Effect of excess estrogen on breast and external genitalia development in growth hormone deficiency.
BACKGROUND
The progress of sexual maturation and development in cases with growth hormone (GH) and insulin-like growth factor-I (IGF-I) deficiency is not well documented in females.


METHODS
We observed breast and genitalia development in a 2-year-old girl with GH deficiency following neonatal asphyxia; this girl later developed central precocious puberty. Markedly pigmented stimulated areolas and nipples without an apparent breast mound, and non-enlarged labia minora in the external genitalia were observed as features of sexual maturation in the patient. The hormonal condition was characterized by increased circulating estradiol levels and extremely low IGF-I levels.


CONCLUSIONS
This case indicates that IGF-I is necessary for exerting the full effect of estrogen on the development of breasts and maturation of external genitalia.
Department of Pediatrics, Dokkyo Medical University School of Medicine, Mibu, Tochigi-ken, Japan.
Susumu
S
Hagisawa
Naoto
N
Shimura
Osamu
O
Arisaka
D001238:Asphyxia Neonatorum / Q000150:complications; D015415:Biomarkers / Q000378:metabolism; D001940:Breast / Q000473:pathology; D002675:Child, Preschool; D004958:Estradiol / Q000378:metabolism*; D005260:Female; D013006:Growth Hormone / Q000172:deficiency*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007334:Insulin-Like Growth Factor I / Q000172:deficiency*; D011629:Puberty, Precocious / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D014844:Vulva / Q000473:pathology
D015415:Biomarkers; D004958:Estradiol; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone