Evolution of the hyperandrogenism-polycystic ovary syndrome from isosexual precocious puberty: report of two cases.

Two girls who presented initially with isosexual precocity later developed the hyperandrogenism-polycystic ovary syndrome. We propose that the pathogenesis of the hyperandrogenism-polycystic ovary syndrome in these two children is related to an abnormal release of hypothalamic gonadotropin-releasing hormone, a subsequent sustained secretion of luteinizing hormone, and a consequent excessive secretion of ovarian androgens that results in hyperandrogenism. The clinical findings in these patients suggest that the dysfunction of the hypothalamic-pituitary regulation of luteinizing hormone secretion that leads to the hyperandrogenism-polycystic ovary syndrome may occur prior to puberty.