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Previous Volume 358:2366-2377 May 29, 2008 Number 22 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.

The parents of a 6-year-old girl bring her to a pediatrician because of breast development. Her medical history is unremarkable. The parents are of average height, and the mother reports first menstruating when she was 11 years old. At physical examination, the girl is 125 cm tall (in the 97th percentile for her age), weighs 28 kg, and has a body-mass index . . . [Full Text of this Article]

The Clinical Problem

Strategies and Evidence

Evaluation

Additional Testing

            Bone Age

            Hormonal Measurements

            Pelvic or Testicular Ultrasound Scans

            Brain Magnetic Resonance Imaging

Management

Central Precocious Puberty

Peripheral Precocious Puberty

Areas of Uncertainty

Guidelines

Conclusions and Recommendations

Source Information

From the Department of Pediatric Endocrinology and Diabetology, INSERM Unité 690, and Centre de Référence des Maladies Endocriniennes de la Croissance, Robert Debré Hospital and University of Paris 7 — Denis Diderot, Paris (J.-C.C., J.L.).

An audio version of this article is available at www.nejm.org.

Address reprint requests to Dr. Carel at Endocrinologie Diabétologie Pédiatrique and INSERM U690, Hôpital Robert Debré, 48, Blvd. Sérurier, 75935 Paris CEDEX 19, France, or at jean-claude.carel@inserm.fr.

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