ABSTRACT
Delayed puberty is defined as lack of breast development after the age of 13 years in girls, and lack of testes enlargement after the age of 14 years in boys. Considering the importance of delayed puberty, the present study tries to analyze its etiological factors. It is hoped that the study would help developing programs, aiming at drawing the attention of families, health centers and physicians to the necessity of early diagnosis and timely treatment of delayed puberty. In this observational descriptive study, we reviewed the etiology of delayed puberty in affected patients, who had been referred to the Institute for Endocrinology and Metabolism in Tehran, during a period of 5 years from 1995 to 1999. Patients [32 boys and 16 girls] were divided into 3 groups based on clinical and laboratory information. 24 patients [50%] were categorized in the group of hypogonadotropic hypogonadism [including 18 cases with isolated hypogonadotropic hypogonadism, 2 cases of Kallmann-syndrome, 3 cases with hypopituitarism, 1 case with hypogondism and thalassemia]. 14 [29.2%] patients including 13 boys and 1 girl were categorized in the group with constitutional delay of growth and puberty. 10 patients [20.8%] were categorized in the group with hypergonadotropic hypogonadism [including 6 cases with Turner syndrome, 2 cases with Klinefelter syndrome, 2 cases with 46XX pure gonadal dysgensis]. The most common cause of hypogonadism in boys was constitutional delay of growth and puberty [40.6%] and hypogonadotropic hypogonadism [40.6%] while in girls it was Turner syndrome [37.5%]. The most common cause for patients to be referred was short stature [43/5%] and then non appearance of pubertal signs [37.5%]. When facing patients with delayed puberty, hypergonadotropic hypogonadism in girls, and constitutional delay of growth and puberty as well as hypogonadotropic hypogonadism in boys, should be considered as the first diagnosis. In all patients, who are referred due to short stature, the stage of puberty should be determined and delayed puberty should be considered as differential diagnosis