​Symptoms and Signs – Differential Diagnosis of Delayed Puberty
• 17-Hydroxylase deficiency in females
• Absence of uterus or vagina
• Acquired
• Associated with congenital anomalies: Kallmann’s syndrome, Prader-Willi syndrome, Laurence-Moon-Biedl syndrome, Friedreich’s ataxia
• Autoimmune hypophysitis
• Bilateral anorchism
• Bilateral gonadal failure resulting from trauma or infection or after surgery, irradiation, or chemotherapy
• Constitutional delay in growth and development
• Functional: chronic endocrinologic or systemic disorders; emotional disorders; drugs: cannabis
• Galactosemia
• Gonadal abnormalities: congenital
• Gonadal dysgenesis
• Hyperprolactinemia
• Hypothalamic or pituitary disorders
• Idiopathic
• Increased serum gonadotropin levels
• Infiltrative disease (histiocytosis)
• Isolated deficiency of gonadotropin-releasing hormone (GnRH)
• Isolated deficiency of growth hormone
• Isolated deficiency of luteinizing hormone (LH) or folliclestimulating hormone (FSH)
• Klinefelter’s syndrome
• Multiple anterior pituitary hormone deficiencies
• Myotonic dystrophy in males
• Normal or low serum gonadotropin levels
• Oophoritis: isolated or with other autoimmune disorders
• Post infection
• Post irradiation
• Resistant ovary syndrome
• Testicular feminization: complete or incomplete androgen insensitivity
• Trauma
• Tumor
• Uterine or vaginal disorders