Endocrine Abstracts

Introduction/aims: Adrenarche, the gradual increase in adrenal androgen secretion resulting in clinical features of pubic hair, axillary hair, body odour and acne, is independent from gonadotrophin-dependent central puberty. It is important that children presenting with these features are not unnecessarily investigated, whilst ensuring significant pathology is not overlooked.

There is variation in practice in management of adrenarche. We identified current practice across Scotland using contacts from the Scottish Paediatric Endocrine Group (SPEG) and developed a guideline to standardise management approach.

Methods: A questionnaire containing four clinic scenarios representing adrenarche, thelarche, thelarche variant and precocious puberty was sent electronically to consultant paediatricians carrying out specialist endocrine clinics across Scotland and to all consultant paediatricians in the South East of Scotland.

A guideline incorporating responses from the questionnaire was developed and discussed at a SPEG meeting.

Results: The questionnaire was sent to 87 consultant paediatricians, with a response rate of 54%. 20 respondents answered all scenarios, 14 (70%) were endocrinologists or those with a special interest in endocrinology.

A wide variety of approaches to investigation and management of adrenarche were reported. The median number of investigations proposed by endocrinologists was three (range 0–8) compared to a median of six investigations (range 4–9) in the non-specialist group. The guideline, which will be presented, was designed to guide referral from general practice and general paediatric clinics and standardise specialist investigations.

Conclusions: This guideline for assessment of features of adrenarche will be used locally and has been submitted for approval by the SPEG Guideline Group.