Premature Adrenarche — RACP Paediatrics MCQ

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ModerateEndocrinologyPremature AdrenarcheRACP Paediatrics

A 9-year-old girl presents with premature adrenarche (pubic hair Tanner 2, axillary odour) but no breast development. Her bone age is age-appropriate. What is the most likely diagnosis?

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Correct answer: A — Premature adrenarche (benign)

Premature adrenarche: isolated pubic/axillary hair and body odour without breast development or other puberty signs, with age-appropriate bone age. It is a benign variant of normal development. However, elevated DHEAS warrants exclusion of CAH (17-OHP) and adrenal tumour. Follow-up is recommended as premature adrenarche may be associated with later PCOS.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Premature Adrenarche