body odor on almost 5 yr. old

[ny2125]

our daughter shows no signs of early puberty other than an odor we happened upon. but the other day my wife said her armpit had a bad smell/BO so to say. they were wrestling and she happened to have her nose in that area. both armpits gave that smell. she said she had to actually purposely go near the area to smell it. we have not noticed this before. she was due for a bath that night--we usually do every other day in the winter--and the night previous she was running and sweating a lot at a b-day party. she does seem to sweat when she is active (i am the same way). so could the 48 hrs. in between and activity level cause that smell to happen? should we be worried about early puberty? her ped. checked her around the holidays and had a clean checkup. any advice would be great. thanks.  oh and my wife said she only has light colored body hair in the pubic and underarm region.  we assume this is the normal body hair.  our neighbor who is the same age as our daughter has very noticeable leg hair.  is that normal?  our child is maybe a little under the avg. for height and weight.  wouldnt early puberty by noticeable like breasts, obvious pubic hair, major growth spurts, etc.  IF this is the case w/kids, how often is it something bad like a tumor?  how common is this issue to begin with?  SORRY for so many ?'s.  i hope you can answer them all.    thanks for any help!!!

[CMRobbins]

A related discussion, 9-year-old diabetic? was started.

[NANCE22765]

A related discussion, Armpit odor  in 6 yr old girl  with petite stature was started.

[ny2125]

so in essence, nothing that can be fatal?  i mean every and anything can be fatal i guess, but in this case it would be rare (if there are any cases of this happening).

[Deanna L Aftab Guy, MD]

if it is just benign premature adrenarche, meaning a slight early tempo in these normal adrenal hormones, then no real problems, if there is a little higher influence there is concern for bone maturation and ultimately compromised height, even higher influence of these hormones there is concern about priming of the pituitary puberty hormones to start pulsing early.

[ny2125]

and dr., what is the real threat of having this condition (early puberty)?  could it be fatal or how common would that be (if it was a tumor are they usually benign in these cases)?

[Deanna L Aftab Guy, MD]

yes, it does sound more like body hair, hard to tell and would be best decided by pediatrician in their office

[ny2125]

oh, and our friend said their child had light colored hairs in the pubic region.  not coarse or curly hair.  would this be like normal body hair on a child?  sorry for so many questions but this topic came up w/some fellow friends and got me wondering again.  thanks!!!

[ny2125]

our friend of ours had some observations/knowledge of this whole topic.  i guess they went through it w/their kid awhile back.  they said if it was early puberty:
1.  that pubic/under arm hair would be very noticeable.
2.  the body odor would also be noticeable, meaning, you dont have to get close to the arm pit area, the odor would be noticeable anyways.
3.  that the real threat of not treating this condition is a possibility of short stature.  they said nobody has died from this condition?  that if it is a tumor, they are benign in this situation?
any clarification would be great if anyone can answer.   thanks!

[1jitterbug]

Is this a possibility?   http://search.yahoo.com/search?p=TMAU&fr=yfp-t-501&toggle=1&cop=mss&ei=UTF-8

Are you the same person that posted on the Urgent Care Forum?
http://www.medhelp.org/posts/show/374097

[ny2125]

thank you again, i wanted to confirm my question about hair in those regions where signs of puberty show.

[Deanna L Aftab Guy, MD]

yes, this is body hair, not the same and you are ok to rest easy!

[ny2125]

and as for normal body hair vs. puberty hair in regions of the body, my kids have a very light (white) hairs throughout their body.  the ped. said this is just normal body hair.  if it changed to dark or longer, then i guess that would be a sign of changes.  just confirming w/you.

[Deanna L Aftab Guy, MD]

glad to hear of the good exam, I am a watch and wait person as well, unless I panic!!!
So bone age is an xray of the left wrist that is compared to that of "normal" children in an atlas of reference. It lets us know the comparable age of the bones in other words if the growth plate is mature for age this may be indicative of exposure to elevated hormones like in early puberty or other hormonal problems.
Thanks for the update.

[ny2125]

you mentioned an x-ray or bone age test.  could you explain what this exactly is?  is it being the bone is older or larger than it should be?   thanks.

[ny2125]

and she gave her a good exam and basically wants to wait and see.  she noticed no other signs or concerns to do anything right now.  she said depending on how active and how much a kid sweats can contribute to this.  

[Deanna L Aftab Guy, MD]

The ultrasound of the abdomen may not have specifically looked at the adrenal glands. I would consider as discussed
see pediatrician then exam first, then perhaps an xray of her left hand to see what we call a bone age is sufficient, then if they see an advanced bone age or anything on exam they can get the labs and follow her every 4 months.

[ny2125]

the "smell" we notice (if we purposely put our nose in the armpit area) is on the day she is due for a bath.  we bathe every other day, unless they swim or get really dirty that day.  the day after a bath we do not notice anything, it is the day she is due for one.  sorry for adding more info., but i might as well.  thank you.

[ny2125]

we are italian and i was wondering if that can have an affect too.  our daughter did have an ultrasound of her stomach last year due to belly aches (found out it was constipation) and it was a normal exam result.  she is a very good eater and very active.  i dont know if any of this other info. can help you.  even if a child has other signs, i assume the tumor is still rare and if so, is the outcome bleak?  do we need to see her ped. asap or just at the next well-check up?  thanks again, we appreciate it!

[Deanna L Aftab Guy, MD]

whew! lots of questions. So body odor in a 5 yo girl, the cute baby sweat that we love starts changing its odor when the adrenal glands kick in, sometime between age 6 (it sounds frightening! but usually around age 8 when the earliest pubic hair may be noted).
If she is not having rapid growth(height) and she has no pubic hair, or axillary hair it is doubtful that this is something scary like a tumor making excess male hormones. But I would indeed talk with your pediatrician. They can measure these adrenal hormones with a blood test-17-OH progesterone, DHEAS, androstenedione , also if they really want to be aggressive an abdominal ultrasound might look at the adrenal glands.
Honestly an exam first, then perhaps an xray of her left hand to see what we call a bone age is sufficient, then if they see an advanced bone age or anything on exam they can get the labs and follow her every 4 months.
Now your neighbor with leg hair-sounds like nonpubertal related hair growth-genetic-this is body hair not necessarily influenced by the adrenal glands per se.
Hope this helps, and it is OK to use deodorant in a 5 yo, sounds crazy but my patients who have been worked up and all is ok other than the annoying symptoms of adrenarche do fine with deodorant/antipersperant and moms feel better.