Hypogonadism in a pediatric patient may present with delayed puberty. One classification is based on serum levels of gonadropins. Elevated gonadotropins (hypergonadotropic) suggests damage to end-organs (ovaries or testes)

Patient selection: delayed puberty with clinical evidence of hypogonadism


Initial testing: elevated serum levels of FSH and LH (hypergonadotropic)


Causes of hypergonadotropic hypogonadism in females:

(1) Turner syndrome

(2) XX and XY gonadal dysgenesis

(3) primary ovarian failure

(4) oophoritis

(5) chemoradiation therapy

(6) ovarian trauma

(7) Noonan syndrome

(8) other hereditary disorders


Causes of hypergonadotropic hypogonadism in males:

(1) gonadal dysgenesis

(2) vanishing testes syndrome

(3) testicular biosynthetic defects

(4) orchitis

(5) chemoradiation therapy

(6) testicular trauma

(7) Noonan syndrome

(8) Klinefelter syndrome

(9) other hereditary disorders

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