A CASE OF PRECOCIOUS PUBERTY IN A FEMALE BY MURRAY McGEORGE and D. V. CONNOR

Sexual precocity is considered to be present when indications of genital maturation become apparent in boys before the age of 10 years and in girls before the age of 8 years (Seckel, 1946). It is customary to divide these cases into two groups. In those with true precocious puberty maturation with spermatogenesis or ovulation has occurred in a normal manner, but at an abnormally early age; in those with pseudoprecocious puberty, premature development of the secondary sex organs, but without spermatogenesis or ovulation, has occurred as a result of an ovarian or adreno-cortical tumour, unusual sensitivity of end-organs to normal hormonal stimulation, or exogenous application of sex hormones or other compounds (Talbot, Sobel, McArthur and Crawford, 1952). In a small proportion of cases true precocious puberty is associated with tumours or cysts in the region of the hypothalamus or with post-meningitic or postencephalitic lesions, but in the majority diligent and repeated search fails to reveal any abnormality in the nervous system or endocrine glands (Wilkins, 1957). Such cases are generally referred to as 'idiopathic' or 'constitutional' (Novak, 1944), and it is suggested that the genetic factor or factors that determine the time of hypothalamic sex maturation must be at fault (Seckel, 1946). In a small percentage of cases there is a heredo-familial tendency (Rush, Bilderback, Slocum and Rogers, 1937; Jacobsen and Macklin, 1952). Precocious puberty of idiopathic origin represents simply the early appearance of normal phenomena, and many of the physical and laboratory examinations reveal findings normal for older children (Lloyd, Lobotsky and Morley, 1950). Except for the hazard of precocious pregnancy and the possibility of subnormal stature, the prognosis of girls with idiopathic precocious puberty is good, and it does not appear that the menopause is accelerated or that premature senility occurs (Talbot et al., 1952; Jolly, 1955). The following case of precocious puberty occurring in a female child appears to present features of sufficient interest to warrant publication. Case History