Zhu L, Wang D-F, Mao J-P
Ruijin Hospital, Shanghai Second Medical University, Shanghai, China

Objective: To recognize onset and features of polycystic ovary syndrome (PCOS) in perimenarchcal girls.
Methods: Investigate the clinical characteresties of PCOS in 11~16 years old adolescent girls consulting in our endocrine clinics,and measure their serum level of gonadotropin,sex hormones,and several adrenocortical hormones. Sonography imaging of adrenals, uterus and ovaries have been examined. Assays for glucose metabolism have been made in obese girls.
Results: Eight case were found with PCOS features during perimenarchcal period. They show one or several abnormalities in the PCOS entity such as high basal LH (luteinizing hormone)value associated with high LH/FSH (follicle stimulating hormone) ratio, hyperandrogenism with serum testosterone (T), or androstenedione (Δ4A) or dehydroepiandrosterone sulphate (DHEA-S) elevated. Obese girls show hyperinsulinemia. With one suffered from non-insulin- dependent diabetes mellitus (NIDDM). Clinical signs of PCOS presented by these 8 patients being irregular menses, hirsutism, acne or obesity with acanthosis nigricans. Sonography examination of adrenals show no abnormality, but pelvic ultrasound apparently show enlarged ovaries and multiple small cysts within both sides.
Conclusion: In perimenarchcal girls when exist the menstrual dysfunction, obesity, acanthosis nigrican associated with hyperinsulinemia and/or girls with hyperandrogenaemia, in addition with clinical evidence of hyper-androgenism plus significantly elevated LH, LH/FSH ratio, pelvic sonograph examination should be made attentively to avoid the suspected PCOS diagnosis