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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Why Would A Child Show Physical Signs Of Puberty Although Blood Test Shows No Hormonal Changes?

Why would a 9 year old girl show physical signs of puberty (advanced bone age; breast tanner stage ii, underarm hair ) but after complete and thorough work-up, show no evidence of hormonal changes to suggest puberty has been initiated? In other words, no suppression has been recommended, because there is nothing to suppress.
posted on Sat, 6 Oct 2012
Twitter Sat, 20 Oct 2012 Answered on
Twitter Mon, 22 Oct 2012 Last reviewed on
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Pediatrician,  's  Response
Hi,

Thank you for your query.

I can understand your dilemma because there is no corelation between the clinical and pathological diagnosis in the girl's case. I would suggest that the hormonal work-up should be repeated as there can be some laboratory discrepancy which should be excluded.

The clinical notes should be followed-up to see the progress over the next 6-9 months. In this way it shall be documented if the physical signs are progressing or are just stationary.

I hope I have responded to your query to your satisfaction.

Regards,

RKK
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Why Would A Child Show Physical Signs Of Puberty Although Blood Test Shows No Hormonal Changes?

Hi, Thank you for your query. I can understand your dilemma because there is no corelation between the clinical and pathological diagnosis in the girl s case. I would suggest that the hormonal work-up should be repeated as there can be some laboratory discrepancy which should be excluded. The clinical notes should be followed-up to see the progress over the next 6-9 months. In this way it shall be documented if the physical signs are progressing or are just stationary. I hope I have responded to your query to your satisfaction. Regards, RKK