C10 (Clinical Case) Precocious Puberty in Internationally Adopted Children: A Tale of Two Thelarches

Abstract Introduction/Background Internationally adopted (IA) children may commonly experience post-adoption medical issues in the infectious, nutritional, developmental and psychological domains. We present a rare endocrinologic case of 2 biologically unrelated into same Canadian family with diagnoses idiopathic central precocious puberty (CPP), years after adoption. Case Description A 13-month-old female was from Kazakhstan past history prematurity (29 weeks gestational age), grade II intraventricular hemorrhage, query hypoxic ischemic encephalopathy, perinatal CMV infection, malnourishment. She demonstrated catch-up growth adoption monitored for concerns. presented at 7 9 months report thelarche 6 months, pubarche accelerated height velocity. Bone age advanced by 3 (+4 SD). By Endocrinology consultation 8 1 month, gonadotropin-releasing hormone (GnRH) stimulation test confirmed CPP. There no nervous system (CNS) symptomatology. Leuprolide initiated to minimize psychosocial impacts CPP not necessarily improve final adult height. Seven their first adoption, welcomed child Vietnam, aged 11 months. Medical profile included malnutrition atopic dermatitis. Thelarche noted 5 4 she had isolated breast development 2.5 (+3 GnRH revealed started. MRI brain showed CNS lesion, which diagnosis Discussion Whereas there is rare, but documented, increased prevalence among IA children, etiology unclear. Theories postulate that it be related rapid or exposure endocrine disruptors. Awareness this risk vary. Initial consults often focus on other screening. Depending counselling about seem remote. This impact timing pubertal concerns are identified. As early identification provides an opportunity intervene preserve height, as well child, surveillance should overlooked. Based caregiver feedback our cases, we now include on, examination for, changes clinic visits. Conclusion puberty. Paediatric clinicians caregivers aware allow timely treatment condition.