bone age over chronological age

[mutlu66]

My daughter bone age is at the end of 10th age but her age is 6 year and 10 months. 4 year of advancement of bone maturation is seen. No breast tissue and axillar hair isfond on the examination. Only black hair is found on the genitalia. What is the probable conditions that cause this problem?

[Deanna L Aftab Guy, MD]

Advanced bone age can be due to many things, early puberty is one of them and this needs to have evaluation, so link up first with your doc then get referred to see an endocrinologist to have this followed.

[mutlu66]

Hello,
New information for my daughter is increased IGF-1 : 560 ng/ml (106-250), and DHEA-S value close to the upper limit, 741.40 (28-852) . What are the possible causes of this situation? and what will we do for treatment? ( My daughter's height is 140 cm. and weight is 34 kg.) Her birthdate was 27th of February, 2002. There was only black pubic hair, not axillary hair nor breast buddies were detected.
( You may remember that her bone age was ten years old.)

                                        Yours Sincerely.

[Deanna L Aftab Guy, MD]

I would definitely ask your pediatrician to have her seen by a pediatric endocrinologist, it may indeed be early puberty, the dheas is a hormone that the adrenal gland makes and is a sign of early but almost normal variation of the adrenal gland maturation process that can occur in this age range in some kids. Her weight and height are both over the 97th percentile for her age if she is indeed only 6 yr 10 months, the rapid weight gain definitely contributes to the bone age advancement as does insulin resistance. her igf-1 may indeed be in a range above that stated for the lab but normal for the degree of bone age, so this needs to be in an endocrinologist hands at this time, ask you doc for referral, the ultimate goal is to #1 find out the etiology for bone age advancement(sometimes hard!) #2 limit any compromise in final height if possible.
Hope this helps