ESPE Abstracts

Objectives: This retrospective and descriptive study aim to study the frequency of children who have a pubertal delay and who are followed at the Department of Pediatrics II at the Children’s Hospital of Rabat. Materials and Methods: Among 1850 records collected, 24 patient records that meet the criteria for inclusion. A delay in the appearance of sexual characters: the lack of breast development after the age of 13.5 years in the girl and the lack of increase in the size of the testicles beyond 14 years in the boy.

Results: 24 patients (9 Girls and 15 Boys) who have a pubertal delay, the sex Ratio is 1.66. Their average age of diagnosis is 15.9 years (extremes: 11-18.8 years). Patients were consulted for small size (-2DS,-3DS) and absence of secondary sexual characteristics. 74% of patients have a weight between -4DS and -2DS, 87% have severe statural delay (-4DS,-3DS). 66% of girls and 53% of boys are pre-pubescent (stage I) according to Tanner and 34% of girls compared to 47% of boys are stage II. The metabolic balance of gonadotropins shows a high rate of FSH in 7% of boys (33.7 mUI/ml) and in 56% of girls, 15% of boys and 22% of girls has an average value. Serum LH is 2mUI/ml in 67% of boys and 22.2% of girls. 77% (13/15) of boys have low testosterone. Estradiol levels are low at 100% (9/9) of girls. Cytogenetic analysis shows 17% (4/24) of patients have Turner syndrome with a karyotype with partial or complete deletion of one of the X chromosomes (45 XX0 or 45XXq), a patient has Klinefelter syndrome with karyotype 49 XXXXY. The radiological examination shows a chronological age-bone age difference ranging from 1 year to 6 years (average: 4.6 years). All our patients have a pubertal development delay and a staturo-weight delay, 60% of which have an AO-AC difference between 4 and 6 years.

Conclusion: This original work shows the frequency of pubertal delay in children and its origin is central due to abnormalities of the hypothalamo-hypophyseal axis (genetic syndromes with hypergonadotropin hypogonadism or hypogonadotropin) or peripheral by abnormalities of gonad function. The pubertal delay is associated with moderate statural inflection and bone maturation delay.