Jaramillo AC, Campuzano MG, Balthazar GV, Alfaro VJM

Idioma: Español
Referencias bibliográficas: 53
Paginas: 311-327
Archivo PDF: 673.87 Kb.

RESUMEN

La pubertad precoz se define como el inicio de la pubertad antes de los 8 años en las niñas y de los 9 años en los niños; sin embargo, hay factores que pueden afectar el inicio de la pubertad, como son la raza, el bajo peso al nacer y la obesidad. Los cambios físicos tempranos característicos del comienzo de la pubertad aparecen como resultado de la producción de hormonas sexuales como consecuencia de la activación del eje hipotálamo- hipófisis-gonadal. El inicio de la pubertad comienza con el desarrollo de las mamas en las niñas y con el aumento del tamaño testicular en los niños. La pubertad precoz se clasifica como central, también llamada dependiente de hormona liberadora de gonadotrofinas (GnRH), y tema central de esta revisión, o como periférica, también llamada independiente de GnRH. El primer paso en la evaluación del paciente con sospecha de pubertad precoz consiste en obtener una cuidadosa y detallada historia familiar y del paciente, seguida de una evaluación física completa. El diagnóstico de pubertad precoz se basa en estudios imagenológicos y en pruebas de laboratorio. La prueba de estimulación con GnRH se considera como la prueba de oro para evaluar la activación del eje hipotálamo-hipófisis-gonadal; los picos de LH o de FSH y el pico de la relación LH/FSH pueden ser utilizados para evaluar la respuesta al estímulo.

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