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My daughter was diagnosed with precocious puberty

My daughter was diagnosed...

My daughter was diagnosed with precocious puberty

Doctor's Assistant: Anything else in your daughter's medical history you think the doctor should know?

Yes of course

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Answered in 4 minutes by:
3/15/2018
Richard Han
Richard Han, Board Certified MD
Category: Medical
Satisfied Customers: 970
Experience: Physican with over 15 years experience
Verified

Hello my name is***** am an American board-certified pediatrician with over 15 years of clinical experience and I am here to help. How can I assist you with your daughter's diagnosis of precocious puberty?

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Customer reply replied 1 month ago
Hello dear doctor,
My daughter, 8 years old (DOB=June 8,2010), was diagnosed with precocious puberty since Jan
21,2017. At the time of diagnosis her height was 133 cm and her weight was 39 kg. Her doctor
prescribed leuprolide 3.75 mg injection once monthly. Until this time, she has received 13
injections. Her physical symptoms improved dramatically (e.g. regression in the size of breasts).
Current Height=136 cm, Weight= 43. After last lab results in March, 1, 2018, we were not be able to access her doctor. Since that time we discontinue the medication.
Should she continue taking the medication again? Does she respond well at this dosage? Any modification? What to do about her diet? Any recommendations?

I understand, thank you for that information. Please give me a moment to plot her values on a growth curve and I will return to address your query.

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Customer reply replied 1 month ago
these are her test results at the time of diagnosis
Customer reply replied 1 month ago
these are the latest lab test results

Thank you for waiting, I have reviewed her growth numbers and her lab test values. She looks to have responded very well to the leuprolide injections with reversal of her pubertal changes as you described and normalization of her hormonal levels. The general reason to treat for precocious puberty is to hold off early physical development for both psychological reasons as well as physically to allow for better height gain. (starting puberty too early would lead to stunted height) Now that she is 8 years old, if you are no longer able to access the treating physician and receive further treatment, it is not entirely unreasonable to allow her body to now undergo puberty, as she would most likely then have her first period in about 2 years, around the age of 10. Depending on your situation, if it is possible to find another provider and continue treatment, some doctors would treat longer, perhaps another year. Again this would allow her more time to not have to deal with bodily puberty changes for longer, and to attain more height as an adult. I would not change any diet at all as her condition is due to hormonal levels.

Can I help with anything else?

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Customer reply replied 1 month ago
Great! I will give her injection again once monthly.
Do we have to check her bone age again?
Do we need to take lab tests every 3 months as usual? What are the required tests?

That is a question for prescribing physician who initially provided the leuprolide treatments. Most would repeat the bone age every 3-6 months to demonstrate reduction in bone age, closer to chronological age, then once that is seen, re-check annually. As far as lab testing, that is somewhat controversial, as some specialists in the U.S. do not even check hormone levels once halting of puberty has been demonstrated, while others do. Can I answer anything else for you today?

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Customer reply replied 1 month ago
You are now her doctor.So I need your opinion so i can go back to you with her lab tests according to your decision.
Another question: will we expect her height stop or will continue getting up at a slow rate? Any numbers?
Thank you for your patience

With good control of her precocious puberty, you will first see a slow down of rapid height gain, then slow steady gain. My apologies, but I cannot assume the responsibility of being your daughter's doctor online, the JustAnswer service is not designed for that, but only for information purposes. You will need to find a local physician to resume supervision and oversight of her medical care. I hope you understand.

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Customer reply replied 1 month ago
Last question: Can I send you her next lab tests in June to re-evaluate her condition?

Yes, you can reach out to me here at JustAnswer by requesting me directly. If I am online and available, I will be happy to answer again. Another physician may attempt to answer, should I not be online and responsive within a few minutes, but that is just how the JustAnswer system works. You can politely refuse and request me again or receive care from another doctor. Thank you and have a good day.

Richard Han
Richard Han, Board Certified MD
Category: Medical
Satisfied Customers: 970
Experience: Physican with over 15 years experience
Verified
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Richard Han
Richard Han
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Category: Medical
Satisfied Customers: 970
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