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Premature adrenarche. Clinical and diagnostic features.
Clinical Pediatrics
|January 1, 1986
Summary
Premature adrenarche (PA) is common in young black females and often presents with axillary odor. While serum DHEA-S can be elevated, diagnosis relies mainly on clinical signs and lack of rapid progression.
Area of Science:
- Pediatric Endocrinology
- Adolescent Medicine
- Clinical Pediatrics
Background:
- Premature adrenarche (PA) is the early development of pubic or axillary hair.
- It can be mistaken for true precocious puberty or virilizing disorders.
- Distinguishing PA is crucial for appropriate clinical management.
Purpose of the Study:
- To compare clinical findings, family history, and DHEA-S levels in children with PA versus controls.
- To identify key diagnostic indicators for premature adrenarche.
- To assess the utility of serum DHEA-S in diagnosing PA.
Main Methods:
- Retrospective case-control study.
- Compared 24 children with PA (79% black females) to 17 age-matched black female controls.
- Evaluated clinical signs, family history, and serum dehydroepiandrosterone sulfate (DHEA-S) concentrations.
Main Results:
- 23 of 24 PA patients had adult-type axillary odor, unlike controls.
- Family history of PA was uncommon in both groups.
- Mean serum DHEA-S was higher in PA children, but with significant overlap with control ranges.
Conclusions:
- PA is common in black females aged 3-8 years.
- Axillary odor is a near-universal sign of PA.
- Serum DHEA-S aids in confirming mild adrenal androgen excess but clinical assessment is primary; lab tests are reserved for complex cases.