Paeds Cases · endocrinology-diabetes-and-growth
Counsel a family on a new diagnosis of central precocious puberty — OSCE
OSCE communication and shared decision-making station: explaining to the parents of a 6-year-old girl what a new diagnosis of progressive central precocious puberty means, why a brain MRI is needed, what a GnRH analog does and does not do, what the height and psychosocial prognosis is, and how the treatment is monitored and eventually stopped — while addressing the parents' anxiety about a 'too-early' puberty, their fear of injections, and the temptation to 'wait and see' when the bone age is already advancing.
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You are the paediatric registrar in the endocrine clinic. You have eight minutes to counsel the parents of a 6-year-old girl whose progressive central precocious puberty has just been confirmed. Address what the diagnosis means, why a brain MRI is needed, what the GnRH-analog treatment does and does not do, what the prognosis is, and how the decision to treat is shared. Use plain language, check understanding, invite questions, and respond to their worry that 'just waiting' might be safer. [1] [2]
References3ShowHide
- [1]Carel JC, Léger J. Clinical practice. Precocious puberty. N Engl J Med, 2008.PMID 18509122
- [2]Kaplowitz PB. Update on Precocious Puberty: Who Should Be Treated? Adv Pediatr, 2020.PMID 32591066
- [3]Bangalore Krishna K, Fuqua JS, Rogol AD, Klein KO, et al. Use of Gonadotropin-Releasing Hormone Analogs in Children: Update by an International Consortium. Horm Res Paediatr, 2019.PMID 31319416