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. 2005 Feb 5;330(7486):301–304. doi: 10.1136/bmj.330.7486.301

Table 5.

Causes of delayed and early puberty

Delay in puberty
• Constitutional delay of growth and puberty (boys)
• Poor nutrition
• Chronic illness
• Eating disorder
• Severe psychosocial stress
• Disorder of hypothalamic-pituitary-gonadal axis
Early puberty
• Familial
• Obesity (girls)
• Benign normal variants of pubertal timing : isolated thelarche (early breast development), premature adrenarche (early pubic hair development)
• Abnormalities of the central nervous system that disrupt the hypothalamic-pituitary-gonadal axis
• Gonadotrophin independent “precocious pseudopuberty”
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