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فتاة تأتي لها العادة الشهرية وهي في السنة الثانية من عمرها

تبلغ هذه الطفلة من العمر ثلاث سنوات وتعاني من الظهور المبكر الغير طبيعي لعلامات ومظاهر الأنوثة أو ما يسمى طبياً بحالة البلوغ المبكر الكاذب Precocious Pseudopuberty وقد بدأت الحالة عندما لاحظت الأم نمو سريع للثديين في أبنتها وهي لازالت سنها سنة ونصف إلا أنه الأمر الذي جعل الأم تذهب بها مباشرة إلى الطبيب المختص هو ظهور دم الحيض مع نهاية السنة الثانية من عمر الطفلة, ليتم تشخيص الحالة بالبلوغ المبكر الكاذب والصورة أعلاه أخذت للطفلة وهي في السنة الثالثة من عمرها.

ما هو البلوغ المبكر الكاذب؟

حالة البلوغ المبكر الكاذب هي ظهور مبّكر جداً لعلامات الأنوثة في الأنثى ولعلامات الرجولة في الذكر وسميت بالكاذب لأنه ورغم ظهور هذه العلامات إلا أنه لا يحصل إباضة أي خروج للبويضات عند الفتاة ولا تكوين للأمشاج المنوية إذا جاءت هذه الحالة في الذكر وسبب ظهور هذه الحالة هو تعرض الطفلة الأنثى لهرمونات الأنوثة وخاصة الأستروجين الذي يفرز عندها من ورم يكون موجوداً أما في المبايض أو الغدة الكضرية أما إذا كانت الحالة عند الطفل الذكر فيكون بسبب تعرض هذا الطفل لهرمونات الرجولة وخاصة الأندوجين والتستسترون والذي يفرز من ورم في الخصيتين أو الغدة الكضرية أو نتيجة تضخم في الغدة الدرقية

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كتاب البلسم الالكتروني :حالات صحية نادرة

     للدكتور: جمال عبد الله باصهي

What Is Precocious Puberty?
"Precocious puberty is the onset of the signs of puberty before age 7 in girls and age 9 in boys," says Karen Klein, MD, a pediatric endocrinologist. The telltale signs of the condition include:

  • the development of breasts or pubic hair or the onset of menstruation in girls

  • the appearance of pubic or facial hair, a deepening of the voice, or enlargement of the penis or testicles in boys

The onset of acne in both sexes can also occur.

One of the problems with starting puberty at an earlier age is that children also enter a period of rapid growth and weight gain during puberty. When puberty ends, growth stops. Because their skeletons mature and bone growth stops at an earlier age than normal, kids with precocious puberty usually don't achieve their full adult height potential. They initially appear to be tall when compared with their peers, but they will stop growing too soon and end up at a shorter height than normal. If untreated, boys typically grow no taller than 5 feet 4 inches (1.6 meters) and girls rarely reach 5 feet (1.5 meters).

Going through puberty early can also be difficult for a child emotionally and socially. "A first grader is not ready emotionally to undergo [physical] changes and/or menstruation," Dr. Klein says. For example, girls with precocious puberty may be confused or embarrassed about physical changes such as breast enlargement that may occur well before any of their peers.

What Causes Precocious Puberty?
The onset of puberty is normally triggered by the pituitary gland (a pea-sized gland near the base of the brain). Sometimes, precocious puberty stems from a structural problem in the brain (such as a tumor) or a problem in the ovaries that triggers the onset of puberty ahead of schedule, but this usually isn't the case.

"In 95% of girls, there's no underlying medical problem," Dr. Klein says, explaining that they simply start puberty too early for no known reason.

In boys, the condition is less common. Sometimes it's caused by a hormone- producing tumor in the pituitary gland or hypothalamus (the area of the brain that helps control pituitary gland function). Other tumors and head trauma can also trigger early puberty. The condition can also accompany untreated hypothyroidism (a condition in which the thyroid is underactive).

In about 5% of boys, precocious puberty is inherited. Starting puberty early can be passed from father to son or from the maternal grandfather through the mother (who will not be affected by the disorder) to the son. Less than 1% of girls affected by precocious puberty have inherited the condition.

Recognizing Precocious Puberty
How can you tell if your child has precocious puberty? In girls, the telltale signs include any of the following before age 7 years:

  • breast development

  • pubic or underarm hair development

  • onset of menstruation

  • acne

  • "mature" body odor

In boys, look for these signs before age 9 years:

  • enlargement of the testicles or penis

  • pubic, underarm, or facial hair development

  • deepening of the voice

  • acne

  • "mature" body odor

The early production of sex hormones will also affect a child's growth pattern. During puberty, kids increase their rate of height growth, usually making kids with precocious puberty taller than their peers during the early years. But remember, once puberty is finished, so is the growing season, which means that kids with this condition often do not reach their full height potential and may end up significantly shorter than their peers in adulthood.

Even emotions and behavior may change in children with precocious puberty. Girls can become moody and irritable. Boys can become more aggressive and also develop a sex drive inappropriate for their age.

Many children who show early signs of puberty have what is known as "partial" precocious puberty. Some girls, usually beginning between the ages of 6 months and 3 years, may show breast development that later disappears or may persist without other physical changes of puberty.

Similarly, some girls and boys may experience early growth of pubic and/or underarm hair that is not associated with other changes in sexual development. Children with "partial" precocious puberty may require evaluation to rule out "true" precocious puberty, but they generally need no treatment and usually will show the other expected signs of puberty at the usual age.

 

 

مجلة البلسم عيادة البلسم كتب البلسم

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