title: Labial adhesions in a girl with isolated premature thelarche: the importance of estrogenization.
abstract: BACKGROUND
  Premature thelarche, a benign condition that affects young girls, has been associated with elevated estrogen levels. On the contrary, labial fusion, a common pediatric gynecological problem, has been associated with low estrogen status. These two conditions are not known to coexist in the same patient.
  
  
  METHODS
  We report the case of a 2-yr-old girl with premature thelarche and labial fusion occurring contemporaneously. She presented with a 7-month history of perivaginal itchiness and a palpable painless breast bud. Examination revealed unilateral breast enlargement (Tanner stage 2) and partially fused labia minora. Pelvic ultrasound findings and gonadotrophin responses to intravenous LHRH were consistent with a diagnosis of isolated premature thelarche. Furthermore, elevated serum estradiol levels were found.
  
  
  CONCLUSIONS
  The combination of isolated premature thelarche and labial adhesions in our patient suggests the existence of other factors as well as estrogen insufficiency in the etiology of the latter.
authors.affiliation: Great Ormond Street Hospital for Children, England, London, UK.
authors.forename: Maria
authors.initials: M
authors.lastname: Papagianni
authors.forename: Richard
authors.initials: R
authors.lastname: Stanhope
mesh_terms: D001940:Breast / Q000254:growth & development*; D002675:Child, Preschool; D004958:Estradiol / Q000097:blood; D004967:Estrogens / Q000502:physiology*; D005260:Female; D006801:Humans; D010388:Pelvis / Q000000981:diagnostic imaging; D000267:Tissue Adhesions / Q000150:complications*; D014463:Ultrasonography; D014845:Vulvar Diseases / Q000150:complications*
chemical_list: D004967:Estrogens; D004958:Estradiol