II. Pathophysiology
- Benign self-limited cause of Precocious Puberty
- Results from adrenal androgen release as opposed to the pubertal Hypothalamus-Pituitary-Gonadal activation
III. Epidemiology
- Onset before age 6 years
IV. Signs
- Early secondary sexual characteristics in children
- Early pubic hair and axillary hair development
- Increased sebaceous activity
- Adult-type body odor
- Mild acne
- No Sexual Development
- Normal linear growth pattern
V. Imaging
- Bone Age consistent Chronological age
- Other imaging studies normal
VI. Labs (May delay evaluation)
- Slight increase in Serum Dehydroepiandrosterone (DHEA) level
- Other adrenal steroid Hormones normal (e.g. Cortisol, Aldosterone)
- Sex Hormone levels normal (Estradiol, Testosterone)
- Normal Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH)
- ACTH Stimulation Test normal
-
GnRH Stimulation Test normal
- Consistent with prepubertal pattern
- 17-Hydroxyprogesterone
- Elevated in <5% of cases (due to mild congeital adrenal hyperplasia)
VII. Management
- Reassurance