Hormone Excretion in Precocious Puberty

At puberty in girls the sex hormones are secreted in increasing quantities and the clinical signs of puberty follow. In precocious puberty it is generally accepted that the excretion of these hormones will reach adolescent or adult levels but will not be abnormally high as it may be in tumour or hyperplasia of the gonad or the adrenal cortex. Published reports vary depending on the laboratory investigations carried out, and also from case to case (Fischer, 1940; Novak, 1944; Hain, 1947; Seckel, Scott and Benditt, 1949; Lloyd, Lobotsky and Morley, 1950; Lowrey and Brown, 1951; Mossberg, 1951; Paschkis, 1952; Lloyd, 1955). In general, the 17-ketosteroids tend to be a little higher than normal for the chronological age but they rarely reach more than the lower limits of adult levels and may be quite normal. Gonadotrophin determinations are usually positive, but were negative in the cases described by Gross (1940) and by Bronstein, Luhan and Mavrelis (1942). Oestrogen excretion has been measured by biological methods. The results are difficult to evaluate but on the whole oestrogen excretion tends to be low. The chemical method recently developed by Brown (1 955a) has made possible the separate estimation of oestrone, oestradiol-17,B and oestriol in human urine. This study was therefore undertaken to assess the clinical value of simultaneous estimations of urinary oestrogens, 1 7-ketosteroids and gonadotrophins in 11 cases of early or precocious puberty. Vaginal smears were also examined. Hormone estimations were carried out on a cont'rol series of 15 normal girls in the age range 3 to 10 years.