Premature Adrenarche



  • Appearance of pubic hair younger than age 8 years in girls and age 9 years in boys
  • Recent 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 are exhibited. 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


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


  • Concentrations of adrenal steroids such as dehydroepiandrosterone (DHEA) and dehydroepiandrosterone-sulfate (DHEA-S) increase earlier than typically seen in normal puberty.
  • Adrenal zona reticularis normally begins to increase androgen secretion at age 7–8 years.

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