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ISSN 0035-0052 (Print)

2022, Number 1

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Rev Mex Pediatr 2022; 89 (1)

Precocius puberty secundary to interpersonal transference of testosterone

Ayuzo-del VC, Flores CO, Saavedra CE, Ayuzo B, Gallaga JM

Language: Spanish
References: 10
Page: 32-35
PDF size: 181.35 Kb.


ABSTRACT

Introduction: precocious puberty (PP) is characterized by the development of secondary sexual characteristics prematurely. There are different causes of PP. The objective of this article is to describe how inadvertent testosterone exposure can cause peripheral PP. Clinical case: five-year-old male with macrogenitosomia and increased growth rate (20 cm/year). Physical examination: height 135 cm (80th percentile), facial acne, and increased muscle development; in genitalia, pubarche grade II, penis length 12 cm (Tanner 5), testicles 4 cm3 (Tanner 2). Bone age of 8.5 years. In laboratory studies, it was highlighted that serum testosterone levels were 98 ng/dL (normal < 5 ng/dL). In directed questioning, the father refers to the use of gel containing testosterone for aesthetic purposes, and close contact with his children. With all this information, diagnosis of peripheral PP was concluded. The gel was suspended, observing a decrease in testosterone to 60 ng/dL at 10 days. Conclusion: testosterone-containing products used topically by parents can cause peripheral PP in children, which is characterized by virilization, with growth of external genitalia and accelerated skeletal maturation.


REFERENCES

  1. Soriano-Guillén, J. Argente. Pubertad precoz central: aspectos epidemiológicos, etiológicos y diagnóstico-terapéuticos. Anales de Pediatría. 2011; 5: 313-336.

  2. Ramos CO, Macedo DB, Bachega TASS, Nascimento ML, Madureira G, Latronico AC et al. Premature pubarche due to exogenous testosterone gel or intense diaper rash prevention cream use: a case series. Horm Res Paediatr. 2019; 91(6): 411-415.

  3. Cabrera SM, Rogol AD. Testosterone exposure in childhood: discerning pathology from physiology. Expert Opin Drug Saf. 2013; 12(3): 375-388.

  4. De Ronde W. Hyperandrogenism after transfer of topical testosterone gel: case report and review of published and unpublished studies. Hum Reprod. 2009; 24(2): 425-428.

  5. Voelker R. Children's exposure to testosterone gel spurs FDA to order boxed label warning. JAMA. 2009; 301(23): 2428.

  6. Sanderson E, Abraham MB, Joseph J, Boyder C, Zhang R, Dedic D et al. Variable persistence of serum testosterone in infants and children exposed to topical testosterone. J Paediatr Child Health. 2020; 56(9): 1464-1467.

  7. Martinez-Pajares JD, Diaz-Morales O, Ramos-Diaz JC, Gomez-Fernandez E. Peripheral precocious puberty due to inadvertent exposure to testosterone: case report and review of the literature. J Pediatr Endocrinol Metab. 2012; 25(9-10): 1007-1012.

  8. Brachet C, Heinrichs C. Central precocious puberty after interpersonal transfer of testosterone gel: just a coincidence? J Pediatr Endocrinol Metab. 2012; 25(7-8): 757-760.

  9. Kunz GJ, Klein KO, Clemons RD, Gottschalk ME, Jones KL. Virilization of young children after topical androgen use by their parents. Pediatrics. 2004; 114: 282-284.

  10. Green AL, Srivatsa A, Rodriguez-Galindo C. Delayed diagnosis and false relapse due to paternal testosterone use in adrenocortical carcinoma. Pediatrics. 2014; 133(6): e1772-1776.




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