Pubertal delay

# Overview
Delayed onset of puberty is considered 14 years old in girls and 15 years old in boys. Most frequently, the delay is due to a constitutional, non-pathologic delay in growth and puberty.

# Causes

## Common Causes 
- Anorexia Nervosa
- Cardiac conditions
- Celiac Sprue
- Chronic infection
- Chronic metabolic disorder
- Chronic Renal Failure
- Cushing syndrome
- Heavy physical excercise
- Hyperprolactinemia
- Hypothyroidism
- Iatrogenic
- Inflammatory Bowel Disease
- Kallmann's Syndrome
- Kleinfelter's syndrome (Boys)
- Malignancy
- Malnutrition
- Multiple tropic hormone deficiency
- Noonan's Syndrome
- Prader-Willi Syndrome
- Somatotropin deficiency
- Turner's syndrome

## Causes by Organ System

## Causes in Alphabetical Order
- Addison's disease
- Adiposogenital dystrophy
- Adrenal failure
- Adrenal hypoplasia congenital
- Alopecia
- Alpha thalassemia
- Anabolic steroids
- Anemia
- Anophthalmia
- Anorchism
- Anorexia nervosa
- Ataxia
- Autoimmune disease
- Autoimmune ovarian failure
- Autoimmune thyroid disease
- Bangstad syndrome
- Bassoe syndrome
- Beta thalassemia
- Biedl-bardet syndrome
- Biemond syndrome type 2
- Bird-headed dwarfism
- Bosma-henkin-christiansen syndrome
- Bulimia nervosa
- Bullous dystrophy
- Camurat-engelmann disease
- Cantu sanchez-corona fragoso syndrome
- Cardiac conditions
- Castration
- Cataract deafness hypogonadism
- Celiac disease
- Celiac sprue
- Central nervous system tumours
- Chemotherapy
- Chondrodysplasia punctata with steroid sulfatase deficiency
- Chromophobe adenoma
- Chromosome 13 ring syndrome
- Chromosome 14 uniparental disomy syndrome
- Chromosome 3, monosomy 3p2
- Chromosome 9, trisomy 9p
- Chronic illness
- Chronic infection
- Chronic metabolic disorder
- Chronic renal failure
- Cockayne syndrome type 1
- Cohen syndrome
- Collagenous celiac disease
- Combined pituitary hormone deficiency
- Congenital adrenal hyperplasia
- Congenital hypopituitarism
- Congenital hypothyroidism
- Congenital spherocytic hemolytic anemia
- Connective-tissue diseases
- Constitutional delay
- Crandall syndrome
- Craniopharyngioma
- Crohn's disease
- Cushing syndrome
- Cyanotic congenital heart disease
- Cystic fibrosis
- Cytotoxic drugs
- Deafness neurosensory
- Diamond-blackfan anemia
- Ectodermal dysplasia
- Eunuchoidism familial
- Excess thyroid hormone consumption
- Excessive exercise
- Fabry disease
- Familial dysautonomia
- Female reproductive toxicity
- Fibromatosis multiple non ossifying
- Fleisher syndrome
- Forbes disease
- Frasier syndrome
- Froelich's syndrome
- Fshb mutation
- Germinoma
- Glioma
- Gluten enteropathy
- Glycogen debranching deficiency
- Gonadal dysgenesis epibulbar dermoid
- Gonadotropin deficiency
- Granulomas
- Growth hormone deficiency
- Hall-riggs mental retardation syndrome
- Haspeslagh fryns muelenaere syndrome
- Head trauma
- Heavy physical excercise
- Hersh-podruch-weisskopk syndrome
- Hydrocephalus obesity hypogonadism
- Hyperprolactinemia
- Hyperthyroidism
- Hypogonadism
- Hypogonadotrophic hypogonadism
- Hypopituitarism
- Hypothalamic cyst
- Hypothalamic damage
- Hypothalamic dysfunction
- Hypothalamic infection
- Hypothalamus disease
- Hypothyroidism
- Iatrogenic
- Ichthyosis male hypogonadism
- Image syndrome
- Infantile hypothyroidism
- Infections
- Inflammatory bowel disease
- Insulin-resistance syndrome
- Intrauterine growth retardation
- Isolated gonadotropin deficiency
- Juvenile arthritis
- Kallmann's syndrome
- Kleinfelter's syndrome
- Kwashiorkor
- Lack of gonadotrophin-releasing hormone
- Laron pituitary dwarfism
- Laron syndrome
- Laurence-moon-biedl syndrome
- Low body weight
- Luteinizing hormone deficiency
- Lymphangiectasies
- Lymphoedema
- Lyndi's syndrome
- Malabsorption syndrome
- Malignancy
- Malnutrition
- Malouf syndrome
- Mandibuloacral dysplasia
- Marinesco-sjogren syndrome
- Masculinizing tumor of ovary
- Meningioma
- Mental retardation
- Metaphyseal undermodeling
- Microcephaly
- Mixed gonadal dysgenesis
- Mullerian agenesis
- Multiple tropic hormone deficiency
- Mumps
- Mumps orchitis
- Myopathy
- Neuroectodermal endocrine syndrome
- Niemann-pick disease
- Noonan's syndrome
- Optic chiasma glioma
- Ovarian cysts
- Ovarian dysgenesis
- Ovarian torsion
- Panhypopituitarism
- Persistent major infection
- Pituitary adenoma
- Pituitary gland abscess
- Pituitary gland cyst
- Pituitary gland damage
- Pituitary gland infection
- Pituitary gland tumor
- Prader-willi syndrome
- Prenatal dwarfism
- Primary gonadal failure
- Prolactinoma
- Pterygia
- Pure dysgenesis
- Pure red cell aplasia
- Radiation therapy
- Refractory celiac disease
- Resistant ovary syndrome
- Retinitis pigmentosa
- Richards-rundle syndrome
- Salti-salem syndrome
- Schaap-taylor-baraitser syndrome
- Schofer beetz bohl syndrome
- Sengers-hamel-otten syndrome
- Serious emotional stress
- Serious ovarian infection
- Serious testicular infection
- Shprintzen-golberg craniosynostosis
- Sickle cell anemia
- Singh-chhaparwal-dhanda syndrome
- Sohval-soffer syndrome
- Somatotropin deficiency
- Spastic paraplegia with kallmann syndrome
- Spinocerebellar ataxia
- Thyroid agenesis
- Torsion of the testis
- Trauma
- Tricho-hepato-enteric syndrome
- Tuberculosis
- Turner's syndrome
- Type 1 diabetes
- Type iii glycogen storage disease
- Ulnar-mammary syndrome of pallister
- Underactive thyroid gland
- Undescended testes
- Vascular lesions
- William's syndrome
- Woodhouse sakati syndrome
- X-irradiation
- Zinc deficiency
-  Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
-  Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X