Premature Adrenarche

Descriptive text is not available for this imageBASICS

DESCRIPTION

  • Appearance of pubic hair before age 8 years in girls/9 years in boys with elevated adrenal androgens (measured as dehydroepiandrosterone-sulfate [DHEA-S])
  • Some data suggest that age of normal sexual development onset in girls is younger than previously recognized; lowering of the traditionally accepted limits remains subject to debate.
  • Axillary hair, acne, and apocrine sweat gland secretion may also be present with premature adrenarche but may not be seen at initial diagnosis.
  • No other signs of sexual development should be present.
  • Presence of breast development in girls or testicular enlargement in boys suggests precocious puberty and not premature adrenarche.
  • Occurs independently of hypothalamic-pituitary-gonadal axis activation seen with true puberty

RISK FACTORS

Genetics

  • Often sporadic
  • Familial patterns suggesting recessive and dominant inheritance have been described.

PATHOPHYSIOLOGY

  • Concentrations of adrenal steroids such as DHEA-S increase earlier than typically seen in normal puberty.
  • Note: Zona reticularis of adrenal normally begins to increase androgen secretion at age 6 to 8 years.

There's more to see -- the rest of this topic is available only to subscribers.