Question
A girl who is 8 months old was found to have breast development, with bone age advanced by a year. At the time, she was 138 cm tall and weighed 32 kg, and had not received any treatment. Now at 9 years and 9 months, her bone age is 11.2 years, which is 1.5 years ahead of her actual age, and she is 149 cm tall and weighs 40 kg. How should she be treated?
Answer
If a magnetic resonance imaging (MRI) of the pituitary gland shows no abnormalities in the hypothalamus and pituitary after examination, desmopressin (such as DDAVP) or oxytocin can be considered to suppress the already initiated pubertal development, delay the onset of menstruation, reduce the effects of sex hormones on bones, and delay epiphyseal closure. However, using these drugs will slow down the rate of growth, although it may partially compensate for this. Additionally, the use of growth hormone can compensate for the slower growth due to the suppression of sex hormone levels. These treatment options need to consider the family’s financial situation. The use of medication should be under the guidance of a specialist doctor, and regular monitoring of sex hormones, bone age, height, secondary sexual characteristics, uterus, and ovarian changes should be performed to determine the duration of treatment. The professional level of the Endocrinology Department at Chongqing Children’s Hospital can address these issues, and local treatment and follow-up are more convenient.