Hypogonadism differential diagnosis: Difference between revisions
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==Differentiating Hypogonadism from other Diseases== | ==Differentiating Hypogonadism from other Diseases== | ||
Hypogonadism must be differentiated from [[diseases]] that cause [[delayed puberty]] or [[infertility]]. These diseases include [[Congenital disease|congenital diseases]] as [[Klinefelter syndrome]], [[Kallmann syndrome]] and [[cryptorchidism]]. The diseases also include [[testicular torsion]] and [[orchitis]] in males, [[polycystic ovary syndrome]], [[pelvic inflammatory disease]], and [[endometriosis]] in females. | Hypogonadism must be differentiated from [[diseases]] that cause [[delayed puberty]] or [[infertility]]. These diseases include [[Congenital disease|congenital diseases]] as [[Klinefelter syndrome]], [[Kallmann syndrome]] and [[cryptorchidism]]. The diseases also include [[testicular torsion]] and [[orchitis]] in males, [[polycystic ovary syndrome]], [[pelvic inflammatory disease]], and [[endometriosis]] in females.<ref name="fertstert2004">{{Citation|last = Denschlag|first = Dominik, MD|last2 = Clemens|first2 = Tempfer, MD|last3 = Kunze|first3 = Myriam, MD|last4 = Wolff|first4 = Gerhard, MD|last5 = Keck|first5 = Christoph, MD|title = Assisted reproductive techniques in patients with Klinefelter syndrome: A critical review|journal = Fertility and Sterility|volume = 82|issue = 4|pages = 775–779|date = October 2004|year = 2004|doi = 10.1016/j.fertnstert.2003.09.085}}</ref><ref name="pmid17462053">{{cite journal| author=Virtanen HE, Bjerknes R, Cortes D, Jørgensen N, Rajpert-De Meyts E, Thorsson AV et al.| title=Cryptorchidism: classification, prevalence and long-term consequences. | journal=Acta Paediatr | year= 2007 | volume= 96 | issue= 5 | pages= 611-6 | pmid=17462053 | doi=10.1111/j.1651-2227.2007.00241.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17462053 }}</ref><ref name="pmid19679025">{{cite journal| author=Schmitz D, Safranek S| title=Clinical inquiries. How useful is a physical exam in diagnosing testicular torsion? | journal=J Fam Pract | year= 2009 | volume= 58 | issue= 8 | pages= 433-4 | pmid=19679025 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19679025 }}</ref><ref name="pmid19378875">{{cite journal |vauthors=Trojian TH, Lishnak TS, Heiman D |title=Epididymitis and orchitis: an overview |journal=Am Fam Physician |volume=79 |issue=7 |pages=583–7 |year=2009 |pmid=19378875 |doi= |url=}}</ref><ref name="pmid21490048">{{cite journal |vauthors=Stewart A, Ubee SS, Davies H |title=Epididymo-orchitis |journal=BMJ |volume=342 |issue= |pages=d1543 |year=2011 |pmid=21490048 |doi= |url=}}</ref><ref name="AMN">{{cite web | author = Christine Cortet-Rudelli, Didier Dewailly | title =Diagnosis of Hyperandrogenism in Female Adolescents| work =Hyperandrogenism in Adolescent Girls | url=http://www.health.am/gyneco/more/diagnosis-of-hyperandrogenism-in-female/ | year = 2006 | month= Sep 21 | publisher=Armenian Health Network, Health.am}}</ref><ref>{{cite journal |author=Legro RS, Barnhart HX, Schlaff WD |title=Clomiphene, Metformin, or Both for Infertility in the Polycystic Ovary Syndrome|journal=N Engl J Med|volume=356 |issue=6 |pages=551-566 |year=2007 |pmid=17287476 |doi=}}</ref><ref name="pmid25992748">{{cite journal |vauthors=Brunham RC, Gottlieb SL, Paavonen J |title=Pelvic inflammatory disease |journal=N. Engl. J. Med. |volume=372 |issue=21 |pages=2039–48 |year=2015 |pmid=25992748 |doi=10.1056/NEJMra1411426 |url=}}</ref><ref name="pmid27107781">{{cite journal |vauthors=Ford GW, Decker CF |title=Pelvic inflammatory disease |journal=Dis Mon |volume=62 |issue=8 |pages=301–5 |year=2016 |pmid=27107781 |doi=10.1016/j.disamonth.2016.03.015 |url=}}</ref><ref name="pmid11949938">{{cite journal| author=Murphy AA| title=Clinical aspects of endometriosis. | journal=Ann N Y Acad Sci | year= 2002 | volume= 955 | issue= | pages= 1-10; discussion 34-6, 396-406 | pmid=11949938 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11949938 }}</ref> | ||
{| class="wikitable" | {| class="wikitable" | ||
! colspan="2" |Diseases | ! colspan="2" |Diseases | ||
| Line 16: | Line 16: | ||
| rowspan="3" |Congenital diseases | | rowspan="3" |Congenital diseases | ||
|[[Klinefelter syndrome]] | |[[Klinefelter syndrome]] | ||
|Clinical features of [[Klinefelter syndrome]] are as the following: | |Clinical features of [[Klinefelter syndrome]] are as the following: | ||
* Language learning impairment. | * Language learning impairment. | ||
| Line 45: | Line 45: | ||
|- | |- | ||
|[[Cryptorchidism]] | |[[Cryptorchidism]] | ||
|Clinical features of cryptorchidism include: | |Clinical features of cryptorchidism include: | ||
* [[Empty scrotum]] | * [[Empty scrotum]] | ||
* [[Inguinal]] fullness | * [[Inguinal]] fullness | ||
| Line 56: | Line 56: | ||
| rowspan="2" |Male diseases | | rowspan="2" |Male diseases | ||
|[[Testicular torsion]] | |[[Testicular torsion]] | ||
|Patients of testicular torsion usually present with following: | |Patients of testicular torsion usually present with following: | ||
* Sudden onset of severe [[pain]] in one [[testicle]], with or without a previous predisposing event | * Sudden onset of severe [[pain]] in one [[testicle]], with or without a previous predisposing event | ||
* [[Swelling]] within one side of the [[scrotum]] (scrotal swelling) | * [[Swelling]] within one side of the [[scrotum]] (scrotal swelling) | ||
| Line 68: | Line 68: | ||
|- | |- | ||
|[[Orchitis]] | |[[Orchitis]] | ||
|Clincial features of orchitis include the following | |Clincial features of orchitis include the following | ||
* [[Scrotum|Scrotal]] [[swelling]] | * [[Scrotum|Scrotal]] [[swelling]] | ||
* [[Scrotal pain]] | * [[Scrotal pain]] | ||
| Line 91: | Line 91: | ||
| rowspan="3" |Female diseases | | rowspan="3" |Female diseases | ||
|[[Polycystic ovarian syndrome]] (PCOS) | |[[Polycystic ovarian syndrome]] (PCOS) | ||
|Possible clinical findings in cases of PCOS: | |Possible clinical findings in cases of PCOS: | ||
* [[Amenorrhea]] | * [[Amenorrhea]] | ||
* [[Oligoamenorrhea]] | * [[Oligoamenorrhea]] | ||
| Line 106: | Line 106: | ||
* Pelvic ultrasound | * Pelvic ultrasound | ||
| | | | ||
* [[Clomiphene citrate]] and [[metformin]] to manage infertility. | * [[Clomiphene citrate]] and [[metformin]] to manage infertility. | ||
* [[Cyproterone acetate]] for the treatment of acne and hirsutism. | * [[Cyproterone acetate]] for the treatment of acne and hirsutism. | ||
* [[Spironolactone]] | * [[Spironolactone]] | ||
|- | |- | ||
|[[Pelvic inflammatory disease]] | |[[Pelvic inflammatory disease]] | ||
|Patients usually present with the following: | |Patients usually present with the following: | ||
* Bilateral [[abdominal pain]] | * Bilateral [[abdominal pain]] | ||
* [[Abnormal uterine bleeding]] | * [[Abnormal uterine bleeding]] | ||
| Line 127: | Line 127: | ||
|- | |- | ||
|[[Endometriosis]] | |[[Endometriosis]] | ||
|Clinical features of endometriosis include the following: | |Clinical features of endometriosis include the following: | ||
* [[Dyspareunia]] | * [[Dyspareunia]] | ||
* [[Nausea and vomiting|Nausea]] and vomiting | * [[Nausea and vomiting|Nausea]] and vomiting | ||
Revision as of 19:27, 8 September 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2]
Overview
Hypogonadism must be differentiated from diseases that cause delayed puberty or infertility. These diseases include congenital diseases as Klinefelter syndrome, Kallmann syndrome and cryptorchidism. The diseases also include testicular torsion and orchitis in males, polycystic ovary syndrome, pelvic inflammatory disease, and endometriosis in females.
Differentiating Hypogonadism from other Diseases
Hypogonadism must be differentiated from diseases that cause delayed puberty or infertility. These diseases include congenital diseases as Klinefelter syndrome, Kallmann syndrome and cryptorchidism. The diseases also include testicular torsion and orchitis in males, polycystic ovary syndrome, pelvic inflammatory disease, and endometriosis in females.[1][2][3][4][5][6][7][8][9][10]
| Diseases | Clinical findings | Diagnosis | Manangement | |
|---|---|---|---|---|
| Congenital diseases | Klinefelter syndrome | Clinical features of Klinefelter syndrome are as the following:
|
|
|
| Kallmann syndrome | Clinical features of Kallmann syndrome include:
|
| ||
| Cryptorchidism | Clinical features of cryptorchidism include:
|
|
| |
| Male diseases | Testicular torsion | Patients of testicular torsion usually present with following: |
|
Management is mainly surgical through detorsion and fixation of the affected testes. |
| Orchitis | Clincial features of orchitis include the following
|
|
| |
| Female diseases | Polycystic ovarian syndrome (PCOS) | Possible clinical findings in cases of PCOS: |
|
|
| Pelvic inflammatory disease | Patients usually present with the following:
|
|
| |
| Endometriosis | Clinical features of endometriosis include the following:
|
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Medical therapy:
Surgery:
| |
References
- ↑ Denschlag, Dominik, MD; Clemens, Tempfer, MD; Kunze, Myriam, MD; Wolff, Gerhard, MD; Keck, Christoph, MD (October 2004), "Assisted reproductive techniques in patients with Klinefelter syndrome: A critical review", Fertility and Sterility, 82 (4): 775–779, doi:10.1016/j.fertnstert.2003.09.085
- ↑ Virtanen HE, Bjerknes R, Cortes D, Jørgensen N, Rajpert-De Meyts E, Thorsson AV; et al. (2007). "Cryptorchidism: classification, prevalence and long-term consequences". Acta Paediatr. 96 (5): 611–6. doi:10.1111/j.1651-2227.2007.00241.x. PMID 17462053.
- ↑ Schmitz D, Safranek S (2009). "Clinical inquiries. How useful is a physical exam in diagnosing testicular torsion?". J Fam Pract. 58 (8): 433–4. PMID 19679025.
- ↑ Trojian TH, Lishnak TS, Heiman D (2009). "Epididymitis and orchitis: an overview". Am Fam Physician. 79 (7): 583–7. PMID 19378875.
- ↑ Stewart A, Ubee SS, Davies H (2011). "Epididymo-orchitis". BMJ. 342: d1543. PMID 21490048.
- ↑ Christine Cortet-Rudelli, Didier Dewailly (2006). "Diagnosis of Hyperandrogenism in Female Adolescents". Hyperandrogenism in Adolescent Girls. Armenian Health Network, Health.am. Unknown parameter
|month=ignored (help) - ↑ Legro RS, Barnhart HX, Schlaff WD (2007). "Clomiphene, Metformin, or Both for Infertility in the Polycystic Ovary Syndrome". N Engl J Med. 356 (6): 551–566. PMID 17287476.
- ↑ Brunham RC, Gottlieb SL, Paavonen J (2015). "Pelvic inflammatory disease". N. Engl. J. Med. 372 (21): 2039–48. doi:10.1056/NEJMra1411426. PMID 25992748.
- ↑ Ford GW, Decker CF (2016). "Pelvic inflammatory disease". Dis Mon. 62 (8): 301–5. doi:10.1016/j.disamonth.2016.03.015. PMID 27107781.
- ↑ Murphy AA (2002). "Clinical aspects of endometriosis". Ann N Y Acad Sci. 955: 1–10, discussion 34-6, 396–406. PMID 11949938.