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Delayed Male Puberty

Delayed Puberty (Male)


Presentation

  • Highly practical and updated with the latest available data, this second edition of Male Hypogonadism: Basic, Clinical and Therapeutic Principles cogently presents a large body of scientific information on male reproductive endocrinology to provide a[books.google.com]
  • الصفحة 69 - Men homozygous for an inactivating mutation of the follicle-stimulating hormone (FSH) receptor gene present variable suppression of spermatogenesis and fertility. Nat Genet 1997; 15:205-206. ‏ الصفحة 97 - Harman SM, Tsitouras PD.[books.google.com]
  • (testing protocol) Testosterone, estradiol, LH, FSH, cortisol, DHEA, DHEAS 17 if hCG elevated tumor in mediastinum klinefelter karyotype testicular ultrasound responsible for bone formation breast tissue incomplete premature puberty due to presentation[brainscape.com]
  • Colon sections presented regular glands and surface epithelium. The lamina propria was edematous and congested with mild increased inflammatory cells Colon sections presented regular glands and surface epithelium.[pubs.sciepub.com]
  • However, determining its causes can often present clinicians with a difficult puzzle to piece together. Although delayed puberty is a common pediatric endocrine condition, determining its etiology can present a hefty clinical challenge.[endocrinenews.endocrine.org]
Male Hypogonadism
  • Now in a revised second edition, this comprehensive text covers all aspects of male hypogonadism from the basic science to clinical management, comprehensively explaining and applying new insights to the treatment of hypogonadal men.[books.google.com]
  • Male hypogonadism is the underactivity of the gonads (testes) which leads to a deficiency of the hormone testosterone. Without testosterone, the development of the genitalia and secondary sexual characteristics is impaired.[healthhype.com]
  • , high FSH LH secondary: Low serum T, low normal LH FSH typical pathophys for delayed male puberty inadequate gonadal steroid secretion due to defection LH FSH from anterior pituitary due to defective production of GnRH from hypo pituitary secondary male[brainscape.com]
  • Puberty & Fertility. a b Male Hypogonadism. Friedrich Jockenhovel. Uni-Med Science. 2004. ISBN 3-89599-748-X. Chapter 3. Diagnostic work up of hypogonadism. Jungmann E, Trautermann C (October 1994).[en.wikipedia.org]
Delayed Male Puberty
  • male puberty inadequate gonadal steroid secretion due to defection LH FSH from anterior pituitary due to defective production of GnRH from hypo pituitary secondary male hypogonadism, low T, and or sperm with low or inappropriately LH and LSH indicates[brainscape.com]
  • Ambler GR ; Androgen therapy for delayed male puberty. Curr Opin Endocrinol Diabetes Obes. 2009 Jun16(3):232-9. Soliman AT, De Sanctis V ; An approach to constitutional delay of growth and puberty.[patient.info]
Pathologist
  • See also Testicular failure Constitutional delay Gonadotrophin releasing hormone stimulation test (consult pathologist): if the boy is within 6 months of spontaneous puberty, the response to the test will be pubertal, rather than prepubertal.[rcpa.edu.au]
Tachycardia
  • The patient was admitted in general ward because of fever and tachycardia resulting in suspicion to severe inflammatory response syndrome due to pneumonia.[pubs.sciepub.com]
Hypertension
  • Hypertension. 2009 May53(5):805-11. doi: 10.1161/HYPERTENSIONAHA.108.126516. Epub 2009 Mar 30.[patient.info]
Testicular Mass
  • Testicular functional damage Viral orchitis Cytotoxic drugs/irradiation Tumour See Testicular mass Vanishing testis syndrome Severe chronic illness Severe nutritional deficiency, including Anorexia nervosa Gross zinc deficiency Zinc.[rcpa.edu.au]

Workup

  • Initial workup should include a thorough history, physical examination, and targeted investigations. No single test is considered foolproof for differentiation between CDGP and hypogonadotropic hypogonadism (HH).[journals.lww.com]
  • Females should also undergo a workup for primary amenorrhea before a diagnosis of CDGP is made. Children with transient hypogonadotropic hypogonadism may achieve fertility after the underlying cause is addressed.[lecturio.com]
  • […] healthy physical development. [2] Delay of puberty may also occur due to various causes such as malnutrition, various systemic diseases, or defects of the reproductive system ( hypogonadism ) or the body's responsiveness to sex hormones. [2] Initial workup[en.wikipedia.org]
Delayed Bone Age
  • Turner Syndrome) Radiation exposure Head Trauma Brain Tumor Constitutional delay of growth and Puberty (60% of boys, 30% of girls) Most common cause of Delayed Puberty (diagnosis of exclusion) Consistent findings Delayed Bone Age Family History of Delayed[fpnotebook.com]
  • Bone age: a delayed bone age may occur in CDGP, growth hormone deficiency and hypothyroidism. Bone age is established by a wrist X-ray. MRI or CT scan of the pituitary and surrounding structures may be indicated.[patient.info]
  • Delayed bone age is also seen in children with gonadal failure, hypogonadotropic hypogonadism and children with chronic illness. If a tumor is suspected, prolactin and hCG levels may aid in diagnosis.[lecturio.com]
Increased Bone Density
  • Note: calcium supplementation during adolescence results in increase bone density -- small breast mound -- sparse pubic hair -- breasts grow some -- more pubic hair -- areola sticks out from breast -- adult pubic hair on mons only -- areola recesses -[quizlet.com]

Treatment

  • treatment, environmental factors, obesity and aging.[books.google.com]
  • Various treatment methods are available for the delivery of external testosterone: Injections - weekly / bi-weekly / 3 monthly Gel - daily application Patches - daily application Buccal patches - daily application of patch worn on the gum Capsusles -[delayed-puberty.com]
  • Treatment for early puberty in males is generally a shot treatment using the drug Lupron. Shots are given every three months until deemed unnecessary by a medical professional.[mcsodoctors.com]
  • Once we've approved your claim, you'll get the private treatment you need. 3 And we’ll pay for treatment After you've been treated, send us your invoices.[aviva.co.uk]
  • Does my child need treatment for delayed puberty? What are the options for treatment? What are the risks and benefits of each treatment option? How long will my child need treatment? Edited: November 2017[hormone.org]

Prognosis

  • This is defined as physiologic hypogonadotropic hypogonadism. [8] Extremely elevated LH and FSH levels are indicative of gonadal dysfunction (ie, pathologic hypergonadotropic hypogonadism) and convey a poor prognosis for spontaneous pubertal development[emedicine.medscape.com]
  • During a period of 0.9 years which included the period of treatment with depot testosterone, mean growth velocity increased to 8.8 (1.9) cm/year ( P P Key words Constitutional delay Testosterone Sexual maturation Height prognosis Abbreviations CDGP constitutional[link.springer.com]

Etiology

  • GDPP - gonadotropin dependent premature puberty due to etiology early pituitary hypothalamic gonadal axis idiopathic CNS lesions (harmartomas, astrocytoma, pinealoma, optic hypothalamic glioma) CNS irradiation Genetics (gain of function in Kisspepten[brainscape.com]
  • Although delayed puberty is a common pediatric endocrine condition, determining its etiology can present a hefty clinical challenge.[endocrinenews.endocrine.org]
  • Etiologies of central precocious puberty Causes of precocious puberty may be central (central nervous system) or peripheral (gonads, adrenal glands, etc.).[lecturio.com]
  • ] Although serum growth hormone levels are low in constitutional delay of puberty, they increase after treatment with sex hormones and in those cases, growth hormone is not suggested to accelerate growth. [7] Subnormal vitamin A intake is one of the etiological[en.wikipedia.org]

Epidemiology

  • Epidemiology Exact prevalence of delayed puberty is not known.[patient.info]
  • Two key types of Precocious Puberty: Central precocious puberty Peripheral Activation of HPA axis Elevated LH and FSH Elevated testosterone/estradiol No HPA axis activation Gonadal or exogenous sex steroids Epidemiology Race may, in part, determine the[lecturio.com]
  • "Celiac disease and reproductive disorders: meta-analysis of epidemiologic associations and potential pathogenic mechanisms". Human Reproduction Update (Review). 20 (4): 582–93. doi : 10.1093/humupd/dmu007. PMID 24619876.[en.wikipedia.org]
Sex distribution
Age distribution

Pathophysiology

  • The focus then turns to the pathophysiology and treatment of hypogonadism and other forms of testicular dysfunction, such as Klinefelter syndrome, cryptorchidism, and disorders of the pituitary, as well as reproductive and endocrine consequences of cancer[books.google.com]
  • Lewkowitz-Shpuntoff HM, Hughes VA, Plummer L, et al ; Olfactory phenotypic spectrum in idiopathic hypogonadotropic hypogonadism: pathophysiological and genetic implications. J Clin Endocrinol Metab. 2012 Jan97(1):E136-44. doi: 10.1210/jc.2011-2041.[patient.info]

Prevention

  • Prevention Most causes of delayed sexual development cannot be prevented. To help reduce the chance, make sure your child maintains a healthy lifestyle. This includes making sure your child is eating well and getting nutrients.[wmhs.com]
  • “We can say with obesity that prevention is key, and in many cases when we are too late for prevention, dietary changes and more exercise are very important.” SOURCE: bit.ly/1PjqvuR Pediatrics, online January 27, 2016.[reuters.com]
  • Centers for Disease Control and Prevention.[consumer.healthday.com]
  • […] from sending the “start puberty” signal conditions that prevent the ovaries or testes from being able to respond to the “start puberty” signal certain genetic conditions, such as Klinefelter’s syndrome in boys and Turner syndrome in girls 3.[childrenshospital.org]

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