Delayed puberty differential diagnosis: Difference between revisions
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{{ | [[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Delayed_puberty]] | ||
{{ | {{CMG}}; {{AE}}{{EG}} | ||
==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}} | |||
{{WS}} | |||
[[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
- 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.[1]
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 | Normal | Normal | Normal | Normal | Normal | - | + | - | Normal | • Imperforate hymen
• Bulging hymen with hematocolpos | |
Mayer-Rokitansky-Kuster-Hauser syndrome | Normal | Normal | Normal | Normal | Normal | - | + | - | Normal | • Variable absence of Mullerian structures in pelvic ultrasound |