Abstract
To determine causes of delayed puberty in a referral population, we analyzed 137 children seen between 1975-84. Pubertal delay was defined in males as testicular volume <2cc beyond age 14 and in females as lack of breast development by age 13 or failure of menarche by age 15 years. Common complaints at clinical presentation included short stature or decreased growth in 82%, delayed puberty in 35%, amenorrhea in 28% of females, signs of intracranial tumor in 3.6%, and evidence of chronic disease in 12%. We obtained height, weight, growth rate, body proportions, parental heights, family history of delay, and Tanner staging. When indicated we measured thyroid function, bone age, gonadotropin and sex hormone levels, growth hormone responses and performed chromosome analysis, skull X-ray or CT scan. 65 patients had a final diagnosis of constitutional pubertal delay; 40% of these had a family history of delay. 46 children had delayed puberty secondary to hypothalamic-pituitary dysfunction. Of 24 who were idiopathic, 7 had isolated gonadotropin deficiency and 17 had other pituitary abnormalities. Six others had congenital anomalies such as septo-optic dysplasia or Kallman's syndrome. The remaining 16 patients had tumors in the pituitary region, of which 7 were craniopharyngiomas. Eleven children had primary gonadal failure with 6 having Turner's syndrome. Two girls with amenorrhea presented with genital tract anatomic anomalies. The last 13 patients had delayed puberty secondary to associated medical problems or chronic disease. Delayed puberty appears most often to be due to constitutional delay, associated with a positive family history, and to idiopathic involvement of the hypothalamic-pituitary axis.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Krainz, P., Hanna, C. & Lafranchi, S. 183 ETIOLOGY OF DELAYED PUBERTY IN 137 CHILDREN EVALUATED OVER A 9–5 YEAR PERIOD. Pediatr Res 19, 634 (1985). https://doi.org/10.1203/00006450-198506000-00203
Issue Date:
DOI: https://doi.org/10.1203/00006450-198506000-00203