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Symptoms and Signs – Differential Diagnosis of Puberty
Delayed
Constitutional growth and puberty delay
Hypogonadism of pre-pubertal onset (See Hypogonadism)
Precocious
Complete (central)
Congenital: hydrocephalus, brain malformations
Acquired: tumours (hypothalamidpituitary: glioma, hamartomas), trauma,
radiation, infiltrations
Incomplete
Premature pubic/axillary hair development: excess androgens
Leydig cells stimulated by hCG (which has LH-like activity), e.g. from hepatoma,
hepatoblastoma, pineal/hypothalamic teratomas
Leydig cells premature activation (testotoxicosis) due to an activating mutation of
the LH receptor
Leydig cell tumour
McCune-Albright syndrome: constitutive activation of the gonadotrophin
receptor on Leydig cells
Excess androgens from adrenal tumours, CAH Exogenous sex steroids
Premature breast development (thelrache): excess oestrogens:
Ovarian cyst (developed possibly due to premature FSH secretion) Hypothyroidism (l thyroid hormone -, TTSH stimulates FSH secretion:
TFSH -, ovarian cyst development) Ovarian neoplasm
McCune-Albright


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Kembara Xtra 

Facts about medicine and its subtopic such as anatomy, physiology, biochemistry, pharmacology, medicine, pediatrics, psychiatry, obstetrics and gynecology and surgery.