The syndrome which is the subject of this paper has recently been described in detail (1) and its literature reviewed.2 It is the object of this paper to report two additional cases, and to discuss certain added information concerning the syndrome which they bring out. Briefly, the characteristics of the syndrome are as follows: a). A disseminated osteitis fibrosa (both hyper and hypo-ostotic), with a distribution suggesting a relationship between the lesions and nerve roots or an embryologic defect in the myotomes; b). Areas of cutaneous pigmentation which have a distribution suggesting some connection between them and the bone lesions; c). Sexual and somatic precocity especially, if not exclusively, when the disease occurs in the female sex. In the previous paper (1) an attempt was made to explain possible relationships between these apparently disconnected manifestations. It was thought that the distribution of the bone and cutaneous lesions was such as to preclude an endocrine or metabolic disturbance as their cause. On the other hand, the possibility of a neurologic (or possibly embryologic) defect seemed highly possible. The question was then discussed whether the gonadal disturbance might not be due to a disturbance in the afferent impulses to the anterior pituitary, thus perhaps explaining the whole bizarre syndrome on one basis—a disseminated neurologic lesion.
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Albright et al. (1938) studied this question.