Case Presentation A 10-year-old female was referred to the pediatric endocrinology clinic for evaluation of short stature and suspected premature menarche. History of Present Illness One-year history of growth arrest with progressive growth deceleration Two episodes of vaginal bleeding occurring eight and five months prior to presentation- First episode lasted five days Intermittent mild headaches Birth and Developmental History Born at 40 weeks’ gestation following an uncomplicated pregnancy Birth weight: 3.36 kg; length: 47 cm; head circumference: 34.5 cm No neonatal complications Family and Social History Normal parental pubertal development Father’s height: 174 cm; mother’s height: 162 cm Target height: 164.1 cm (25th–50th percentile) Initial Clinical Examination Height: 128 cm (<3rd percentile) Weight: 23.3 kg (<3rd percentile) Body mass index: 14.2 kg/m² Proportionate body habitus…