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Precocious pubarche in a young boy-unusual etiology.

Kumar KV, Shaikh A - Indian J Endocrinol Metab (2012)

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology, Command Hospital, Lucknow, Uttar Pradesh, India.

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Precocious pubarche is defined as the appearance of pubic hair before age 8 years in girls and 9 years in boys... Obesity is characterized by precocity in girls and delayed puberty in boys... Obesity leads to a state of hypogonadotropic hypogonadism in boys due to feedback effects of estrogen excess derived from peripheral aromatization of testosterone... Obesity and metabolic syndrome leading to pseudoprecocity is rarely seen in boys... Fasting blood glucose was 117 mg/dl, fasting serum insulin 21 μU/ml, HOMA-IR 6.2, HbA1c 6.1%, total cholesterol 196 mg/dl, LDL cholesterol 167 mg/dl, triglycerides 225 mg/dl, and HDL cholesterol 43 mg/dl... Neuroimaging did not reveal any abnormality in pituitary and sella regions... Obesity leads to a form of hypogonadotropic hypogonadism by feedback inhibition of excess estrogen due to peripheral aromatization of testosterone... Obesity in boys results in higher testicular volume and elevated adrenal steroids... Metabolic syndrome and Type 2 diabetes in children are nightmare to treat due to lifestyle and behavioral problems in children... Our patient had all the features of metabolic syndrome and we advised lifestyle measures along with metformin... To conclude, we report a case of pseudoprecocity in a young boy due to metabolic syndrome.

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Precocious pubarche
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Figure 2: Precocious pubarche

Mentions: An 8 1/2-year-old boy was brought by the parents after noticing progressive development of pubic hair for over 2 months. The boy is a product of non-consanguineous marriage and was delivered at term with birth weight of 3.2 kg. The motor milestones, speech, and language development were normal in the patient. The boy was obese throughout childhood and the parents denied noticing any phase of rapid growth. The boy gave no symptoms to suggest neurological, systemic or syndromic illness, and the family history was not contributory. Anthropometry revealed height 137 cm (75th to 95th centile), weight 65 kg (>97th centile), body mass index (BMI) 34.1 kg/m2, BMI for age >95th centile, abdominal circumference 93 cm, hip circumference 97 cm, and waist hip ratio 0.95. General examination revealed normal body proportions, acanthosis nigricans, and bilateral lipomastia [Figure 1]. Pubertal staging according to Tanner was A1P2G1, with testicular volume of 4 ml and stretched penile length of 4.2 cm [Figure 2]. Bone age according to Greulich and Pyle was 10 years.


Precocious pubarche in a young boy-unusual etiology.

Kumar KV, Shaikh A - Indian J Endocrinol Metab (2012)

Precocious pubarche
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3475929&req=5

Figure 2: Precocious pubarche
Mentions: An 8 1/2-year-old boy was brought by the parents after noticing progressive development of pubic hair for over 2 months. The boy is a product of non-consanguineous marriage and was delivered at term with birth weight of 3.2 kg. The motor milestones, speech, and language development were normal in the patient. The boy was obese throughout childhood and the parents denied noticing any phase of rapid growth. The boy gave no symptoms to suggest neurological, systemic or syndromic illness, and the family history was not contributory. Anthropometry revealed height 137 cm (75th to 95th centile), weight 65 kg (>97th centile), body mass index (BMI) 34.1 kg/m2, BMI for age >95th centile, abdominal circumference 93 cm, hip circumference 97 cm, and waist hip ratio 0.95. General examination revealed normal body proportions, acanthosis nigricans, and bilateral lipomastia [Figure 1]. Pubertal staging according to Tanner was A1P2G1, with testicular volume of 4 ml and stretched penile length of 4.2 cm [Figure 2]. Bone age according to Greulich and Pyle was 10 years.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology, Command Hospital, Lucknow, Uttar Pradesh, India.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Precocious pubarche is defined as the appearance of pubic hair before age 8 years in girls and 9 years in boys... Obesity is characterized by precocity in girls and delayed puberty in boys... Obesity leads to a state of hypogonadotropic hypogonadism in boys due to feedback effects of estrogen excess derived from peripheral aromatization of testosterone... Obesity and metabolic syndrome leading to pseudoprecocity is rarely seen in boys... Fasting blood glucose was 117 mg/dl, fasting serum insulin 21 μU/ml, HOMA-IR 6.2, HbA1c 6.1%, total cholesterol 196 mg/dl, LDL cholesterol 167 mg/dl, triglycerides 225 mg/dl, and HDL cholesterol 43 mg/dl... Neuroimaging did not reveal any abnormality in pituitary and sella regions... Obesity leads to a form of hypogonadotropic hypogonadism by feedback inhibition of excess estrogen due to peripheral aromatization of testosterone... Obesity in boys results in higher testicular volume and elevated adrenal steroids... Metabolic syndrome and Type 2 diabetes in children are nightmare to treat due to lifestyle and behavioral problems in children... Our patient had all the features of metabolic syndrome and we advised lifestyle measures along with metformin... To conclude, we report a case of pseudoprecocity in a young boy due to metabolic syndrome.

No MeSH data available.


Related in: MedlinePlus