RT Book, Section A1 Hay, Jr, William W. A1 Levin, Myron J. A1 Deterding, Robin R. A1 Abzug, Mark J. SR Print(0) ID 1145455008 T1 Delayed Puberty, Girls T2 Quick Medical Diagnosis & Treatment Pediatrics YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9781264257614 LK accesspediatrics.mhmedical.com/content.aspx?aid=1145455008 RD 2024/03/28 AB Indications for evaluationNo pubertal signs by age 13 yearsNo menarche by age 16 yearsMost common cause of delayed puberty is constitutional growth delayPrimary hypogonadism in girls refers to a primary abnormality of the ovariesMost common diagnosis in this category is Turner syndromeOther types of primary ovarian insufficiency include46,XY and 46,XX gonadal dysgenesisGalactosemiaAutoimmune ovarian failureRadiation, chemotherapyPremutation carriers for fragile X syndrome are also at increased risk for premature ovarian failureCentral hypogonadismRefers to a hypothalamic or pituitary deficiency of gonadotrophin-releasing hormone (GnRH) or follicle-stimulating hormone/luteinizing hormone (FSH/LH), respectivelyCan be functional (reversible), caused by stress, undernutrition, prolactinemia, excessive exercise, or chronic illnessCan be permanent, which is typically associated with conditions that cause multiple pituitary hormone deficiencies, such as congenital hypopituitarism, CNS tumors, or cranial irradiationIsolated gonadotropin deficiency is rare but may occur in Kallmann syndrome