Premature Adrenarche May Mean Adrenal Hyperplasia, PCOS.
Issue: August 1, 2001
TORONTA — Premature adrenarche in girls, even in the absence of tumors, is no longer thought to be benign, said Dr. Kristi Muichahey said at the annual meeting of the North American Society for Pediatric and Adolescent Gynecology.
“It used to be thought that if there was no tumor causing the excess of androgens, the condition was nothing to worry about. But now there’s some evidence that up to 40% of these girls could have non-classical adrenal hyperplasia and could also be at increased risk for developing polycystic ovarian syndrome later on,” said Dr. Mulchahey, who is a pediatric and adolescent gynecologist in private practice in Atlanta.
Girls who develop pubic hair, body odor, and acne– signs of androgen production–before age 7 or 8 years should be watched very carefully through their other pubertal milestones, she said.
“Make sure they have appropriate onset of menstrual function. I don’t think you can throw out an arbitrary age for when it should start, but I think you have to look at the individual development of the child, and the first period should begin roughly 2 years after breast development starts,” Dr. Mulchahey said.
If menarche does not start in an appropriate time frame, or if the girl starts to develop signs of hirsutism, weight gain, or acanthosis nigricans (darkening of the skin folds), she should be evaluated for an androgen problem.
“If I see a child with premature adrenarche, I always tell her parents, ‘We’re not going to treat this right now. But when she starts to go through puberty, we need to watch her carefully'” Dr. Mulchahey said.
COPYRIGHT 2001 International Medical News Group
COPYRIGHT 2001 Gale Group