Anthropometric and endocrine features in girls with isolated premature pubarche or non-classical congenital adrenal hyperplasia.
Clinical and hormonal changes in girls with precocious pubarche, a multifactorial entity, have not been thoroughly investigated.


OBJECTIVE
To describe anthropometric features and bone age in Brazilian girls with precocious pubarche, and to compare clinical and hormonal findings for patients with isolated precocious pubarche (IPP) or non-classical congenital adrenal hyperplasia (NC-CAH).


METHODS
Twenty-eight girls with precocious pubarche were consecutively seen at the Child and Pubertal Gynecologic Clinic and the Gynecological Endocrinology Unit of Hospital de Clinicas de Porto Alegre. Patients with central precocious puberty and pseudopuberty were excluded from the study. Diagnostic criteria: NC-CAH: 17-hydroxyprogesterone (17OHP) >12 ng/ml 60 min after 0.25 mg i.m. ACTH; IPP: hormonal levels compatible with adrenarche and normal adrenal function confirmed by ACTH testing. Anthropometric and hormonal features and bone age were assessed.


RESULTS
Six patients had NC-CAH, and 22 IPP. NC-CAH frequency was 21.42%. Weight and BMI were above 50th percentile except for patients <4 years; 46% of the girls were either overweight or obese. Clinical and hormonal features, except for response to ACTH testing, were similar in both groups; all patients were in or above the 50th percentile for height. Bone age was advanced in 43% of the patients. There was no statistical difference between the groups.


CONCLUSIONS
Slight acceleration of height and bone age, one of the clinical manifestations of precocious pubarche, is unlikely to be progressively severe.
Accetta
Solange Garcia
SG
Department of Obstetrics and Gynecology, Medicine School, Universidade Federal do Rio Grande do Sul, Brazil.
Di Domênico
Khristiane
K
Ritter
Clarice Gabardo
CG
Ritter
Anelise Teichmann
AT
Capp
Edison
E
Spritzer
Poli Mara
PM
D019326:17-alpha-Hydroxyprogesterone / Q000097:blood*; D000312:Adrenal Hyperplasia, Congenital / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology*; D000324:Adrenocorticotropic Hormone; D000735:Androstenedione / Q000097:blood; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D001846:Bone Development; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D005260:Female; D006801:Humans; D011629:Puberty, Precocious / Q000097:blood / Q000503:physiopathology*; D013268:Stimulation, Chemical; D013739:Testosterone / Q000097:blood
D013739:Testosterone; D000735:Androstenedione; D019314:Dehydroepiandrosterone Sulfate; D019326:17-alpha-Hydroxyprogesterone; D000324:Adrenocorticotropic Hormone