Precocious Pubarche in Thai Children
Somchit Jaruratanasirikul MD* Maethanee Thaiwong MD*
Affiliation : * Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
Objective : To describe the etiologies, clinical characteristics, and laboratory investigations of young Thai children being
evaluated for precocious pubarche.
Material and Method: The medical records of 41 children referred for evaluation of precocious presence of pubic hair at
Songklanagarind Hospital between 1995 and 2011 were retrospectively reviewed.
Results : The etiologies of precocious pubarche in young Thai children were congenital adrenal hyperplasia (n = 19, 46.3%),
isolated premature adrenarche without pathology (n = 12, 29.3%), hypothalamic hamartoma (n = 7, 17.1%), adrenocortical
carcinoma (n = 2, 4.9%), and Leydig cell tumor (n = 1, 2.4%). The weight and height of patients with pathological etiologies
were significantly greater than those with isolated premature adrenarche (p < 0.001). Patients with congenital adrenal
hyperplasia had significantly greater levels of basal and peak 17-hydroxyprogesterone than those with isolated premature
adrenarche (p < 0.001). Patients with adrenocortical carcinoma had significantly greater level of DHEAS than those with
congenital adrenal hyperplasia and isolated premature adrenarche (p < 0.001).
Conclusion : The precocious presence of pubic hair in young Thai children should be investigated for an underlying
pathological etiology. The most common underlying pathology of precocious presence of pubic hair is congenital adrenal
hyperplasia.
Keywords : Precocious pubarche, premature adrenarche, congenital adrenal hyperplasia
