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Clinical presentation of children with premature adrenarche

Julia von Oettingen1, Joaquim Sola Pou, Lynne L Levitsky

  • 1Massachusetts General Hospital for Children and Harvard Medical School, Boston, MA 02114, USA. julia.v.oettingen@gmail.com

Clinical Pediatrics
|August 16, 2012
PubMed

Insights

Premature adrenarche (PA) patients are often overweight with advanced bone age but normal predicted height. Late-onset congenital adrenal hyperplasia (LOCAH) presents earlier with higher adrenal androgens.

Area of Science:

  • Pediatric Endocrinology
  • Adolescent Medicine
  • Endocrine Disorders

Background:

  • Premature adrenarche (PA) is a common condition characterized by early pubic hair development.
  • Distinguishing PA from late-onset congenital adrenal hyperplasia (LOCAH) is crucial for appropriate management.
  • Understanding the phenotype and correlates of PA is essential for clinical practice.

Purpose of the Study:

  • To characterize the phenotype of premature adrenarche (PA) patients.
  • To identify historical and physical factors associated with PA.
  • To differentiate PA from late-onset congenital adrenal hyperplasia (LOCAH).

Main Methods:

  • Retrospective chart review of 122 patients diagnosed with PA.
  • Inclusion of 11 patients with confirmed LOCAH for comparison.
  • Analysis of anthropometric data, bone age, and hormonal levels.

Main Results:

  • PA patients exhibited high body mass index standard deviation scores (SDSs) and elevated bone age (BA) SDSs, particularly in boys.
  • PA subjects were taller with predicted adult height at or above genetic potential.
  • Late-onset congenital adrenal hyperplasia (LOCAH) patients presented with earlier pubic hair, more advanced BA, lower height SDSs, and higher adrenal androgen levels.

Conclusions:

  • Premature adrenarche is associated with overweight and bone age acceleration but typically normal predicted adult height.
  • Late-onset congenital adrenal hyperplasia is characterized by earlier onset and elevated 17-hydroxyprogesterone and adrenal androgens.
  • Clinical and hormonal profiles help distinguish PA from LOCAH.
Abstract

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