{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:19:00Z","timestamp":1761059940662},"reference-count":22,"publisher":"Walter de Gruyter GmbH","issue":"9-10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Signs of puberty in very young children are often benign, but the evaluation needed and follow-up are controversial.<\/jats:p><jats:p>The study had three objectives: 1) to analyze the frequency of diagnoses in children &lt;3 years referred for early puberty; 2) to examine the usefulness of lab testing; and 3) to identify red flags indicating a more serious diagnosis.<\/jats:p><jats:p>Charts of all children younger than age 3 referred for early puberty between 7\/09 and 6\/13 were reviewed.<\/jats:p><jats:p>Of 275 patients, 156 (57%) were diagnosed with premature thelarche (PT), 69 (25%; 56 F\/13M) with genital hair of infancy (GHI) and 37 (13%, all F) with both (GHI\/PT). Six patients had axillary odor only. Four patients had more serious diagnoses, one each with congenital adrenal hyperplasia (CAH), non-classical CAH, McCune-Albright syndrome and central precocious puberty (CPP). Diagnoses did not change in those who returned for follow-up. Hormone tests revealed that none of the PT patients had elevation of both luteinizing hormone (LH) and estradiol, and half of the GHI patients tested had mildly elevated DHEA-S but normal testosterone and 17-OH progesterone.<\/jats:p><jats:p>Very few children referred for puberty at &lt;3 years appear to have a serious underlying diagnosis, and progression of PT to CPP was not identified in this series. Hormone testing is unlikely to be helpful in typical cases of PT, GHI or both, and many such cases may be followed in the primary care setting after initial clinical evaluation.<\/jats:p>","DOI":"10.1515\/jpem-2015-0124","type":"journal-article","created":{"date-parts":[[2015,6,2]],"date-time":"2015-06-02T03:34:25Z","timestamp":1433216065000},"source":"Crossref","is-referenced-by-count":8,"title":["Clinical characteristics of children referred for signs of early puberty before age 3"],"prefix":"10.1515","volume":"28","author":[{"given":"Paul B.","family":"Kaplowitz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rinku","family":"Mehra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","reference":[{"key":"ref51","first-page":"148","article-title":"Isolated scrotal hair in infancy","author":"Papadimitriou","year":"2006","journal-title":"J Pediatr"},{"key":"ref81","first-page":"122","article-title":"Leonidas Ovarian microcysts in girls with isolated premature thelarche","author":"Freedman","year":"1993","journal-title":"J Pediatr"},{"key":"ref101","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1159\/000362414","article-title":"Activation of the hypothalamic - pituitary - gonadal axis in infancy minipuberty","volume":"82","author":"Kuiri","year":"2014","journal-title":"Horm Res Paediatr"},{"key":"ref141","first-page":"146","article-title":"DM PC Pubic hair in","author":"Adams","year":"1992","journal-title":"infancy Am J Dis Child"},{"key":"ref181","doi-asserted-by":"crossref","first-page":"2835","DOI":"10.1210\/jc.2009-0314","article-title":"Precocious pubarche : distinguishing late - onset congenital adrenal hyperplasia from premature adrenarche","author":"Armengaud","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"key":"ref31","first-page":"146","article-title":"DM PC Pubic hair in","author":"Adams","year":"1992","journal-title":"infancy Am J Dis Child"},{"key":"ref201","first-page":"67","article-title":"OH KM GB Premature thelarche and central precocious puberty : the relationship between clinical presentation and the gonadotropin response to luteinizing hormone - releasing hormone","author":"Pescovitz","year":"1988","journal-title":"J Clin Endocrinol Metab"},{"key":"ref121","first-page":"99","article-title":"The response to gonadotropin releasing hormone stimulation test does not predict the progression to true precocious puberty in girls with onset of premature thelarche in the first three years of life","author":"Bizzarri","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"key":"ref131","first-page":"114","article-title":"Root hair in","author":"Diamond","year":"1989","journal-title":"infancy J Pediatr"},{"key":"ref161","first-page":"148","article-title":"Isolated scrotal hair in infancy","author":"Papadimitriou","year":"2006","journal-title":"J Pediatr"},{"key":"ref21","first-page":"114","article-title":"Root hair in","author":"Diamond","year":"1989","journal-title":"infancy J Pediatr"},{"key":"ref191","first-page":"122","article-title":"Leonidas Ovarian microcysts in girls with isolated premature thelarche","author":"Freedman","year":"1993","journal-title":"J Pediatr"},{"key":"ref11","first-page":"99","article-title":"The response to gonadotropin releasing hormone stimulation test does not predict the progression to true precocious puberty in girls with onset of premature thelarche in the first three years of life","author":"Bizzarri","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"key":"ref41","first-page":"117","article-title":"Pubic hair of infancy endocrinopathy or enigma","author":"Nebesio","year":"2006","journal-title":"Pediatrics"},{"key":"ref71","doi-asserted-by":"crossref","first-page":"2835","DOI":"10.1210\/jc.2009-0314","article-title":"Precocious pubarche : distinguishing late - onset congenital adrenal hyperplasia from premature adrenarche","author":"Armengaud","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"key":"ref171","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1515\/JPEM.2007.20.5.597","article-title":"Steroid profiles in serum by liquid chromatography - tandem mass spectrometry in infants with genital hair","volume":"20","author":"Kaplowitz","year":"2007","journal-title":"J Pediatr Endocrinol Metab"},{"key":"ref61","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1515\/JPEM.2007.20.5.597","article-title":"Steroid profiles in serum by liquid chromatography - tandem mass spectrometry in infants with genital hair","volume":"20","author":"Kaplowitz","year":"2007","journal-title":"J Pediatr Endocrinol Metab"},{"key":"ref151","first-page":"117","article-title":"Pubic hair of infancy endocrinopathy or enigma","author":"Nebesio","year":"2006","journal-title":"Pediatrics"},{"key":"ref01","first-page":"156","article-title":"Premature thelarche : age at presentation affects clinical course but not clinical characteristics or risk to progress to precocious puberty","author":"Mark","year":"2010","journal-title":"De Vries J Pediatr"},{"key":"ref211","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1159\/000362414","article-title":"Activation of the hypothalamic - pituitary - gonadal axis in infancy minipuberty","volume":"82","author":"Kuiri","year":"2014","journal-title":"Horm Res Paediatr"},{"key":"ref111","first-page":"156","article-title":"Premature thelarche : age at presentation affects clinical course but not clinical characteristics or risk to progress to precocious puberty","author":"Mark","year":"2010","journal-title":"De Vries J Pediatr"},{"key":"ref91","first-page":"67","article-title":"OH KM GB Premature thelarche and central precocious puberty : the relationship between clinical presentation and the gonadotropin response to luteinizing hormone - releasing hormone","author":"Pescovitz","year":"1988","journal-title":"J Clin Endocrinol Metab"}],"container-title":["Journal of Pediatric Endocrinology and Metabolism"],"original-title":[],"link":[{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2015-0124\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,22]],"date-time":"2021-04-22T01:39:09Z","timestamp":1619055549000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2015-0124\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,1,1]]},"references-count":22,"journal-issue":{"issue":"9-10"},"URL":"https:\/\/doi.org\/10.1515\/jpem-2015-0124","relation":{},"ISSN":["2191-0251","0334-018X"],"issn-type":[{"value":"2191-0251","type":"electronic"},{"value":"0334-018X","type":"print"}],"subject":[],"published":{"date-parts":[[2015,1,1]]}}}