrasound large uterus leading follicle unknown cause early puberty hormone disorder
TLDR A 24-month-old Nigerian girl developed early puberty with no family history, needing treatment her family couldn't afford.
A 24-month-old Nigerian girl, referred to as BA, exhibited signs of precocious puberty, including a year of progressive breast development, six months of pubic hair growth, increased weight and height, and vaginal secretion. No family history of similar conditions was reported, and her mother's menarche was at 14 years. BA's weight was 17 kg, and her height was 90.5 cm, placing her above the 95th and 90th percentiles for her age and sex, respectively. Her sexual maturity was rated at Tanner stage 3 for breasts and stage 2 for pubic hair. Investigations revealed an advanced bone age of 5 years, pubertal range serum gonadotrophins, a normal cranial CT, and an enlarged uterus with a dominant follicle on ultrasonography. Despite the need for treatment to halt the progression of her precocious puberty, her parents had not responded due to financial constraints after 2 years of diagnosis. The case underscores the high incidence of idiopathic female precocious puberty, which is ten times more common than in males, and highlights the need for better integration of childhood endocrine disorder management into health insurance schemes in developing countries.