II. Causes: GnRH dependent (True or Central): Complete Isosexual
- Idiopathic
- CNS Lesion (e.g. pituitary tumor)
- Secondary to GnRH independent Precocious Puberty
- Hypothyroidism (unclear cause)
- Chronic Adrenal Insufficiency
III. Causes: GnRH independent (Peripheral - always abnormal)
- Adrenal Causes
- 21-OH deficiency
- 11-OH deficiency
- Results
- Girls: contrasexual
- Boys: isosexual
- Tumor: Contrasexual OR Isosexual
- Gonadal Cause
- McCune-Albright Syndrome (Isosexual)
- Polyostotic fibrous dysplasia
- Cafe Au Lait spots
- Precocious Puberty
- Associated with Hyperthyroidism, Cushing's Syndrome
- Familial Male (Testotoxicosis, Isosexual)
- Tumor (Isosexual or Contrasexual)
- McCune-Albright Syndrome (Isosexual)
- Miscellaneous Cause
- Ectopic hCG Secreting tumor (Isosexual in boys)
- Extraglandular aromatization (Contrasexual in boys)
- Factitious (Isosexual or Contrasexual)
IV. Causes: Partial Sexual Development Causes
-
Benign Premature Thelarche
- Isolated Breast development as early as
-
Benign Premature Adrenarche
- Isolated pubic hair develops under age 6 years
V. Causes: Contrasexual Development Causes
- Boys
- Girls
- Excessive pubic hair
- Adrenal hyperplasia
- Benign Premature Adrenarche
- Polycystic Ovary Disease (older girls)
- Virilization (clitoromegaly and increased Muscle)
- Ovarian tumor
- Adrenal tumor
- Cushing's Syndrome
- Hyperprolactinemia
- Acromegaly
- Exogenous androgens
- Excessive pubic hair