How do you evaluate a case of pubertal delay in a boy?
#pubertaldelay#pubertaldelayinboy
1. What is pubertal delay in boys?
at 14 year of age, testicle size should be more than 4cm but if it is less than that, it suggest hypogonadism. It can be either primary or secondary hypogonadism.
2. How do we differentiate constitutional delay from pathological causes of pubertal delay?
X-rays won't help differentiate it because bone age is lagging in both conditions. The only clue is family h/o pubertal delay and growth going continuously along one percentile in the growth chart.
3. What features alert you to evaluate further with FSH, LH, and testosterone in a case of short stature ?
lack of family history, pubertal delay in boy (lack of facial, pubic, axillary hair and small testis)
4. What are the causes of primary and secondary hypogonadism?
causes of primary hypogonadism is Klinefelter syndrome, while causes of secondary hypogonadism include malnutrition, chronic illness, stress, kallmann syndrome, craniopharyngioma, hypothyroidism and hyperprolactinemia
5. What other endocrinological abnormality, apart from hypogonadism, can cause pubertal delay?
the answer is hypothyroidism and hyperprolactinemia
6. in what conditions MRI brain is required?
if craniopharyngioma is suspected (patient has cranial symptoms),
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