Premature isolated adrenarche in a six-year-old girl
- Authors: Miftakhova A.M.1,2, Bobkov D.N.1,3, Chulkova E.A.1, Nichaeva E.I.1, Mitrashov K.V.1, Krivenkova O.V.1, Navruzova T.E.1, Orluk M.A.1
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Affiliations:
- Moscow Financial and Industrial University “Synergy”
- Medical Association “Healthy Generation”
- Limited Liability Company “Network of Family Medical Centers”
- Issue: Vol 12, No 2 (2025)
- Pages: 246-254
- Section: Clinical case reports
- URL: https://journal-vniispk.ru/2313-8726/article/view/310282
- DOI: https://doi.org/10.17816/aog643223
- EDN: https://elibrary.ru/KQWXXP
- ID: 310282
Cite item
Abstract
Premature isolated adrenarche is a diagnosis of exclusion that requires careful differential diagnosis and subsequent long-term follow-up to monitor for potential late complications (such as polycystic ovary syndrome, carbohydrate metabolism disorders, and cardiovascular diseases). Conditions that may mimic isolated adrenarche include central precocious puberty and congenital adrenal hyperplasia, both of which necessitate timely diagnosis and appropriate pharmacotherapy. However, in pediatric clinical practice, isolated forms of precocious puberty are more common and require ongoing monitoring to assess the risk of complications involving the carbohydrate metabolism, reproductive, and cardiovascular systems.
This article presents a clinical case of isolated adrenarche in a six-year-old girl. Her parents sought medical attention due to the appearance of terminal hair in the axillary region. On physical examination, dark, coarse terminal hair was observed in the axillary, pubic, and perilabial areas, without signs of hirsutism. Laboratory examination revealed increased dehydroepiandrosterone sulfate, whereas markers of congenital adrenal hyperplasia and central precocious puberty were excluded.
Based on the patient’s complaints, medical history, and laboratory and instrumental data, a diagnosis of isolated adrenarche was established. The condition was attributed to premature maturation of the adrenal zona reticularis. It was accompanied by increased dehydroepiandrosterone sulfate (as confirmed by laboratory tests), advancement of bone age by one calendar year, and clinical signs such as pubic and axillary hair growth. Comprehensive examination ruled out congenital adrenal hyperplasia, central precocious puberty, adrenal or gonadal tumors. No treatment was indicated in this case. However, regular follow-up is necessary, as scientific data indicate that girls with early adrenarche are at increased risk for developing certain conditions. Parents of children with this variant of precocious puberty should be counseled on the importance of long-term monitoring.
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##article.viewOnOriginalSite##About the authors
Albina M. Miftakhova
Moscow Financial and Industrial University “Synergy”; Medical Association “Healthy Generation”
Author for correspondence.
Email: albinamiftahova91@mail.ru
ORCID iD: 0000-0002-7173-4293
SPIN-code: 2020-4134
Associate Professor
Russian Federation, Moscow; MoscowDaniil N. Bobkov
Moscow Financial and Industrial University “Synergy”; Limited Liability Company “Network of Family Medical Centers”
Email: DBobkov@synergy.ru
ORCID iD: 0000-0002-7145-8954
SPIN-code: 5311-5050
MD, Cand. Sci. (Medicine)
Russian Federation, Moscow; MoscowElena A. Chulkova
Moscow Financial and Industrial University “Synergy”
Email: echulkova@synergy.ru
ORCID iD: 0000-0003-4424-9062
SPIN-code: 7154-4611
Associate Professor
Russian Federation, MoscowElena I. Nichaeva
Moscow Financial and Industrial University “Synergy”
Email: ele-kuznetsova@yandex.ru
ORCID iD: 0009-0005-5063-4081
SPIN-code: 3471-7340
Russian Federation, Moscow
Konstantin V. Mitrashov
Moscow Financial and Industrial University “Synergy”
Email: mark498@yandex.ru
ORCID iD: 0000-0002-0712-0422
SPIN-code: 5758-1114
Associate Professor
Russian Federation, MoscowOlga V. Krivenkova
Moscow Financial and Industrial University “Synergy”
Email: krivenkova-olga@yandex.ru
ORCID iD: 0009-0003-7565-2070
SPIN-code: 2375-3570
Russian Federation, Moscow
Tatiana E. Navruzova
Moscow Financial and Industrial University “Synergy”
Email: tmay2002@mail.ru
ORCID iD: 0009-0002-3633-6350
Russian Federation, Moscow
Maria A. Orluk
Moscow Financial and Industrial University “Synergy”
Email: morliuk@synergy.ru
ORCID iD: 0009-0000-0176-4588
SPIN-code: 5842-8593
Associate Professor
Russian Federation, MoscowReferences
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