220
The causes of functional hypogonadotropic hypogonadism include anorexia
nervosa and chronic systemic illness like celiac disease, Crohn’s disease,
nephrotic syndrome, and rheumatoid arthritis. The causes of permanent hypo-
gonadotropic hypogonadism include congenital isolated hypogonadotropic
hypogonadism, congenital multiple pituitary hormone deficiency, and tumors/
cysts in sellar–suprasellar region. Turner syndrome, Klinefelter syndrome, and
post-chemotherapy/gonadal irradiation are the common causes of hypergonad-
otropic hypogonadism (Fig. 7.4).abFig. 7.4 (a) An 18-year-old girl with poor development of secondary sexual characteristics due to
hypogonadotropic hypogonadism, (b) Tanner breast stage B 1 in the same patient
7 Delayed Puberty