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Objective: To describe the etiologies, clinical characteristics, and laboratory investigations of young Thai children being evaluated for precocious pubarche., Material and Method: The medical records of 41 children referred for evaluation of precocious presence of pubic hair at Songklanagarind Hospital between 1995 and 2011 were retrospectively reviewed., Results: The etiologies of precocious pubarche in young Thai children were congenital adrenal hyperplasia (n = 19, 46.3%), isolated premature adrenarche without pathology (n = 12, 29.3%), hypothalamic hamartoma (n = 7, 17.1%), adrenocortical carcinoma (n = 2, 4.9%), and Leydig cell tumor (n = 1, 2.4%). The weight and height of patients with pathological etiologies were significantly greater than those with isolated premature adrenarche (p < 0.001). Patients with congenital adrenal hyperplasia had significantly greater levels of basal and peak 17-hydroxyprogesterone than those with isolated premature adrenarche (p < 0.001). Patients with adrenocortical carcinoma had significantly greater level of DHEAS than those with congenital adrenal hyperplasia and isolated premature adrenarche (p < 0.001)., Conclusion: The precocious presence of pubic hair in young Thai children should be investigated for an underlying pathological etiology. The most common underlying pathology of precocious presence of pubic hair is congenital adrenal hyperplasia.

Background: Central precocious puberty (CPP) is defined as pubertal development caused by activation of the hypothalamic-pituitary-gonadal axis before 8 years of age in girls and 9 years in boys. Failure to recognize and/or treat this condition can result in short adult stature., Objective: To determine the etiology, clinical presentation and near-final height (NFH) of Thai children with CPP with or without gonadotropin-releasing hormone analog (GnRHa) treatment., Methods: In a longitudinal observational study, 73 CPP patients who attended Songklanagarind Hospital between 1995 and 2009 were followed up every 3-6 months until they attained their NFH., Results: The etiologies observed were idiopathic CPP, hypothalamic hamartoma and central nervous system diseases. The mean age at time of diagnosis was 6.4 +/- 2.9 years. Bone age was on average 4 years more advanced than chronological age. Of the 52 patients who reached their NFH during the study, 32 were treated with GnRHa and 20 were not. The mean age at menarche was significantly greater for GnRHa-treated than for untreated girls (11.6 +/- 0.8 vs 10.1 +/- 1.1 years, p < 0.001). The median NFH of GnRHa-treated girls was 152.4 +/- 5.2 cm, which was significantly greater than the 144.4 +/- 5.0 cm for untreated girls (p < 0.001)., Conclusion: GnRHa treatment can preserve the genetic height potential of children with CPP.

Background: Precocious puberty (PP) is defined as the appearance of secondary sex characteristic at an age <8 years in girls and <9 years in boys, or menarche <9 years in girls., Objective: To determine the etiologies and clinical characteristics of children presenting with PP., Subjects and Method: The medical records of 307 children (292 girls, 15 boys) with PP (1995-2009) were reviewed., Results: The most common etiology of PP in girls was premature thelarche (35.5%), followed by early puberty (25.4%) and central precocious puberty (23.8%). All boys had underlying pathologic etiologies. The average age of girls with premature thelarche was significantly younger than those with any other etiologies (2.8 +/- 1.6 vs 6.7 +/- 1.7 years, p <0.001). Height and weight SDSs of girls with central precocious puberty and early puberty were significantly greater than those with premature thelarche., Conclusions: The most common etiologies of PP in girls are premature thelarche in girls <6 years and early puberty in girls >6 years. PP in boys has to be investigated for underlying etiologies.