DELAYED PUBERTY

Ask the following questions:

1. Is there a positive drug history? Boys and girls may take anabolic steroids or androgens and thyroid hormones. These hormones may cause a delay in puberty.
2. Is there a significant weight loss? Significant weight loss would suggest anorexia nervosa, hyperthyroidism, celiac disease, cystic fibrosis, and uncontrolled diabetes among other conditions.
3. Is there a short stature? The presence of a short stature would suggest pituitary tumors, hypothalamic syndromes, gonadal dysgenesis, adrenal tumors, hyperplasia, hypothyroidism, and ovarian tumors.
4. Is there a hemianoptic field defect? The presence of a hemianoptic field defect would suggest a pituitary tumor. The presence of a normal or tall stature would suggest constitutional delayed puberty among other more rare conditions.

DIAGNOSTIC WORKUP

Before proceeding with an expensive diagnostic workup, it is perhaps best to consult an endocrinologist. If one is not available, routine tests would be a CBC, chemistry panel, and thyroid profile. Blood tests for a serum FSH, LH, and testosterone or estradiol may be done, although urine gonadotrophins may be a cheaper screening test.

Pelvic ultrasound and CT scans of the abdomen and pelvis will help identify ovarian and adrenal tumors and abnormal configuration of the uterus. CT scans of the brain will help identify pituitary tumors. If all these studies are negative, a psychiatrist may need to be consulted. Remember, the family may be in more need of the psychiatrist than the child.

Book Source Details

• Book Title: Algorithmic Diagnosis of Symptoms and Signs
• Author(s): R. Douglas Collins
• Year of Publication: 2003
• Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.

Other Book Chapters Related to Delayed puberty

Read excerpts from these other book chapters related to Delayed puberty:

Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2008 Williams & Wilkins.

More About Causes of Delayed puberty

• Back to symptom: Delayed puberty: Introduction (review 251 causes)
• Next Book Extract About Delayed puberty: Pubertal Delay (In A Page: Pediatric Signs and Symptoms)
• All Book Extracts: All Online Book Extracts for Delayed puberty

More About This Book: Title: Algorithmic Diagnosis of Symptoms and Signs Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2003 ISBN: 0-7817-3805-9

 » Next page: Pubertal Delay (In A Page: Pediatric Signs and Symptoms)

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