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Constitutional delay of growth and puberty — SCE Endocrinology MCQ

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ModerateReproductive EndocrinologyConstitutional delay of growth and pubertySCE Endocrinology

A 15-year-old boy has delayed puberty. Height is on the 9th centile, testes are 3 mL bilaterally and bone age is delayed by 2 years. His father entered puberty late. LH, FSH and testosterone are low-normal for prepuberty and smell is normal. What is the most likely diagnosis?

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Correct answer: C — Constitutional delay of growth and puberty

Delayed bone age, family history and otherwise normal health favour constitutional delay. Kallmann syndrome would often have anosmia and persistent hypogonadotrophic hypogonadism. The pearl is that testicular volume is central to assessing male pubertal progression.

Reference: British Society for Paediatric Endocrinology guidance