The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.
A 16-year-old girl with no significant past medical history presents with primary amenorrhea. Secondary sexual characteristics, such as breast development and pubic hair, started to develop 3.5 years ago. The patient reports slow progression of puberty and has not noticed any significant change in breast tissue in the past 3.5 years.
She denies any acne, hirsutism, hair loss, abdominal or pelvic pain, headache, or changes in vision. She has normal appetite and bowel movements. She has no desire to lose weight. The patient also reports no change in her diet or exercise regimen and is currently not taking any medications.
The patient has never been sexually active. She has no history of cancer, surgeries, chemotherapy, or radiation exposure. Her birth history is unremarkable, and all of her developmental milestones have been age-appropriate. She has no family history of infertility or delayed puberty.
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Cite this: Varshini Chakravarthy, Sehar Ejaz. A 16-Year-Old With Amenorrhea and Delayed Breast Development - Medscape - Jan 14, 2020.