青春期延迟的临床特征和病因:苏丹某三级医疗中心15年的经验

Marwa S. Galal, Salwa A. Musa, Omer O. Babiker, H. Hamdan, M. Abdullah
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摘要

【摘要】目的青春期延迟是内分泌门诊的常见表现,成人身高、性能力和生育能力是儿童及其家庭关注的主要问题。表现是可变的,包括身材矮小和/或没有第二性征。病因可以是体质性、功能性或永久性促性腺功能减退症、永久性高促性腺功能减退症或未分类。尽管这个问题很重要,但苏丹没有发表任何出版物。方法采用回顾性医院研究。回顾了所有在Gaffar Ibn Auf儿童医院内分泌科就诊并被诊断为青春期延迟的患者的记录,并获得了人口统计学、临床和调查数据。结果本研究共纳入136例患者。表现包括身材矮小的占52.2%,身材矮小和青春期延迟的占27.2%,青春期延迟的占20.6%。最常见的病因是永久性促性腺功能低下和功能性促性腺功能低下,分别占37.5%和36%,而体质性生长迟缓和青春期发育迟缓仅占14.7%。1型糖尿病(T1DM)是最常见的慢性疾病,其次是乳糜泻。11.7%诊断为促性腺激素亢进性性腺功能减退,其中以女性居多。本系列报告的病因学模式强调了营养和总体健康在青春期发育中的作用,以及遗传和血缘对疾病模式的主要影响。来自非洲国家的数据有限,这是苏丹首次报道的关于青春期延迟的队列。
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Clinical profile and aetiologies of delayed puberty: a 15 years’ experience from a tertiary centre in Sudan
Abstract Objectives Delayed puberty is a common presentation to endocrine clinics, with adult height, sexual capability and fertility being the main concerns for the child and his/her family. Presentation is variable including short stature and/or absence of secondary sexual characteristics. The aetiology can either be constitutional, functional or permanent hypogonadotropic hypogonadism, permanent hypergonadotropic hypogonadism or unclassified. Despite the importance of this subject, there are no publications from Sudan. Methods A retrospective hospital-based study. Records of all patients who were seen in the endocrinology unit at Gaffar Ibn Auf Children’s Hospital and were diagnosed as having delayed puberty were reviewed and demographic, clinical, and investigations data were obtained. Results A total of 136 patients were included in this study. Presentation includes short stature in 52.2%, both short stature and delayed puberty in 27.2%, and delayed puberty in 20.6%. The most common aetiologies were permanent hypogonadotropic hypogonadism and functional hypogonadotropic hypogonadism presented in 37.5% and 36% respectively, while constitutional delay of growth and puberty was found in only 14.7%. Type 1 diabetes mellitus (T1DM) was the most frequent chronic illness followed by coeliac disease. Hypergonadotropic hypogonadism was diagnosed in 11.7%, the majority of which were females. Conclusions The aetiological pattern reported in this series highlights the role of nutrition and general well-being in pubertal development, as well as the major impact of genetics and consanguinity on disease patterns. Data from African countries are limited and this is the first reported cohort on delayed puberty from Sudan.
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