A 7-year-old girl presents with breast development (Tanner stage 2) and pubic hair. Bone age is advanced at 9 years. GnRH stimulation test shows LH response >5 IU/L. The MOST appropriate treatment is:

• A Aromatase inhibitor (letrozole)
• B Spironolactone and prednisolone
• C Reassurance; no treatment needed before age 8
• D GnRH analogue (leuprolide acetate) ✓

Explanation

This child has central (GnRH-dependent) precocious puberty — GnRH stimulation shows an LH-predominant response (LH >5 IU/L) confirming hypothalamic-pituitary activation. Treatment with GnRH analogues (depot leuprolide, triptorelin) suppresses the HPG axis, slows bone maturation, and allows achievement of full predicted adult height. Aromatase inhibitors and spironolactone are used in peripheral (GnRH-independent) precocious puberty such as McCune-Albright syndrome.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.