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In Reply.—We appreciate Dr Buchta's letter pointing out the ambiguity of our definition of sexual precocity. Our sentence should have read, "the appearance of secondary sex characteristics before 7½ years of age, or menarche, as an isolated event, before 8 years of age," is defined as sexual precocity. Isolated menarche may rarely occur as the first and only (temporarily) sign of sexual precocity.
We cannot entirely agree with Dr Buchta's definition of sexual precocity, as some girls who manifest secondary sexual characteristics after 7½ years of age will menstruate before the age of 10 years. Although such patients deserve careful examination and follow-up during the time of relatively rapid sexual development, they may go through the normal pubertal process with menstruation prior to 10 years of age.
LIGHTNER ES, KELCH RP. Secondary Sexual Characteristics and Menstruation-Reply. Am J Dis Child. 1984;138(11):1087. doi:10.1001/archpedi.1984.02140490087033