Premature Adrenarche

Basics

Appearance of pubic hair before age 8 years in girls and age 9 years in boys with elevated adrenal androgens (dehydroepiandrosterone [DHEA] or dehydroepiandrosterone-sulfate [DHEA-S])
Some data suggest that the age of normal sexual development onset in girls is younger than previously recognized, but lowering of the traditionally accepted limits remains subject to debate.
Axillary hair, acne, and apocrine sweat gland secretion are not always present with premature adrenarche.
No other signs of sexual development should be present.
Presence of breast development in girls or testicular enlargement in boys suggests precocious puberty and not premature adrenarche.
Occurs independently of hypothalamic–pituitary–gonadal axis activation seen with true puberty

Often sporadic
Familial patterns suggesting recessive and dominant inheritance have been described.

Concentrations of adrenal steroids such DHEA or DHEA-S increase earlier than typically seen in normal puberty.
Note: Zona reticularis of adrenal normally begins to increase androgen secretion at age 6 to 8 years.

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