Precocious puberty in a rural Guatemalan boy: Unraveling the role of malnutrition and psychosocial stress

Abstract Precocious puberty is a rare condition, particularly in boys, characterized by the early development of secondary sexual characteristics. This case report presents a 5-year-old male from rural Guatemala who exhibited signs of accelerated sexual maturation, including Tanner stage IV genitalia, pubic and facial hair, and advanced bone age. After evaluation, the diagnosis was associated with environmental factors such as chronic malnutrition and psychosocial stress, which likely contributed to the premature activation of the hypothalamic–pituitary-gonadal axis. In low-resource settings, factors like poverty, limited access to healthcare, and nutritional deficiencies can significantly impact growth and development, leading to atypical presentations of conditions like precocious puberty. This case highlights the importance of considering environmental factors and social determinants of health when diagnosing and managing puberty, especially in underserved populations.