A 5-year-old girl presents with sparse pubic hair and body odor noted by her parents for 4 months. There is no breast development, no acne, and no growth acceleration. Height velocity is 6 cm/year (normal for age). Bone age is equal to chronological age. DHEAS is mildly elevated for age. What is the most likely diagnosis?
- A Non-classical congenital adrenal hyperplasia
- B Premature adrenarche ✓
- C Adrenal tumor
- D Central precocious puberty
Correct answer: B. Premature adrenarche
Explanation
Premature adrenarche is benign early maturation of the adrenal androgen axis presenting with isolated pubic hair, axillary hair, and/or body odor before age 8 in girls, without breast development or growth acceleration. Bone age is normal. Non-classical CAH presents with more pronounced virilization, acne, and advanced bone age. Adrenal tumors cause rapid, progressive virilization. Central precocious puberty always includes breast development as the first sign in girls.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.