Prognosis

In untreated girls, a mean adult height ranging from 151-155 cm has been reported. Treatment with gonadotrophin-releasing hormone (GnRH) agonists improves the adult height of children with rapidly progressing puberty, based on a calculation of a predicted adult height, particularly in younger children (less than 6 years old).[5][61][62][63]​​ There is only minimally convincing evidence of an improvement in adult height with GnRH agonist treatment after the bone age of 12.5 years in girls and 14 years in boys.[64]​ Therefore, for children with more advanced bone age at presentation, parents need to be told that treatment may have little effect on adult height, and an informed discussion of costs and benefits is needed prior to recommending therapy.[65] There are few results of adult height benefit in boys. Gonadotrophin secretion recommences approximately 3-4 months after stoppage of treatment, with normal pubertal progress and fertility.

In some patients, short- and long-term psychological consequences can be more profound than the loss in height potential. This can lead to disruptive behaviour, difficulties in interpersonal relationships, and an earlier onset of sexual behaviour. Practical difficulties with respect to menarche in very young girls can also lead to psychosocial adjustment.

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