Rapid occurrence of thelarche and menarche induced by hydrocortisone in a teenage girl with previously untreated congenital adrenal hyperplasia.

UNLABELLED

A 14-year-old girl with untreated simple virilizing congenital adrenal hyperplasia presented with absent breast development. She had not had menarche. During treatment with hydrocortisone, breasts progressed from Tanner stage one to three within 6 months and menarche occurred after 10 months. However, a 1.5 cm pituitary adenoma, later described as unspecific pituitary enlargement, remained unchanged.

CONCLUSION

In a female with untreated congenital adrenal hyperplasia and an adult bone age, signs of puberty appeared very rapidly once appropriate treatment had begun. This was supposedly due to the declining androgen secretion from the adrenals and the release of their restraining action on the hypothalamic-pituitary ovarian axis.