Girl, 13-4/12 years old, with constitutional delay in growth and puberty. History revealed a normal growth rate but short stature at all ages. Physical.

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Presentation transcript:

Girl, 13-4/12 years old, with constitutional delay in growth and puberty. History revealed a normal growth rate but short stature at all ages. Physical examination revealed a height of 138 cm (−4.5 SD) and a weight of 28.6 kg (−3 SD). The patient recently had early stage 2 breast development, with 1 cm of glandular tissue on the right breast and 2 cm on the left breast. The vaginal mucosa was dulled, and there was no pubic hair. Karyotype was 46,XX. Bone age was 10 years. After administration of GnRH, LH and FSH rose in a pubertal pattern. Estradiol was 40 pg/mL. She has since spontaneously progressed through further pubertal development. (Reproduced with permission from Styne DM, Kaplan SL. Normal and abnormal puberty in the female. Pediatr Clin North Am. 1979 Feb;26(1):123-148.) Source: Puberty, Greenspan's Basic & Clinical Endocrinology, 10e Citation: Gardner DG, Shoback D. Greenspan's Basic & Clinical Endocrinology, 10e; 2017 Available at: http://accessmedicine.mhmedical.com/DownloadImage.aspx?image=/data/books/2178/gardgreen10_ch15_f003a-1.png&sec=166251619&BookID=2178&ChapterSecID=166251551&imagename= Accessed: September 26, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved