CPP
MCID: CNT075
MIFTS: 53

Central Precocious Puberty (CPP)

Categories: Endocrine diseases, Genetic diseases, Metabolic diseases, Rare diseases, Reproductive diseases

Aliases & Classifications for Central Precocious Puberty

MalaCards integrated aliases for Central Precocious Puberty:

Name: Central Precocious Puberty 25 59 37 29 6 40
Precocious Puberty, Central 13 73
Cpp 25 59
Gonadotropin-Dependent Precocious Puberty 25
Gonadotropin-Dependant Precocious Puberty 59

Characteristics:

Orphanet epidemiological data:

59
central precocious puberty
Inheritance: Autosomal dominant,Not applicable; Age of onset: Childhood,Infancy; Age of death: normal life expectancy;

Classifications:



External Ids:

Orphanet 59 ORPHA759
UMLS via Orphanet 74 C0342543
ICD10 via Orphanet 34 E22.8
KEGG 37 H02018
UMLS 73 C0342543

Summaries for Central Precocious Puberty

Genetics Home Reference : 25 Central precocious puberty is a condition that causes early sexual development in girls and boys. While puberty normally starts between ages 8 and 13 in girls and between ages 9 and 14 in boys, girls with central precocious puberty begin exhibiting signs before age 8, and boys with this disorder begin before age 9. Signs of puberty include development of pubic and underarm hair, a rapid increase in height (commonly referred to as a "growth spurt"), acne, and underarm odor. Girls also develop breasts and begin their menstrual periods. Boys have growth of the penis and testes and deepening of the voice. Because of the early growth spurt, children with central precocious puberty may be taller than their peers; however, they may stop growing abnormally early. Without proper treatment, some affected individuals are shorter in adulthood compared with other members of their family. Developing ahead of their peers can be emotionally difficult for affected individuals and may lead to psychological and behavioral problems.

MalaCards based summary : Central Precocious Puberty, also known as precocious puberty, central, is related to idiopathic central precocious puberty and precocious puberty. An important gene associated with Central Precocious Puberty is KISS1R (KISS1 Receptor), and among its related pathways/superpathways is Peptide ligand-binding receptors. The drugs Leuprolide and Deslorelin have been mentioned in the context of this disorder. Affiliated tissues include testes, bone and breast, and related phenotypes are obesity and hydrocephalus

Related Diseases for Central Precocious Puberty

Diseases in the Precocious Puberty family:

Precocious Puberty, Central, 1 Precocious Puberty, Central, 2
Central Precocious Puberty Secondary Central Precocious Puberty

Diseases related to Central Precocious Puberty via text searches within MalaCards or GeneCards Suite gene sharing:

(show top 50) (show all 125)
# Related Disease Score Top Affiliating Genes
1 idiopathic central precocious puberty 33.3 IGF1 KISS1 KISS1R MKRN3
2 precocious puberty 32.4 GNRH1 KISS1 KISS1R MKRN3
3 hypothalamic hamartomas 32.2 GNRH1 KISS1 KISS1R
4 hyperandrogenism 30.2 GNRH1 IGF1
5 insulin-like growth factor i 30.2 IGF1 LEP
6 polycystic ovary syndrome 30.1 GNRH1 IGF1 LEP
7 empty sella syndrome 29.9 GNRH1 IGF1
8 hyperprolactinemia 29.9 GNRH1 IGF1
9 hypogonadotropic hypogonadism 29.8 GNRH1 KISS1 KISS1R
10 hypogonadism 29.8 GNRH1 KISS1 KISS1R
11 prader-willi syndrome 29.6 GNRH1 IGF1 LEP MKRN3
12 secondary central precocious puberty 12.5
13 papilloma of choroid plexus 12.1
14 precocious puberty, central, 2 11.5
15 precocious puberty, central, 1 11.5
16 chondrocalcinosis 2 11.3
17 atypical choroid plexus papilloma 11.1
18 body mass index quantitative trait locus 1 10.5
19 prostatitis 10.5
20 lipoid congenital adrenal hyperplasia 10.3
21 williams-beuren syndrome 10.2
22 growth hormone deficiency 10.2
23 lubs x-linked mental retardation syndrome 10.2
24 enamel erosion 10.2
25 nevus, epidermal 10.1
26 adrenal hypoplasia, congenital 10.1
27 diabetes mellitus 10.1
28 arthritis 10.1
29 sexual disorder 10.1
30 myoma 10.0 GNRH1 LEP
31 amenorrhea 10.0 GNRH1 LEP
32 hypogonadotropic hypogonadism 7 with or without anosmia 10.0
33 neurofibromatosis, type i 10.0
34 mccune-albright syndrome 10.0
35 adrenal hyperplasia, congenital, due to 21-hydroxylase deficiency 10.0
36 adrenocortical carcinoma, hereditary 10.0
37 metachromatic leukodystrophy 10.0
38 phenylketonuria 10.0
39 tay-sachs disease 10.0
40 hypomelanosis of ito 10.0
41 hypophosphatemic rickets, x-linked recessive 10.0
42 langerhans cell histiocytosis 10.0
43 cerebral palsy 10.0
44 hydrocephalus 10.0
45 fibrous dysplasia 10.0
46 leukodystrophy 10.0
47 rickets 10.0
48 neonatal diabetes mellitus 10.0
49 epilepsy 10.0
50 astrocytoma 10.0

Graphical network of the top 20 diseases related to Central Precocious Puberty:



Diseases related to Central Precocious Puberty

Symptoms & Phenotypes for Central Precocious Puberty

Human phenotypes related to Central Precocious Puberty:

59 32 (show all 15)
# Description HPO Frequency Orphanet Frequency HPO Source Accession
1 obesity 59 32 occasional (7.5%) Occasional (29-5%) HP:0001513
2 hydrocephalus 59 32 very rare (1%) Very rare (<4-1%) HP:0000238
3 acne 59 32 occasional (7.5%) Occasional (29-5%) HP:0001061
4 increased circulating gonadotropin level 59 32 frequent (33%) Frequent (79-30%) HP:0000837
5 meningitis 59 32 very rare (1%) Very rare (<4-1%) HP:0001287
6 cafe-au-lait spot 59 32 very rare (1%) Very rare (<4-1%) HP:0000957
7 overgrowth 59 32 frequent (33%) Frequent (79-30%) HP:0001548
8 abnormality of secondary sexual hair 59 32 frequent (33%) Frequent (79-30%) HP:0009888
9 proportionate short stature 59 32 frequent (33%) Frequent (79-30%) HP:0003508
10 hypothalamic hamartoma 59 32 occasional (7.5%) Occasional (29-5%) HP:0002444
11 isosexual precocious puberty 59 32 obligate (100%) Obligate (100%) HP:0008236
12 accelerated bone age after puberty 59 32 frequent (33%) Frequent (79-30%) HP:0002805
13 premature thelarche 59 32 frequent (33%) Frequent (79-30%) HP:0010314
14 prenatal maternal abnormality 59 32 occasional (7.5%) Occasional (29-5%) HP:0002686
15 increased body weight 59 Frequent (79-30%)

GenomeRNAi Phenotypes related to Central Precocious Puberty according to GeneCards Suite gene sharing:

26 (show all 17)
# Description GenomeRNAi Source Accession Score Top Affiliating Genes
1 Decreased shRNA abundance (Z-score < -2) GR00366-A-104 9.62 IGF1 LEP
2 Decreased shRNA abundance (Z-score < -2) GR00366-A-112 9.62 LEP
3 Decreased shRNA abundance (Z-score < -2) GR00366-A-116 9.62 KISS1R
4 Decreased shRNA abundance (Z-score < -2) GR00366-A-134 9.62 IGF1
5 Decreased shRNA abundance (Z-score < -2) GR00366-A-139 9.62 IGF1
6 Decreased shRNA abundance (Z-score < -2) GR00366-A-144 9.62 IGF1
7 Decreased shRNA abundance (Z-score < -2) GR00366-A-153 9.62 IGF1
8 Decreased shRNA abundance (Z-score < -2) GR00366-A-180 9.62 KISS1R
9 Decreased shRNA abundance (Z-score < -2) GR00366-A-193 9.62 IGF1
10 Decreased shRNA abundance (Z-score < -2) GR00366-A-20 9.62 KISS1R
11 Decreased shRNA abundance (Z-score < -2) GR00366-A-200 9.62 IGF1
12 Decreased shRNA abundance (Z-score < -2) GR00366-A-213 9.62 IGF1 KISS1R LEP
13 Decreased shRNA abundance (Z-score < -2) GR00366-A-216 9.62 LEP
14 Decreased shRNA abundance (Z-score < -2) GR00366-A-34 9.62 IGF1
15 Decreased shRNA abundance (Z-score < -2) GR00366-A-55 9.62 LEP
16 Decreased shRNA abundance (Z-score < -2) GR00366-A-60 9.62 KISS1R
17 Decreased shRNA abundance (Z-score < -2) GR00366-A-84 9.62 IGF1

MGI Mouse Phenotypes related to Central Precocious Puberty:

46
# Description MGI Source Accession Score Top Affiliating Genes
1 endocrine/exocrine gland MP:0005379 9.77 GNRH1 IGF1 KISS1 KISS1R LEP
2 adipose tissue MP:0005375 9.73 IGF1 KISS1 KISS1R LEP
3 integument MP:0010771 9.72 GNRH1 IGF1 KISS1 KISS1R LEP
4 digestive/alimentary MP:0005381 9.71 GNRH1 KISS1 KISS1R LEP
5 liver/biliary system MP:0005370 9.56 GNRH1 KISS1 KISS1R LEP
6 nervous system MP:0003631 9.55 GNRH1 IGF1 KISS1 KISS1R LEP
7 renal/urinary system MP:0005367 9.35 GNRH1 IGF1 KISS1 KISS1R LEP
8 reproductive system MP:0005389 9.02 GNRH1 IGF1 KISS1 KISS1R LEP

Drugs & Therapeutics for Central Precocious Puberty

Drugs for Central Precocious Puberty (from DrugBank, HMDB, Dgidb, PharmGKB, IUPHAR, NovoSeek, BitterDB):

(show all 20)
# Name Status Phase Clinical Trials Cas Number PubChem Id
1
Leuprolide Approved, Investigational Phase 4,Phase 3 53714-56-0 657181 3911
2 Deslorelin Investigational, Vet_approved Phase 4,Phase 3,Phase 2 57773-65-6
3 Antineoplastic Agents, Hormonal Phase 4,Phase 3,Phase 2
4 Fertility Agents Phase 4,Phase 3
5 Contraceptive Agents Phase 4,Phase 3
6 Luteolytic Agents Phase 4,Phase 3
7 Hormone Antagonists Phase 4,Phase 2
8 Hormones, Hormone Substitutes, and Hormone Antagonists Phase 4,Phase 2
9 Prolactin Release-Inhibiting Factors Phase 4
10 Hormones Phase 4,Phase 3,Phase 2
11 Triptorelin Pamoate Phase 4,Phase 3
12 Pharmaceutical Solutions Phase 3
13
Spironolactone Approved Phase 2 52-01-7, 1952-01-7 5833
14
Testolactone Approved, Investigational Phase 2 968-93-4 13769
15
Testosterone Approved, Investigational Phase 2 58-22-0 6013
16 Natriuretic Agents Phase 2
17 Diuretics, Potassium Sparing Phase 2
18 diuretics Phase 2
19 Mineralocorticoids Phase 2
20 Mineralocorticoid Receptor Antagonists Phase 2

Interventional clinical trials:

(show all 19)
# Name Status NCT ID Phase Drugs
1 Analysis of Body Mass Index in Central Precocious Puberty Patients Treated With Leuprolide Acetate Unknown status NCT02974270 Phase 4 Leuprolide
2 Comparative Validation of the Triptorelin Test for the Diagnosis of CPP in Girls Unknown status NCT01278290 Phase 4 Triptorelin acetate and Gonadorelin acetate;Gonadorelin acetate and Triptorelin acetate
3 Analysis of Genetic and Environmental Parameters Influencing Growth Rate of Precocious Puberty Children Unknown status NCT00438217 Phase 4 Triptorelin (GnRH agonists);Leuprolide (GnRH agonists)
4 A Study to Assess the Safety and Efficacy of Leuprorelin in Central Precocious Puberty in Chinese Patients Completed NCT02427958 Phase 4 Leuprorelin
5 Study of Comprehensive Diagnosis and Treatment for Children Precocious Puberty Completed NCT02920515 Phase 4 Triptorlin or Leuprorelin;Zhibo dihuang pills;Dabu ying pills
6 The Clinical Trial to Evaluate the Efficacy and Safety of Luphere Depot Inj. 3.75mg(Leuprolide Acetate 3.75mg) in Patients With Precocious Puberty Completed NCT01634321 Phase 4 Luphere depot 3.75mg(Leuprolide acetate 3.75mg)
7 Leuprorelin Acetate DPS (Leuplin DPS) Treatment Quarterly in Patients With Central Precocious Puberty Recruiting NCT03316482 Phase 4 Leuplin DPS 11.25mg
8 Histrelin Subcutaneous Implant in Children With Central Precocious Puberty Completed NCT00779103 Phase 3 Histrelin Subcutaneous Implant
9 Safety Extension Study Of Leuprolide Acetate (Lupron Depot) In The Treatment Of Central Precocious Puberty Completed NCT00667446 Phase 3 Leuprolide Acetate 3 Month Depot
10 Efficacy, Safety, and Pharmacokinetics (PK) of Triptorelin 6-month Formulation in Patients With Central Precocious Puberty Completed NCT01467882 Phase 3 Triptorelin
11 Study of Lupron Depot In The Treatment of Central Precocious Puberty Completed NCT00660010 Phase 3 Lupron (leuprolide acetate)
12 A Study of Leuprolide 11.25 mg and 30 mg Administered Every 3 Months to Treat Central Precocious Puberty Completed NCT00635817 Phase 3 Leuprolide acetate 11.25 mg;Leuprolide acetate 30 mg
13 Pharmacokinetic Study of Leuprolide Acetate Injectable Suspension in the Treatment of Central Precocious Puberty Completed NCT02452931 Phase 3 Leuprolide Acetate 45 mg
14 A Study to Evaluate Safety, Efficacy, Pharmacokinetics, and Pharmacodynamics of Leuprolide Acetate 45mg 6-Month Formulation in Children With Central Precocious Puberty (CPP) Recruiting NCT03695237 Phase 3 Leuprolide Acetate (LA)
15 Treatment of Boys With Precocious Puberty Completed NCT00001202 Phase 2 Spironolactone;Testolactone;Deslorelin
16 Long-term Outcome of GnRH Analogues Treatment of Children With Idiopathic Central Precocious Puberty Unknown status NCT02790112 Not Applicable
17 A Study to Assess the Safety and Efficacy of Leuprorelin in Central Precocious Puberty (CPP) Among Chinese Participants Completed NCT02993926 Leuprorelin
18 Psychosocial Impact of Early Puberty in Girls Aged 6 to 8 Years Completed NCT01679925
19 Markers of Pubertal Suppression During Therapy for Precocious Puberty Terminated NCT02006680

Search NIH Clinical Center for Central Precocious Puberty

Genetic Tests for Central Precocious Puberty

Genetic tests related to Central Precocious Puberty:

# Genetic test Affiliating Genes
1 Central Precocious Puberty 29 KISS1R

Anatomical Context for Central Precocious Puberty

MalaCards organs/tissues related to Central Precocious Puberty:

41
Testes, Bone, Breast, Pituitary, Brain, Ovary, Pancreas

Publications for Central Precocious Puberty

Articles related to Central Precocious Puberty:

(show top 50) (show all 468)
# Title Authors Year
1
CENTRAL PRECOCIOUS PUBERTY CAUSED BY A HETEROZYGOUS DELETION IN THE MKRN3 PROMOTER REGION. ( 29763903 )
2018
2
Central precocious puberty in a case of late-diagnosed familial testotoxicosis and long-term treatment monitoring. ( 29858851 )
2018
3
Herbal medicine for idiopathic central precocious puberty: A protocol for a systematic review of controlled trials. ( 29595688 )
2018
4
Gonadotropin-Releasing Hormone (GnRHa) Therapy for Central Precocious Puberty (CPP): Review of Nuances in Assessment of Height, Hormonal Suppression, Psychosocial Issues, and Weight Gain, with Patient Examples. ( 29806750 )
2018
5
Subnormal Growth Velocity And Related Factors During GnRH Analog Therapy For Idiopathic Central Precocious Puberty. ( 29687783 )
2018
6
Investigation of <i>MKRN3</i> mutation in patients with familial central precocious puberty. ( 29537379 )
2018
7
Evaluation of characteristics of the craniofacial complex and dental maturity in girls with central precocious puberty. ( 29708396 )
2018
8
The prevalence of brain abnormalities in boys with central precocious puberty may be overestimated. ( 29614125 )
2018
9
Analysis of the PvuII and XbaI polymorphisms in the estrogen receptor alpha gene in girls with central precocious puberty: a pilot study. ( 29801469 )
2018
10
LHCGR Gene Analysis in Girls with Non-Classic Central Precocious Puberty. ( 29506309 )
2018
11
Review and evaluation of patient-centered psychosocial assessments for children with central precocious puberty or early puberty. ( 29649000 )
2018
12
Prevalence of cranial MRI findings in girls with central precocious puberty: a systematic review and meta-analysis. ( 29902155 )
2018
13
Etiological trends in male central precocious puberty. ( 29969878 )
2018
14
Predictors of bone maturation, growth rate and adult height in children with central precocious puberty treated with depot leuprolide acetate. ( 29750651 )
2018
15
Longitudinal follow-up to near final height of auxological changes in girls with idiopathic central precocious puberty treated with gonadotropin-releasing hormone analog and grouped by pretreatment body mass index level. ( 29609441 )
2018
16
Presentation of central precocious puberty in two patients with Tay-Sachs disease. ( 29943104 )
2018
17
Triptorelin depot for the treatment of children 2 years and older with central precocious puberty. ( 29957076 )
2018
18
Central precocious puberty in Boston boys: A 10-year single center experience. ( 29949619 )
2018
19
Triptorelin (Triptodur) for central precocious puberty. ( 29294465 )
2018
20
Association between bisphenol a exposure and idiopathic central precocious puberty (ICPP) among school-aged girls in Shanghai, China. ( 29650233 )
2018
21
Comparison of two bone markers with growth evolution in 74 girls with central precocious puberty. ( 29986677 )
2018
22
Serum levels of LH, IGF-1 and leptin in girls with idiopathic central precocious puberty (ICPP) and the correlations with the development of ICPP. ( 30037185 )
2018
23
Toward More Targeted and Cost-Effective Gonadotropin-Releasing Hormone Analog Treatment in Girls with Central Precocious Puberty. ( 30048994 )
2018
24
Applicability of a novel mathematical model for the prediction of adult height and age at menarche in girls with idiopathic central precocious puberty. ( 30066730 )
2018
25
The clinical effects of gonadotropin-releasing hormone agonists for the treatment of children patients with central precocious puberty. ( 30070338 )
2018
26
Central precocious puberty: From genetics to treatment. ( 30086862 )
2018
27
Serum Osteocalcin Levels in Girls with Central Precocious Puberty: Relation to the Onset of Puberty. ( 30089739 )
2018
28
Increased final adult height by gonadotropin-releasing hormone agonist in girls with idiopathic central precocious puberty. ( 30133462 )
2018
29
Central Precocious Puberty in a Child With Metachromatic Leukodystrophy. ( 30197627 )
2018
30
Associations among IGF-1, IGF2, IGF-1R, IGF-2R, IGFBP-3, insulin genetic polymorphisms and central precocious puberty in girls. ( 30249230 )
2018
31
MKRN3 Levels in Girls with Central Precocious Puberty during GnRHa Treatment: A Longitudinal Study. ( 30269125 )
2018
32
Resistin levels are not associated with obesity in central precocious puberty. ( 30273692 )
2018
33
A mathematical model for predicting the adult height of girls with idiopathic central precocious puberty: A European validation. ( 30300409 )
2018
34
High prevalence of syndromic disorders in patients with non-isolated central precocious puberty. ( 30324796 )
2018
35
Arterial Spin Labeling and Central Precocious Puberty. ( 30397727 )
2018
36
Methylome profiling of healthy and central precocious puberty girls. ( 30466473 )
2018
37
Prevalence of Pathological Brain Lesions in Girls with Central Precocious Puberty: Possible Overestimation? ( 30546283 )
2018
38
Serum inhibin B concentration as a predictor of age at first menstruation in girls with idiopathic central precocious puberty. ( 30550563 )
2018
39
Change in body mass index and insulin resistance after 1-year treatment with gonadotropin-releasing hormone agonists in girls with central precocious puberty. ( 28443256 )
2017
40
A Critical Appraisal of the Effect of Gonadotropin-Releasing Hormon Analog Treatment on Adult Height of Girls with Central Precocious Puberty. ( 29280737 )
2017
41
MKRN3 levels in girls with central precocious puberty and correlation with sexual hormone levels: a pilot study. ( 28299573 )
2017
42
Long-term Outcomes of Patients with Central Precocious Puberty due to Hypothalamic Hamartoma After GnRH Analog Treatment: Anthropometric, Metabolic and Reproductive Aspects. ( 28558376 )
2017
43
Central Precocious Puberty and Response to GnRHa Therapy in Children with Cerebral Palsy and Moderate to Severe Motor Impairment: Data from a Longitudinal, Case-Control, Multicentre, Italian Study. ( 28791047 )
2017
44
Paternally Inherited DLK1 Deletion Associated With Familial Central Precocious Puberty. ( 28324015 )
2017
45
The mystery of puberty initiation: genetics and epigenetics of idiopathic central precocious puberty (ICPP). ( 28251550 )
2017
46
Treatment outcomes of gonadotropin-releasing hormone agonist in obese girls with central precocious puberty. ( 29301187 )
2017
47
Metabolic Outcomes, Bone Health, and Risk of Polycystic Ovary Syndrome in Girls with Idiopathic Central Precocious Puberty Treated with Gonadotropin-Releasing Hormone Analogues. ( 28391271 )
2017
48
Corrigendum to: Increased high molecular weight adiponectin, but decreased total adiponectin and kisspeptin, in central precocious puberty compared with aged-matched prepubertal girls. ( 29145926 )
2017
49
Meta-Analysis of Paediatric Patients with Central Precocious Puberty Treated with Intramuscular Triptorelin 11.25 mg 3-Month Prolonged-Release Formulationa8c. ( 28334719 )
2017
50
Effects of pomegranate extract in supplementing gonadotropin-releasing hormone therapy on idiopathic central precocious puberty in Chinese girls: a randomized, placebo-controlled, double-blind clinical trial. ( 28091641 )
2017

Variations for Central Precocious Puberty

ClinVar genetic disease variations for Central Precocious Puberty:

6
# Gene Variation Type Significance SNP ID Assembly Location
1 KISS1R NM_032551.4(KISS1R): c.1157G> C (p.Arg386Pro) single nucleotide variant Likely pathogenic rs121908499 GRCh37 Chromosome 19, 920708: 920708
2 KISS1R NM_032551.4(KISS1R): c.1157G> C (p.Arg386Pro) single nucleotide variant Likely pathogenic rs121908499 GRCh38 Chromosome 19, 920708: 920708

Expression for Central Precocious Puberty

Search GEO for disease gene expression data for Central Precocious Puberty.

Pathways for Central Precocious Puberty

GO Terms for Central Precocious Puberty

Cellular components related to Central Precocious Puberty according to GeneCards Suite gene sharing:

# Name GO ID Score Top Affiliating Genes
1 extracellular space GO:0005615 8.92 GNRH1 IGF1 KISS1 LEP

Biological processes related to Central Precocious Puberty according to GeneCards Suite gene sharing:

# Name GO ID Score Top Affiliating Genes
1 signal transduction GO:0007165 9.78 GNRH1 IGF1 KISS1R LEP
2 negative regulation of apoptotic process GO:0043066 9.61 GNRH1 IGF1 LEP
3 response to ethanol GO:0045471 9.46 GNRH1 LEP
4 regulation of signaling receptor activity GO:0010469 9.43 GNRH1 IGF1 LEP
5 female pregnancy GO:0007565 9.4 GNRH1 LEP
6 positive regulation of phosphatidylinositol 3-kinase signaling GO:0014068 9.37 IGF1 LEP
7 positive regulation of MAPK cascade GO:0043410 9.33 IGF1 KISS1 LEP
8 positive regulation of tyrosine phosphorylation of STAT protein GO:0042531 9.32 IGF1 LEP
9 bone mineralization involved in bone maturation GO:0035630 8.96 IGF1 LEP
10 positive regulation of luteinizing hormone secretion GO:0033686 8.62 KISS1 LEP

Molecular functions related to Central Precocious Puberty according to GeneCards Suite gene sharing:

# Name GO ID Score Top Affiliating Genes
1 hormone activity GO:0005179 8.8 GNRH1 IGF1 LEP

Sources for Central Precocious Puberty

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