Pediatric Endocrinology Expert Forum
Premature adrenarche
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Questions in the Pediatric Endocrinology forum are answered by Dr. Deanna L Aftab Guy. Topics covered include adrenal problems, diabetes insipidus, menstrual irregularities, obesity, parathyroid abnormalities, pituitary abnormalities, puberty concerns, rapid growth, rickets and bone disease, short stature, and thyroid.

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Premature adrenarche

My son has just turned 8.  He is 57 inches tall and has been in the 95 percentile for height.  He weighs 100 pounds. Last week his doctor found hair under his arms and had him X-ray.  He has a bone age 13.5.  He is having blood work done tomorrow and should see the endo right after the Holidays.

Any information and advice is welcomed.
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This is premature adrenarche, the early production of the male hormones from the adrenal glands, when they are produced early or in excess it is important to rule out abnormal reasons. One important cause that is rare and often screened for at birth is congenital adrenal hyperplasia, this is a block in the enzymes that the adrenal glands make and there is a build up of the male hormones that then cause the hair to become coarse and curly in the pubic and axillary area and cute baby sweat to change to  body odor. There is a nonclassical kind that may not show till later after birth due to an incomplete block, this needs to be ruled out, if all is well and there is just an early blip of these normally occuring hormones then they can monitor her closely to be sure that things do not advance to stimulate the pituitary to trigger the female hormones associated with early puberty as we know it.
so with an advanced bone age we worry about compromised growth, let the peds endo interpret the bone age themselves, sometimes we beg to differ in our opinion in regards to the degree of advancement of the bones. Also the weight is an issue, this can drive the body to make extra insulin and together along with the weight make for slight advancement in bone maturity. You are in good hands with the peds endo, good luck!
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