Kulshreshtha Bindu, Khadgawat Rajesh, Gupta Nandita, Ammini Ariachery
Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, Delhi, India.
Indian J Endocrinol Metab. 2013 Sep;17(5):851-4. doi: 10.4103/2230-8210.117245.
Onset of puberty in boys usually occurs by 14 years of age. Some boys may exhibit delayed sexual maturation till about 17-18 years of age. However, pubertal onset beyond 18 years of age is exceedingly rare.
Patients diagnosed as idiopathic hypogonadotropic hypogonadism (IHH) who had onset of puberty (increase in testicular volume >10 ml) while on androgen therapy were studied. These patients were evaluated prospectively.
There were nine subjects that were included in the study. The pre-therapy testicular volumes ranged from 3 to 6 ml. Luteinizing hormone (LH) levels increased from 1.2 ± 0.96 to 2.8 ± 1.0 IU/L, follicular stimulating hormone (FSH) levels increased from 1.5 ± 0.79 to 3.5 ± 1.9 IU/L, and testosterone increased from 0.36 ± 0.16 to 3.4 ± 2.1 ng/ml. Three out of nine patients had testosterone levels below 3 ng/ml.
Our present study indicates that pubertal development can occur in patients presenting with hypogonadotropic hypogonadism after 18 years of age. However, acquired pubertal status may be subnormal.
男孩青春期通常在14岁时开始。一些男孩的性成熟可能会延迟至17 - 18岁左右。然而，18岁以后出现青春期启动的情况极为罕见。
对诊断为特发性低促性腺激素性性腺功能减退（IHH）且在接受雄激素治疗期间出现青春期启动（睾丸体积增加>10 ml）的患者进行研究。对这些患者进行前瞻性评估。
该研究纳入了9名受试者。治疗前睾丸体积为3至6 ml。促黄体生成素（LH）水平从1.2±0.96 IU/L升至2.8±1.0 IU/L，促卵泡生成素（FSH）水平从1.5±0.79 IU/L升至3.5±1.9 IU/L，睾酮水平从0.36±0.16 ng/ml升至3.4±2.1 ng/ml。9名患者中有3名睾酮水平低于3 ng/ml。
我们目前的研究表明，18岁以后出现低促性腺激素性性腺功能减退的患者可能会发生青春期发育。然而，获得的青春期状态可能未达正常水平。
