Delayed puberty differential diagnosis: Difference between revisions

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__NOTOC__
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{{Delayed puberty}}
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Delayed_puberty]]
{{CMG}}; {{AE}}{{EG}}


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==Overview==
Delayed [[puberty]] must be differentiated from other [[diseases]] that cause latency in [[secondary sexual characteristics]] development, such as [[constitutional delay of puberty]], [[hypopituitarism]], and [[chromosomal abnormalities]]. [[Chromosomal abnormalities]] are [[Turner's syndrome]], [[Klinefelter's syndrome]], and [[Noonan's syndrome]].
 
==Differentiating Delayed puberty from other diseases==
* Delayed [[puberty]] must be differentiated from other [[diseases]] that cause latency in [[secondary sexual characteristics]] development, such as [[constitutional delay of puberty]], [[hypopituitarism]], and [[chromosomal abnormalities]]. [[Chromosomal abnormalities]] are [[Turner's syndrome]], [[Klinefelter's syndrome]], and [[Noonan's syndrome]].<ref name="pmid10414639">{{cite journal |vauthors=Blondell RD, Foster MB, Dave KC |title=Disorders of puberty |journal=Am Fam Physician |volume=60 |issue=1 |pages=209–18, 223–4 |year=1999 |pmid=10414639 |doi= |url=}}</ref>
{| class="wikitable"
! colspan="2" rowspan="2" |Diseases
! colspan="5" |Laboratory Findings
! colspan="4" |Physical examinations
! rowspan="2" |Other Findings
|-
!GnRH
!LH
!FSH
!Estradiol
!Testosterone
!Lack of secondary sexual characteristics
!Amenorrhea
!Webbed neck
!Final height
|-
| rowspan="2" |'''Delayed [[puberty]]'''
|'''Primary hypogonadism'''
|'''↑'''
|'''↑'''
|'''↑'''
|↓
|↓
| +
| +
| -
|↓
| -
|-
|'''Secondary hypogonadism'''
|↓
|↓
|↓
|↓
|↓
| +
| +
| -
|↓
| -
|-
| colspan="2" |[[Constitutional delay of puberty|'''Constitutional delay of puberty''']]
|Normal
|Normal
|Normal
|Normal
|Normal
| +
| +
| -
|Normal
|• Normal [[puberty]], finally
|-
| colspan="2" |[[Hypopituitarism|'''Hypopituitarism''']]
|'''↑'''
|↓
|↓
|↓
|↓
| +
| +
| -
|↓
| -
|-
| colspan="2" |[[Turner's syndrome|'''Turner's syndrome''']]
|↓
|'''↑'''
|'''↑'''
|↓
| -
| +
| +
| +
|↓
|• [[Bicuspid aortic valve]]
|-
| colspan="2" |'''[[Klinefelter's syndrome]]''' 
|↓
|'''↑'''
|'''↑'''
| -
|↓
| +
| -
| -
|Normal
|• [[Testicular]] [[dysgenesis]]
|-
| colspan="2" |[[Noonan's syndrome|'''Noonan's syndrome''']]
|↓
|'''↑'''
|'''↑'''
| -
|↓
| +
| -
| +
|Normal
|• [[Mitral valve prolapse]]
|-
| colspan="2" |'''Outflow tract obstruction'''
'''([[imperforate hymen]] or [[Vaginal septum|transverse vaginal septum]])'''
|Normal
|Normal
|Normal
|Normal
|Normal
| -
| +
| -
|Normal
|• [[Imperforate hymen]]
• [[Rectal mass|Perirectal mass]]
 
• Bulging [[hymen]] with [[hematocolpos]]
|-
| colspan="2" |'''[[Rokitansky syndrome|Mayer-Rokitansky-Kuster-Hauser syndrome]]'''
|Normal
|Normal
|Normal
|Normal
|Normal
| -
| +
| -
|Normal
|• Variable absence of [[Müllerian duct|Mullerian]] structures in [[pelvic ultrasound]]
|}


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


​
{{WH}}
{{WH}}
{{WS}}
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[[Category:Needs content]]
[[Category:Disease]]
[[Category:Disease]]
[[Category:Medicine]]
[[Category:Pediatrics]]
[[Category:Endocrinology]]
[[Category:Endocrinology]]
[[Category:Mature chapter]]
[[Category:Developmental biology]]
[[Category:Sexuality and age]]
[[Category:Sexual health]]
[[Category:Growth disorders]]
[[Category:Congenital disorders]]
[[Category:Up-To-Date]]

Latest revision as of 21:15, 29 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

Overview

Delayed puberty must be differentiated from other diseases that cause latency in secondary sexual characteristics development, such as constitutional delay of puberty, hypopituitarism, and chromosomal abnormalities. Chromosomal abnormalities are Turner's syndrome, Klinefelter's syndrome, and Noonan's syndrome.

Differentiating Delayed puberty from other diseases

Diseases Laboratory Findings Physical examinations Other Findings
GnRH LH FSH Estradiol Testosterone Lack of secondary sexual characteristics Amenorrhea Webbed neck Final height
Delayed puberty Primary hypogonadism ↑ ↑ ↑ ↓ ↓ + + - ↓ -
Secondary hypogonadism ↓ ↓ ↓ ↓ ↓ + + - ↓ -
Constitutional delay of puberty Normal Normal Normal Normal Normal + + - Normal • Normal puberty, finally
Hypopituitarism ↑ ↓ ↓ ↓ ↓ + + - ↓ -
Turner's syndrome ↓ ↑ ↑ ↓ - + + + ↓ • Bicuspid aortic valve
Klinefelter's syndrome  ↓ ↑ ↑ - ↓ + - - Normal • Testicular dysgenesis
Noonan's syndrome ↓ ↑ ↑ - ↓ + - + Normal • Mitral valve prolapse
Outflow tract obstruction

(imperforate hymen or transverse vaginal septum)

Normal Normal Normal Normal Normal - + - Normal • Imperforate hymen

• Perirectal mass

• Bulging hymen with hematocolpos

Mayer-Rokitansky-Kuster-Hauser syndrome Normal Normal Normal Normal Normal - + - Normal • Variable absence of Mullerian structures in pelvic ultrasound

References

  1. ↑ Blondell RD, Foster MB, Dave KC (1999). "Disorders of puberty". Am Fam Physician. 60 (1): 209–18, 223–4. PMID 10414639.

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