Delayed puberty classification: Difference between revisions
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==Classification== | ==Classification== | ||
Delayed puberty is almost always due to physiologic exaggerated prolongation of puberty timing in boys, a condition called "constitutional delay of growth and puberty (CDGP)". Delayed puberty may sometimes has another pathophysiologies, however, the CDGP is the most common cause of delayed puberty in both boys and girls. The main classification of delayed puberty is as following: | Delayed puberty is almost always due to physiologic exaggerated prolongation of puberty timing in boys, a condition called "constitutional delay of growth and puberty (CDGP)". Delayed puberty may sometimes has another pathophysiologies, however, the CDGP is the most common cause of delayed puberty in both boys and girls. The main classification of delayed puberty is as following:<ref name="PalmertDunkel2012">{{cite journal|last1=Palmert|first1=Mark R.|last2=Dunkel|first2=Leo|title=Delayed Puberty|journal=New England Journal of Medicine|volume=366|issue=5|year=2012|pages=443–453|issn=0028-4793|doi=10.1056/NEJMcp1109290}}</ref> | ||
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{{Family tree | | | | | | | | A01 | | | | | | | | | | | | | |A01= '''Delayed puberty'''<br>classification}} | |||
{{Family tree | | | | | | | | |!| | | | | | | | | | | | | | |}} | |||
{{Family tree | | | | | | | | B01 | | | | | | | | | | | | | B01= LH, FSH, and GnRH<br>measurement}} | |||
{{Family tree | | | |,|-|-|-|-|^|-|-|-|-|.| | | | | | | | | }} | |||
{{Family tree | | | C01 | | | | | | | | C02 | | | | | | |C01= Normal| C02= Abnormal}} | |||
{{Family tree | | | |!| | | | |,|-|-|-|-|+|-|-|-|-|.| | | | |}} | |||
{{Family tree | | | D01 | | | D02 | | | D03 | | | D04 | | | |D01= Constitutional delay of growth and puberty (CDGP)|D02=[[LH]] and [[FSH]] decreased<br>[[GnRH]] increased|D03=[[LH]] and [[FSH]] decreased<br>[[GnRH]] decreased|D04=[[LH]] and [[FSH]] decreased<br>[[GnRH]] decreased<br>(transient) }} | |||
{{Family tree | | | | | | | | |!| | | | |!| | | | |!| | | | | |}} | |||
{{Family tree | | | | | | | | E01 | | | E02 | | | E03 | | | |E01= Hypergonadotropic hypogonadism|E02=Permanent hypogonadotropic hypogonadism|E03=Functional hypogonadotropic hypogonadism}} | |||
{{Family tree/end}} | |||
The differential diagnosis of CDGP can be divided into three main categories[http://www.nejm.org/doi/full/10.1056/NEJMcp1109290#ref7 7]: hypergonadotropic hypogonadism (characterized by elevated levels of luteinizing hormone and FSH owing to the lack of negative feedback from the gonads), permanent hypogonadotropic hypogonadism (characterized by low levels of luteinizing hormone and FSH owing to hypothalamic or pituitary disorders), and transient hypogonadotropic hypogonadism (functional hypogonadotropic hypogonadism), in which pubertal delay is caused by delayed maturation of the HPG axis secondary to an underlying condition | The differential diagnosis of CDGP can be divided into three main categories[http://www.nejm.org/doi/full/10.1056/NEJMcp1109290#ref7 7]: hypergonadotropic hypogonadism (characterized by elevated levels of luteinizing hormone and FSH owing to the lack of negative feedback from the gonads), permanent hypogonadotropic hypogonadism (characterized by low levels of luteinizing hormone and FSH owing to hypothalamic or pituitary disorders), and transient hypogonadotropic hypogonadism (functional hypogonadotropic hypogonadism), in which pubertal delay is caused by delayed maturation of the HPG axis secondary to an underlying condition | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Classification
Delayed puberty is almost always due to physiologic exaggerated prolongation of puberty timing in boys, a condition called "constitutional delay of growth and puberty (CDGP)". Delayed puberty may sometimes has another pathophysiologies, however, the CDGP is the most common cause of delayed puberty in both boys and girls. The main classification of delayed puberty is as following:[1]
| Delayed puberty classification | |||||||||||||||||||||||||||||||||||||||||||||||||
| LH, FSH, and GnRH measurement | |||||||||||||||||||||||||||||||||||||||||||||||||
| Normal | Abnormal | ||||||||||||||||||||||||||||||||||||||||||||||||
| Constitutional delay of growth and puberty (CDGP) | LH and FSH decreased GnRH increased | LH and FSH decreased GnRH decreased | LH and FSH decreased GnRH decreased (transient) | ||||||||||||||||||||||||||||||||||||||||||||||
| Hypergonadotropic hypogonadism | Permanent hypogonadotropic hypogonadism | Functional hypogonadotropic hypogonadism | |||||||||||||||||||||||||||||||||||||||||||||||
The differential diagnosis of CDGP can be divided into three main categories7: hypergonadotropic hypogonadism (characterized by elevated levels of luteinizing hormone and FSH owing to the lack of negative feedback from the gonads), permanent hypogonadotropic hypogonadism (characterized by low levels of luteinizing hormone and FSH owing to hypothalamic or pituitary disorders), and transient hypogonadotropic hypogonadism (functional hypogonadotropic hypogonadism), in which pubertal delay is caused by delayed maturation of the HPG axis secondary to an underlying condition
References
- ↑ Palmert, Mark R.; Dunkel, Leo (2012). "Delayed Puberty". New England Journal of Medicine. 366 (5): 443–453. doi:10.1056/NEJMcp1109290. ISSN 0028-4793.