Central Precocious Puberty (CPP)

Precocious puberty is defined as the onset of developmental signs of sexual maturation earlier than would be expected based on population norms. This is typically delineated as puberty onset before 8 years in girls and 9 years in boys. In its most common form, central precocious puberty (CPP), sexual maturation proceeds from a premature activation of the hypothalamic–pituitary–gonadal (HPG) axis³. The HPG axis is active during infancy, dormant during childhood, and reactivated at the onset of puberty.

The epidemiology of CPP is somewhat nebulous, with a commonly cited prevalence range of 1 in 5000 to 1 in 10,000 children⁷. CPP is known to occur more frequently in girls than in boys and has different predominant causes for each sex. Idiopathic CPP, without an identifiable predisposing condition, accounts for the majority of cases of precocious puberty in girls, but is less frequent in boys^4,6,8. Central nervous system findings such as tumors and congenital malformations are more frequently observed in boys who present with central precocious puberty^5,6,7. It is estimated that two thirds of precocious puberty cases in boys are due to neurological abnormalities⁵. The likelihood of an organic cause for CPP is greater in patients who present at younger ages^6,7.