Clinical Signs and Symptoms Associated with Causes of Delayed Puberty in an Adolescent

Certain clinical findings may be clues to the underlying cause of delayed puberty.

Patient: delayed puberty

Clinical Finding	Suggests
abdominal distention and/or tenderness	celiac disease, inflammatory bowel disease
abnormal neurological exam	CNS disease
bilateral cryptorchidism (in male)	congenital hypogonadtropic hypogonadism
bradycardia	hypothyroidism
cleft lip or palate or other midline defect	congenital syndrome
cold intolerance	hypothyroidism
congenital heart disease	congenital syndrome
constipation	celiac disease, inflammatory bowel disease
decreased height velocity	growth hormone deficiency
diarrhea	celiac disease, inflammatory bowel disease
dry skin	hypothyroidism
dysmorphic features	congenital syndrome
excessive exercise	anorexia nervosa
exophthalmos	hyperthyroidism
fatigue	hypothyroidism
food restriction	anorexia nervosa
goiter	hyperthyroidism, hypothyroidism
headaches	CNS disease
heat intolerance	hyperthyroidism
history chemotherapy or radiation therapy	acquired hypergonadotropic hypogonadism
history of testicular trauma (in male)	acquired hypergonadotropic hypogonadism
hypertension	hyperthyroidism
increased weight for height	hypothyroidism
insomnia	hyperthyroidism
intellectual disability	congenital syndrome
low weight for height	hyperthyroidism, celiac disease, inflammatory bowel disease
micropenis (in male)	congenital hypogonadotropic hypogonadism
seizures	CNS disease
smell, abnormal	Kallmann syndrome
sweaty skin or tremor	hyperthyroidism
tachycardia	hyperthyroidsm
visual field defect	CNS disease

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