Jasper’s mother recently died of brain cancer. He has recently been getting into a lot of fights and is having problems in school. He has had frequent nosebleeds. His younger sister Lucy was recently admitted with restrictive pericarditis.
An ambulance was called for Jasper when he had a nosebleed that wouldn’t stop after ten minutes. When the ambulance arrived, the bleeding had stopped, but his sister Lucy had collapsed and was having difficulty breathing.
However, Jasper was soon paying a lot of attention to Dr. Cameron, first by stealing flowers to give to her. He was also running around the hospital without supervision.
Lucy was soon diagnosed with precocious puberty. Dr. Cameron suspected an environmental cause. Jasper then started to ask if Dr. Cameron liked Dr. Chase and offered to be her boyfriend. When she tried to return him to his father, he put his hand on her buttocks showing a more sexual attraction to the older woman.
Later that day, Jasper saw Dr. Cameron and Dr. Chase talking and Jasper became enraged, attacked Dr. Chase, and bit him on the right arm. Dr. Cameron reported this to Dr. House who first wrote it off as childish behavior, but he soon realized that an excess of testosterone in an 8 year old boy could cause the same behavior. He had realized Jasper and Lucy were both suffering from the same problem.
Jasper was tested and his testosterone level was about 100 times the normal level for an 8 year old boy. Like his sister, there was no sign of a tumor in his brain or reproductive tract, which appeared to indicate the cause was environmental. However, everything in the patients’ home tested negative for hormones. Dr. Chase suggested that it might be genetic and that their mother’s death from brain cancer was related. An excess of hormones from a tumor wouldn’t show up in an adult, and the doctors may have ignored symptoms because they had a diagnosis. Dr. House ordered his team to review the mother’s medical records and to draw blood from Jasper as well to prevent excess clotting and a stroke.
Jasper protested that he didn’t feel sick and wanted Dr. Cameron to treat him. Dr. Foreman confirmed to Jasper’s father that his recent behavioral issues were probably also related to the excess testosterone.
It appeared Lucy had a pituitary adenoma that they could not find with a scan. However, Dr. House was still looking for an environmental cause and turned his attention to the day care center where both children went after school. However, the father insisted none of the other children there were sick. Dr. House wondered how he could be so sure when he hadn’t been there for four days. The father insisted he would have heard.
This prompted Dr. House to go to the day care. He spoke to the day care worker Janie and realized that she was dating the father even though she was much younger that he was. However, she denied ever being at the patients’ house. However, Dr. House also noticed that Janie had recently had a lip wax, but no other beauty treatment. The only explanation he could think of was that she woke up with a moustache.
He went to speak to the father to tell him that excess facial hair in women is also a sign of overexposure to testosterone. As the day care worker and the children had only one thing in common, the father had to be the source of exposure. The father admitted to using testosterone cream to keep up with his girlfriend, but insisted that he kept it at the gym. Dr. House told him that excess testosterone is excreted through the skin and the children absorbed it every time he touched them. Once they realized the father was the source, he could remove himself from the children temporarily until they recovered and stop using the cream altogether.
Jasper soon recovered and was discharged along with his sister.