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eISSN: 2083-8441
ISSN: 2081-237X
Pediatric Endocrinology Diabetes and Metabolism
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Original paper

Transient clitoromegaly in an extremely preterm twin infant with popliteal pterygium

Lavinia La Grasta Sabolić
1
,
Ana Kovačević
2
,
Lucija Ana Trtanj
3
,
Bernardica Valent Morić
1, 2
,
Jasna Tumbri
3

  1. Department of Paediatrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
  2. Catholic University of Croatia’s School of Medicine, Zagreb, Croatia
  3. Department of Obstetrics and Gynaecology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Pediatr Endocrinol Diabetes Metab 2024; 30
DOI: https://doi.org/10.5114/pedm.2024.142585
Online publish date: 2024/09/02
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Clitoromegaly can be congenital or acquired, and it is usually associated with exposure to androgen excess. Pathophysiological mechanisms responsible for transient clitoromegaly in premature female infants have not been fully elucidated. Herein, we present the case of an extremely premature female twin infant, with an extensive web of skin on the back of the left leg, hypoplastic left labia majora, and normal clitoris appearance at birth. At the age of 48 days, clitoral enlargement was observed. Significantly elevated levels of gonadotropins, testosterone, and dehydroepiandrosterone sulphate (DHEAS) were recorded. 17-hydroxyprogesterone (17OHP) was unremarkable, and anti-Müllerian hormone (AMH) was low, in accordance with normal female karyotype. Ovaries were not visualised ultrasonographically. During the following weeks, gradual normalisation of gonadotropin, testosterone, and DHEAS levels was accompanied by regression of clitoromegaly. As described in this case, transient clitoral enlargement may appear in extremely premature female infants due to transitory elevated androgens of ovarian and adrenal origin.
keywords:

preterm neonate, transient clitoromegaly, popliteal pterygium

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