Abstract
59 patients (49 females and 10 males; aged 7 months - 9 years) were studied in the last 13 years for precocious isolated pubarche. We evaluated clinical signs, bone age (B.A.), hormonal findings (ACTH-test, LHRH-test), ultrasound examination of adrenal and gonads. We devided ipatients in four groups:A) 81.3% Idiopathic precocious pubarche (HPP): with normal steroids plasma levels, high DHEAs plasma levels (47.3%), advanced B.A. (29%), advanced statural age (S.A.)(22.9%), normal pelvic ultrasonography.B) 10.1% Late Onset CAH (LOCAH): elevated basal and after ACTH stimulus 17 OH Progesteron plasma levels in all patients, advanced B.A. (83%), advanced S.A. (50%), normal pelvic ultrasonography.C) 6.9% Central Precocious Puberty (CPP): elevated LH plasma levels, advanced B.A. and advanced S.A. in 100%. In all patients large size of gonads were found with pelvic ultrasonography.D) 1 female (1.7%) had adrenal adenomas demonstred by hormonal data and adrenal ultrasound and tomography.In conclusion: HPP is the most frequent cause of premature pubarche, a differential ethiological diagnosis can be easily performed by hormonal and ultrasound investigations.
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