Minipuberty: A Clinical Case
Objective of the Paper: To present a clinical case of a patient with significant signs of minipuberty and describe an algorithm for differential diagnosis between this phenomenon and various disorders with similar clinical manifestations.
Key Points: This paper describes a rare clinical case of minipuberty in a three-month-old boy. At the first examination the testicular volume, as measured by Prader orchidometer, was 6 mL (normal value <4 mL for prepubertal boys). A second examination, at the age of 6 months (by which time minipuberty has normally ended), found that testicular volume had described to 4 mL on the left and 5 mL on the right, which was evaluated as resolution of minipuberty.
Differential diagnosis ruled out the following disorders: pituitary, hypothalamic, adrenal, and testicular tumors (normal hormone levels and the absence of signs of progressing puberty), McCune-Albright-Braitsev syndrome (absence of cafe-au-lait spots or signs of progressing puberty), testotoxicosis (absence of signs of progressing puberty, advanced osseous maturation, or elevated testosterone levels at the age of one year), congenital dysfunction of the adrenal cortex (normal 17-hydroxyprogesterone levels), and hypothyroidism (normal thyroid-stimulating hormone levels and non-delayed psychomotor and physical development).
Conclusion: Minipuberty is viewed as a variant of the normal physiological development of the male reproductive system. The diagnostic algorithm for suspected minipuberty includes physical examination, assessment of pubertal development using the Tanner scale (including measurement of testicular size), and monitoring (second examination at six months of age). Since the boy did not have any signs of progressing puberty, no additional examinations were required. Hormone levels were measured at the age of one to confirm that the period of minipuberty had ended.
Contribution: Egoryan, L.B. was responsible for observation and examination of the patient, analysis and interpretation of the data, and review of relevant publications. Vitebskaya, A.V. participated in observation and examination of the patient and analysis and interpretation of data, and approved the final version of the manuscript submitted for publication. Starostina, L.S. contributed to observation and examination of the patient and approved the final version of the manuscript submitted for publication.
Conflict of interes: The authors declare that they do not have any conflict of interests.
L.B. Egoryan — I.M. Sechenov First Moscow State Medical University (Sechenov University), Russian Ministry of Health; 19 Bolshaya Pirogovskaya Str., Moscow, Russian Federation 119881. E-mail: firstname.lastname@example.org
A.V. Vitebskaya — I.M. Sechenov First Moscow State Medical University (Sechenov University), Russian Ministry of Health; 19 Bolshaya Pirogovskaya Str., Moscow, Russian Federation 119881. eLIBRARY.RU SPIN: 6977-0200. E-mail: email@example.com
L.S. Starostina — I.M. Sechenov First Moscow State Medical University (Sechenov University), Russian Ministry of Health; 19 Bolshaya Pirogovskaya Str., Moscow, Russian Federation 119881. eLIBRARY.RU SPIN: 6977-0200. E-mail: firstname.lastname@example.org
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