Pseudopuberdade precoce é muito menos comum e refere-se às condições em que o aumento da produção de esteróides sexuais é gonadotrofina-independente. O diagnóstico correto da etiologia da precocidade sexual é fundamental, porque a avaliação e tratamento de pacientes com pseudopuberdade precoce é bastante diferente do que para os pacientes com puberdade precoce central. Caso não seja combatido, o aumento dos esteróides sexuais mediados pelo estrogênio ocasionarão a progressão da idade óssea, com fusão prematura das epífises ou cartilagens de crescimento e baixa estatura adulta, que se caracteriza desde a fase criança, infantil, juvenil, pré-adolescente, adolescente maturando na puberdade e finalizando com a fase adulta. A elevação puberal dos esteróides gonadais exerce efeitos diretos e indiretos sobre a produção do IGF-1. O estradiol (secretado ou aromatizado a partir da testosterona), a diminuição do hormônio progesterona em mulheres e do hormônio testosterona em homens, ambos os hormônios androgênicos. Este processo que converte androgênicos em estrogênios é chamado de AROMATIZAÇÃO. Enzima ou grupo de enzimas oxidoredutases endógenas (que se formam no interior das células). É encontrada no tecido do retículo endoplasmático das células produtoras de estrogênio, incluindo os ovários, placenta, células de Sertoli, células de Leydig, adipócitos (células de gordura) e cérebro este complemento finaliza a aromatização. Portanto, o estradiol (secretado ou aromatizado a partir da testosterona) estimula diretamente a produção de IGF-1 na cartilagem e aumenta a secreção de GH-hormônio de crescimento, o que estimula indiretamente a produção de IGF-1. Ambas as ações são importantes no surto (estirão) de crescimento puberal.
IMPORTANCE OF STEROIDS IN SEXUAL GROWTH PHASE PUBERTAL (JUVENILE AND PRE-TEEN); OUTBREAK OR SPURT; DR. J. S. CAIO JR.
EVIDENCE OF THE OUTBREAK OR SPURT: SEXUAL GONADAL STEROIDS EXERT A MAJOR INFLUENCE ON THE PUBERTAL GROWTH SPURT, WHILE THE ABSENCE OF SUCH FACTORS ON GROWTH IS NOT IMPORTANT PREPUBERTAL: PHYSIOLOGY-ENDOCRINOLOGY-NEUROENDOCRINOLOGY-GENETICS-ENDOCRINE-PEDIATRICS (SUBDIVISION OF ENDOCRINOLOGY): DR. JOÃO SANTOS CAIO JR. ET DRA. HENRIQUETA VERLANGIERI CAIO.
In excess, gonadal and adrenal sex steroids can cause a rapid increase in growth as well as the onset and early progression of secondary sexual characteristics.
Early onset of puberty can cause several problems. The outbreak or (spurt) early growth may initially cause high stature and rapid bone maturation may lead to linear growth can leave very early to develop and can result in lower final adult height. The early appearance of breasts or menstruation in girls and increased libido in men can cause emotional distress for some child, infant and youth. Premature pubarche and premature thelarche are 2 factors that might be benign and normal common variants that may resemble early puberty, but are not progressive or very slowly progressive. Premature thelarche refers to the appearance of isolated breast development, usually in girls under 3 years this fact should be considered precocious puberty; premature pubarche refers to the appearance of pubic hair without other signs of puberty in girls and boys aged less than 7 to 8 years old. A complete clinical history, physical examination and revision in the growth curve can help distinguish these normal variants of true sexual precocity precocious puberty or who have complicated consequences. If the clinical history, physical examination and laboratory and instrumental data suggest that a child, infant or youth presents early and sustained evidence of pubertal maturation, the clinician must differentiate central precocious puberty (CPP ) from early pseudopuberty. Central precocious puberty is gonadotropin-dependent, is the early maturity of the entire hypothalamic-pituitary-gonadal (HPG) axis, with the entire spectrum of physical and hormonal changes of puberty. Early pseudopuberty is much less common and refers to conditions in which increased production of sex steroids is gonadotropin -independent. The correct diagnosis of the etiology of sexual precocity is critical because the assessment and treatment of patients with early pseudopuberty is quite different from that for patients with central precocious puberty.
If not tackled, the increase of sex steroids mediated by estrogen will cause the progression of bone age with premature fusion of the epiphysis and cartilage growth and low adult height, which is characterized from the stage child, infant, pre-teen, teen maturing at puberty and end with adulthood. The pubertal rises in gonadal steroids exert direct and indirect effects on the production of IGF-1. Estradiol (flavored or secreted from testosterone) decrease of the hormone progesterone in women and testosterone hormone in men, both androgenic hormones. This process that converts androgen to estrogen is called AROMATIZATION. Enzyme or group of enzymes endogenous oxidoreductases (which form within the cells). Tissue is found in the endoplasmic reticulum of estrogen producing cells, including ovary, placenta, Sertoli cells, Leydig cells, adipocytes (fat cells) and terminates this add brain aromatization. Therefore, estradiol (flavored or secreted from testosterone) directly stimulates production of IGF-1 in cartilage and increases the secretion of GH-Growth hormone, which indirectly stimulates the production of IGF-1. Both actions are important the outbreak (spurt) of pubertal growth.
Dr. João Santos Caio Jr.
Endocrinologia – Neuroendocrinologista
CRM 20611
Dra. Henriqueta V. Caio
Endocrinologista – Medicina Interna
CRM 28930
1. No momento do nascimento, com a interrupção do fornecimento de glicose via cordão umbilical, o recém-nascido é exigido no sentido de continuar a suprir as necessidades dos seus diversos órgãos da economia orgânica e, muito particularmente, do cérebro...
http://hormoniocrescimentoadultos.blogspot.com
2. É extremamente delicado o equilíbrio entre produção e utilização de glicose no recém-nascido e na criança pequena, e este fato poderá perdurar em todas as fases por que passam as crianças, infantil, juvenil, adolescente...
http://longevidadefutura.blogspot.com
3. Não existem dúvidas quanto ao comprometimento das ações hormonais que podem mudar de acordo com o estádio de desenvolvimento...
http://imcobesidade.blogspot.com
AUTORIZADO O USO DOS DIREITOS AUTORAIS COM CITAÇÃO
DOS AUTORES PROSPECTIVOS ET REFERÊNCIA BIBLIOGRÁFICA.
Referências Bibliográficas:
Caio Jr, João Santos, Dr.; Endocrinologista, Neuroendocrinologista, Caio,H. V., Dra. Endocrinologista, Medicina Interna – Van Der Häägen Brazil, São Paulo, Brasil; Tanner JM, (ed) 1962 Growth at adolescence, 2nd Ed. Oxford: Blackwell; Tanner JM, 1986 Growth as a target-seeking function: catch up and catch down growth in man. In: Human growth. Falkner F, Tanner JM, (eds), vol 1. New York: Plenum Press, pp,167-179; Claessens A, Lefevre J, Beunen G, Malina RM. 1999 The contribution of anthropometric characteristics to performance scores in elite female gymnasts. J Sports Med Phys Fitness 39: 355-360; Buckler J, Brodie D, 1977 Growth and maturity characteristics of schoolboy gymnasts. Annals Hum Biol 4: 455-463; Caldarone G, Leglise M, Giampietro M, Berlutti G, 1986 Anthropometric measurements, body composition, biological maturation and growth predictions in young female gymnasts of high agonistic level. J Sports Med 26: 263-273; Claessens AL, Malina RM, Lefevre J,Beunen G, Stijnen V, Maes H, Veer FM, 1992 Growth and menarcheal status of elite female gymnasts. Med Sci Sports Exercise 24: 755-763; Jost-Relyveld A, Sempe M, 1982 Analyse de la croissance et de la maturation squelettique de 80 jeunes gymnasts internationaux. Pediatrie 37: 247-262; Smit PJ, 1973 Anthropometric observations on South African gymnasts. Afr Med J 47: 480-485; Theintz GE, Howald H, Weiss U, Sizonenko PC, 1993 Evidence for a reduction of growth potential in adolescent female gymnasts. J Pediatr 122: 306-313; Theintz GE, Howald H, Allemann Y, Sizonenko PC, 1989 Growth and pubertal development of young female gymnasts and swimmers: a correlation with parental data. Int J Sports Med 10: 87_91.
Contato:
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e-mails: vanderhaagenbrasil@gmail.com
Site Van Der Häägen Brazil
www.vanderhaagenbrazil.com.br
http://drcaiojr.site.med.br
http://dracaio.site.med.br
João Santos Caio Jr
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Video
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Referências Bibliográficas:
Caio Jr, João Santos, Dr.; Endocrinologista, Neuroendocrinologista, Caio,H. V., Dra. Endocrinologista, Medicina Interna – Van Der Häägen Brazil, São Paulo, Brasil; Tanner JM, (ed) 1962 Growth at adolescence, 2nd Ed. Oxford: Blackwell; Tanner JM, 1986 Growth as a target-seeking function: catch up and catch down growth in man. In: Human growth. Falkner F, Tanner JM, (eds), vol 1. New York: Plenum Press, pp,167-179; Claessens A, Lefevre J, Beunen G, Malina RM. 1999 The contribution of anthropometric characteristics to performance scores in elite female gymnasts. J Sports Med Phys Fitness 39: 355-360; Buckler J, Brodie D, 1977 Growth and maturity characteristics of schoolboy gymnasts. Annals Hum Biol 4: 455-463; Caldarone G, Leglise M, Giampietro M, Berlutti G, 1986 Anthropometric measurements, body composition, biological maturation and growth predictions in young female gymnasts of high agonistic level. J Sports Med 26: 263-273; Claessens AL, Malina RM, Lefevre J,Beunen G, Stijnen V, Maes H, Veer FM, 1992 Growth and menarcheal status of elite female gymnasts. Med Sci Sports Exercise 24: 755-763; Jost-Relyveld A, Sempe M, 1982 Analyse de la croissance et de la maturation squelettique de 80 jeunes gymnasts internationaux. Pediatrie 37: 247-262; Smit PJ, 1973 Anthropometric observations on South African gymnasts. Afr Med J 47: 480-485; Theintz GE, Howald H, Weiss U, Sizonenko PC, 1993 Evidence for a reduction of growth potential in adolescent female gymnasts. J Pediatr 122: 306-313; Theintz GE, Howald H, Allemann Y, Sizonenko PC, 1989 Growth and pubertal development of young female gymnasts and swimmers: a correlation with parental data. Int J Sports Med 10: 87_91.
Contato:
Fones: 55 11 2371-3337 - 5572-4848 ou 98197-4706 tim
Rua Estela, 515 - Bloco D - 12º andar - Conj. 121/122
Paraiso - São Paulo - SP - Cep 04011-002
e-mails: vanderhaagenbrasil@gmail.com
Site Van Der Häägen Brazil
www.vanderhaagenbrazil.com.br
http://drcaiojr.site.med.br
http://dracaio.site.med.br
João Santos Caio Jr
http://google.com/+JoaoSantosCaioJr
Video
http://youtu.be/woonaiFJQwY
Google Maps:
http://maps.google.com.br/maps/place?cid=5099901339000351730&q=Van+Der+Haagen+Brasil&hl=pt&sll=-23.578256,46.645653&sspn=0.005074,0.009645&ie =UTF8&ll=-23.575591,-46.650481&spn=0,0&t = h&z=17