Delayed pubey seen in -

Ans. is All Delayed pubey o Delayed pubey is defined as failure of development of signs of sexual development by the age of 14 years in boy and breast budding by 13 years of girls. o Etiology of Delayed Pubey : 1. Chronic systemic diseases : Gluten enteropathy, anorexia nervosa. 2. Constitutional delay in growth and pubeal development - most common cause. 3. Hypogonadotropic hypogonadism (Low FSH. LH). a) CNS causes : Congenital anomalies, intracranial tumors, inflammatory diseases, traumatic lesions of CNS : b)Primary gonadotropin deficiency : Hypopituitarism. c) Syndromes with gonadotropin deficiency : Kallmann, Prader-Willi; Laurence-Moon-Biedl-Bardet, Froehlich. d)Miscellaneous : Hypothyroidism, hyperprolactinemia. 4. Hypergonadotropic hypogonadism (high FSH, LH, Gonadal disorders) : a) Turner syndrome (45 XO), Noonan syndrome, Klinefelter syndrome (47 XXY). b) Anticancer therapy for neoplasms of gonads. c) Orchitis d) Vanishing testes syndrome. e) Testosterone biosynthetic defects. f) Infiltration and autoimmune disease of gonads.