Precocious puberty and HIV infection: A possible emerging Endocrinopathy?
Date
2008
Authors
Iwuala, S.O
Adeyemi-Doro, A
Sabir, A
Odeniyi, I.A
Fasanmade, O.A
Journal Title
Journal ISSN
Volume Title
Publisher
American Association of Clinical Endocrinologists
Abstract
Background: HIV infection and/or its treatment are associated with a variety ofendocrinopathies. However, precocious puberty ascribable to HIV infection appears to be very rare. Objective: To report a case of precocious puberty associated with HIV infection and review
the association between HIV and precocious puberty. Methods: A boy with evidence of premature puberty was referred for endocrine evaluation and management. A full history and physical examination were performed. Investigations carried out included bone age determination, abdominal ultrasound, cranial X-rays, and basal gonadal evaluation. He was subsequently managed with progestogens to arrest further sexual development. The boy presented at age six years with an 11-month history of the appearance of features of
puberty but denied a history of ejaculations or sexual relationship. He had tested positive for HIV five months prior to presentation after his mother was found to be seropositive. The patient denied a history of blood transfusion. Pregnancy and early childhood were unremarkable.
Physical examination revealed a healthy-looking big for age boy, without café-au-lait spots, visual field defects, or palpable organ enlargement intra-abdominally. He was 1.48 m tall and weighed 39 kg. The B.P. was 80/60 mmHg. He had pubic hair of Tanner stage 4. The testes and phallus were of adult size. Lab results: Basal plasma hormone assays showed testosterone of0.8ng/ml(normal), , LH of 13mlU/ml (normal for puberty), FSH of 10mlU/ml (normal for puberty), 9.00am serum Cortisol 170ng/ml(normal), DHEAS of 550ng/ml (high). His bone age was between 9 to 14 years.
Abdominal USS and skull X-rays were normal. He could not afford further investigations. He was
placed on medroxyprogesterone acetate. Pubertal development has since not Progressed.
Conclusion: It is conjectural that HIV could have induced precocious puberty in this boy, but such association appears very rare as only one case could be found in the world literature. There is a need to establish whether this is one of the HIV-related endocrinopathies.
Description
Confefence presentation
Keywords
Precocious puberty , HIV/AIDS , Endocrinopathy
Citation
Iwuala SO, Adekunle Adeyemi – Doro AA,Sabir A, Odeniyi IA, Fasanmade OA. Precocious puberty and HIV infection: A possible emerging Endocrinopathy? Presented at the American Association of Clinical endocrinologists conference, 2008.