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Constitutional Delay of Growth and Puberty — RACP Paediatrics MCQ

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ModerateAdolescent MedicineConstitutional Delay of Growth and PubertyRACP Paediatrics

A 16-year-old boy presents with concerns about delayed puberty. He has Tanner stage 1 genitalia and testes <4 mL bilaterally. His height is on the 10th centile. His father had late puberty. Bone age is 12 years. LH and FSH are low-normal. What is the most likely diagnosis?

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Correct answer: C — Constitutional delay of growth and puberty

Constitutional delay of growth and puberty (CDGP) is the most common cause of delayed puberty. Features include a family history of late puberty (especially in the father), delayed bone age, and low-normal gonadotropins. It is a diagnosis of exclusion. A short course of low-dose testosterone (e.g. testosterone enanthate 50–100 mg IM monthly for 3–6 months) may be offered to 'kickstart' puberty.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Delayed Puberty