{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:11:46Z","timestamp":1791893506679,"version":"4.3.4"},"reference-count":50,"publisher":"FapUNIFESP (SciELO)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq Bras Endocrinol Metab"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:p>O in\u00edcio da puberdade caracteriza-se pelo aumento de amplitude e frequ\u00eancia dos pulsos do horm\u00f4nio secretor de gonadotrofinas (GnRH) ap\u00f3s um per\u00edodo de relativa supress\u00e3o hormonal durante a inf\u00e2ncia. A reemerg\u00eancia da secre\u00e7\u00e3o puls\u00e1til do GnRH resulta em aumento na secre\u00e7\u00e3o de gonadotrofinas, horm\u00f4nio luteinizante (LH) e fol\u00edculo estimulante (FSH), pela hip\u00f3fise anterior e consequente ativa\u00e7\u00e3o gonadal. A ativa\u00e7\u00e3o prematura do eixo hipot\u00e1lamo-hip\u00f3fise-gonadal resulta em puberdade precoce dependente de gonadotrofinas, tamb\u00e9m conhecida como puberdade precoce central (PPC), e se caracteriza pelo desenvolvimento dos caracteres sexuais secund\u00e1rios antes dos 8 anos nas meninas e 9 anos nos meninos. O in\u00edcio do desenvolvimento puberal prov\u00e9m da intera\u00e7\u00e3o complexa de fatores gen\u00e9ticos, nutricionais, ambientais e socioecon\u00f4micos. O diagn\u00f3stico cl\u00ednico da PPC baseia-se em reconhecimento de desenvolvimento puberal progressivo, concentra\u00e7\u00f5es p\u00faberes de LH em condi\u00e7\u00e3o basal e\/ou ap\u00f3s est\u00edmulo com GnRH e avan\u00e7o de idade \u00f3ssea. A resson\u00e2ncia magn\u00e9tica de enc\u00e9falo \u00e9 \u00fatil no estabelecimento de diagn\u00f3stico diferencial entre as formas org\u00e2nica ou idiop\u00e1tica. Os an\u00e1logos de GnRH de a\u00e7\u00e3o prolongada representam o tratamento de escolha da PPC. O componente gen\u00e9tico da PPC foi recentemente fortalecido pela evid\u00eancia de muta\u00e7\u00f5es no gene MKRN3, localizado no bra\u00e7o longo do cromossomo 15, em crian\u00e7as com PPC familial. Nessa revis\u00e3o, dados cl\u00ednicos e terap\u00eauticos da PPC ser\u00e3o amplamente discutidos, visando \u00e0 atualiza\u00e7\u00e3o e \u00e0 conduta criteriosa dessa condi\u00e7\u00e3o cl\u00ednica de grande relev\u00e2ncia na endocrinologia pedi\u00e1trica.<\/jats:p>","DOI":"10.1590\/0004-2730000002931","type":"journal-article","created":{"date-parts":[[2014,5,12]],"date-time":"2014-05-12T12:58:27Z","timestamp":1399899507000},"page":"108-117","source":"Crossref","is-referenced-by-count":17,"title":["Avan\u00e7os na etiologia, no diagn\u00f3stico e no tratamento da puberdade precoce central"],"prefix":"10.1590","volume":"58","author":[{"given":"Delanie B.","family":"Macedo","sequence":"first","affiliation":[{"name":"Universidade de S\u00e3o Paulo, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priscilla","family":"Cukier","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berenice B.","family":"Mendonca","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Claudia","family":"Latronico","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinicius Nahime","family":"Brito","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","reference":[{"key":"ref1","first-page":"2","article-title":"The neuroendocrinology of human puberty revisited","volume":"57","author":"Grumbach MM","year":"2002","journal-title":"Horm Res"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1093\/humupd\/dmh001","article-title":"Neurobiological mechanisms of puberty in higher primates","volume":"10","author":"Plant TM","year":"2004","journal-title":"Human Reprod Update"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"2364","DOI":"10.1210\/jcem.86.6.7603","article-title":"Variation in the timing of puberty: clinical spectrum and genetic investigation","volume":"86","author":"Palmert MR","year":"2001","journal-title":"J Clin Endocrinol Metab"},{"key":"ref4","first-page":"111","article-title":"Neurobiological mechanisms of the onset of puberty in primates","volume":"22","author":"Terasawa E","year":"2001","journal-title":"Endocr Rev"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1210\/en.2005-1136","article-title":"The neuroendocrine regulation of puberty: is the time for a systems biology approach?","volume":"147","author":"Ojeda SR","year":"2006","journal-title":"Endocrinology"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1210\/er.2002-0019","article-title":"The Timing of normal puberty and age limits of sexual precocity: variations around the world, secular trends and changes after migration","volume":"24","author":"Parent AS","year":"2003","journal-title":"Endocrinol Rev"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1093\/humupd\/7.3.292","article-title":"Pathogenesis and epidemiology of precocious puberty. 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