5-year-old boy has pubic hair, big penis

May 14, 2022 14:55 GMT+7

At a recent seminar on early puberty organized by Children’s Hospital 2, BS.CK1 Ngo Thi Ngai, Department of Nephrology – Endocrinology, Children’s Hospital 2 said that during the examination and treatment process, the majority of women were female. The patient responded well to treatment. With precocious puberty boys are less young than girls.

Doctor Ngai gave an example of patient Pham HH as a typical case. The male patient was born in 2016, with a history of the third child. From the age of 5, the mother noticed that the small penis was large and the height was suddenly large, so she took it to a provincial hospital and did not receive any treatment.

The baby often craves salty foods, has no history of convulsions or injuries, but has a slightly sluggish nerve.

When the baby came to Children’s Hospital 2, the doctor saw that he had a large penis, hair in the pubic area but no armpit hair. When X-ray of the bones of the hand, the doctor found that the child’s bone age was similar to that of a 14-year-old child. Ultrasound showed testicular tumor.

Because it was early puberty in boys, the doctor suspected there was a secondary cause, so he did more chest CT, brain MRI, adrenal test, abdominal ultrasound. Results, laboratory tests were normal. The patient had only bilateral testicular tumors.

The clinician suspects an ectopic adrenal tumor due to congenital adrenal hyperplasia. Doctor Ngai said the above diagnoses were also suitable for the patient because the child had identified early puberty from the age of 5 but did not receive timely treatment.

Another patient is a 6-year-old boy admitted to the hospital because of rapid growth and large penis. Diagnosed peripheral precocious puberty because of 2 testicular tumors on ultrasound. After 1 year of treatment, the patient again showed signs of early puberty that were more advanced, such as nightmares, armpit hair, pubic hair, 14-year-old bone age was twice the baby’s age.

Doctors re-screened for precocious puberty causes and changed treatment results for patients’ precocious puberty problems was limited. At present, the 12-year-old patient went to ultrasound examination without testicular tumor, height 1.56 cm.

Illustrated photo.

BS.CK2. Hoang Ngoc Quy – Department of Nephrology – Endocrinology, Children’s Hospital 2, said that the age of puberty onset tends to be earlier than the previous generation of grandparents and parents. Precocious puberty is considered precocious if secondary sexual characteristics (breasts, white discharge, menstruation, pubic hair, armpit hair, testicles, penis) appear before the age of 8 in girls and before 9 years of age in boys. .

From the onset of symptoms of puberty to the time when secondary sexual characteristics are fully detected, it is 10.5 – 11 years old in girls and 11.5 – 12 years old in boys. Precocious puberty is 5 times more common in girls than boys. More common in urban areas than in rural areas.

According to Dr. Quy, precocious puberty is divided into 3 groups:

First, central precocious puberty: Due to excessive secretion of sex hormones from the brain (Hypothalamus-pituitary gland). This is the most common group.

The cause of precocious puberty in this group is mostly idiopathic (especially in girls), meaning there is no physical cause for precocious puberty.

This group is treated with the drug Triptoreline to prevent rapid growth of secondary sex organs.

Second, peripheral precocious puberty: This pattern is less common than central precocious puberty. Usually associated with ovarian, testicular, adrenal tumors…

This group did not use Triptoreline for treatment.

Third, incomplete precocious puberty: Precocious, solitary development, a secondary sex characteristic (eg, isolated mammary gland hyperplasia)

Puberty is an inevitable human development process.

Doctor Quy said that if a child reaches puberty too early, there will be impacts, more or less psychological and physical on the child and family. The degree of influence depends on the age of onset of puberty, the degree of development of the secondary sex organs (size, menstruation, etc.), depending on the child’s economic and social circumstances, living environment and family…

Girls with precocious puberty are vulnerable to sexual abuse because they are not yet able to recognize abusive behaviors and protect themselves.

The goal of treatment for precocious puberty is to improve height, stop sexual maturation, and reduce the risk of early sexual intercourse and sexual abuse. Prevention of psychological disorders.

Duration of treatment to the mean age of puberty (approximately 11 years), when stopping treatment, the clinical and biological pubertal development will be repeated.

K.Chi