Congenital adrenal hyperplasia complicated by gonadotropin-dependent precocious puberty
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Date
2024
Authors
Journal Title
BMJ Case Reports
Journal ISSN
Volume Title
Publisher
BMJ Publishing Group
Abstract
Precocious puberty, characterised by the early appearance of secondary sexual characteristics, poses challenges in diagnosis and management. Here, we describe a case of precocious puberty diagnosed in a boy in middle childhood, who presented with progressive phallus enlargement, pubic hair development and increased aggressive behaviour. Hormonal evaluation confirmed the diagnosis of congenital adrenal hyperplasia (CAH), complicated by gonadotropin-dependent precocious puberty. The case highlights the importance of assessment of testicular volume in a patient presenting with precocious puberty. Symmetrical testicular enlargement in a patient with CAH suggests premature activation of the hypothalamic-pituitary-gonadal axis. The patient received glucocorticoid therapy to suppress androgen production related to CAH and gonadotropin-releasing hormone analogue therapy to control premature activation of the hypothalamic-pituitary-gonadal axis. Follow-up visits showed regression of secondary sexual characteristics and improved growth velocity. � BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.
Description
Keywords
Drugs: endocrine system, Pituitary disorders