American Academy of Pediatrics – Section on Endocrinology

View all recommendations from this society

October 2, 2017

Avoid ordering LH and FSH and either estradiol or testosterone for children with pubic hair and/or body odor but no other signs of puberty.

Premature adrenarche is usually the diagnosis and does not involve activation of the pituitary- gonadal axis but is due to an early increase in adrenal androgens. DHEA-S levels are elevated for age but do not alter the management of this common and generally benign condition.

These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

How The List Was Created

The American Academy of Pediatrics’ Section on Endocrinology (SOEn) consists of pediatric endocrinologists, pediatricians, and allied health care professionals who are actively involved in some aspect of the study of endocrinological disease in infants, children and adolescents. SOEn strives to inform pediatricians, parents, communities and policy makers on endocrinological disease in children. Thus, the Executive Committee of SOEn was queried to develop a list of on diagnostic and management decisions that have resulted in patient harm either from a misdiagnosis or inappropriate therapy. The list was shared with membership of the Section on Endocrinology for feedback and then finalized by the SOEn Executive Committee. These five clinical issues are the result. Consensus on the items was received from 20 AAP expert groups. The list was critically reviewed and approved by the AAP Executive Committee.

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Kaplowitz P, Bloch C, the SECTION ON ENDOCRINOLOGY. Evaluation and Referral of Children with Signs of Early Puberty. Pediatrics. 2016;137(1):e20153732.