Premature adrenarche. Clinical and diagnostic features.
Premature adrenarche (PA) or isolated growth of sexual hair in young children, is a benign condition that may initially be confused with true precocious puberty or pathologic virilizing disorders. The clinical findings, family history, and serum concentrations of dehydroepiandrosterone sulfate (DHEA-S) were compared in 24 children with PA (79% black females) seen in a 2-year period and in an age-matched control group of 17 black females. Twenty three of 24 patients, but none of the controls, had an adult-type axillary odor. There was a positive family history of PA in only three of 24 children with PA, and in one of 17 controls. The mean serum DHEA-S was significantly higher in the PA children than in the controls, but there was a broad range of concentrations (10-143 micrograms/dl), with values in 10 of 24 cases falling within the control range for age. We conclude that: (1) PA is a relatively common finding in black females between ages 3 and 8, (2) an axillary odor is almost always present in children with PA, and (3) determination of serum DHEA-S may be of some help in confirming the clinical impression of a modest increase in adrenal androgen secretion and in ruling out a more serious disorder. In most cases, however, the diagnosis of PA can be made on the basis of the history, physical examination, and lack of rapid progression over time; the use of laboratory tests to rule out a pathologic virilizing process may best be reserved for those children with very early onset, increased linear growth, or other signs of virilization.
D000311:Adrenal Glands / Q000378:metabolism; D000367:Age Factors; D044383:Black People; D002648:Child; D002675:Child, Preschool; D003687:Dehydroepiandrosterone / Q000031:analogs & derivatives* / Q000097:blood; D019314:Dehydroepiandrosterone Sulfate; D005260:Female; D006197:Hair / Q000254:growth & development; D006801:Humans; D008297:Male; D011629:Puberty, Precocious / Q000175:diagnosis*
D003687:Dehydroepiandrosterone; D019314:Dehydroepiandrosterone Sulfate