PREMATURE ADRENARCHE

The physical and hormonal events that occur at the time of normal deve lopment of sex hair growth during childhood are referred to as the adr enarche. Appearance of pubic or axillary hair before age 8 in girls or age 9 in boys characterizes the syndrome of premature adrenarche; its hormonal concomitant is comparably early activation of adrenal androg enesis. In most clinical situations, this condition is simply a normal variant of early puberty and has minimal significance. On rare occasi ons, adrenal neoplasms or late-onset con genital adrenal hyperplasia m ay cause increased adrenal androgenesis and onset of hair growth. The regulation of androgen synthesis in the adrenal zona reticularis is po orly understood. Long-term follow up of these patients has generally n ot revealed clinical adnormalities, but there may be an increased inci dence of functional ovarian hyperandrogenism or polycystic ovarian dis ease that appears in late teenage years.