Key Diagnostic Finding in a Condition with Variable Clinical Presentations

Table 1

Patient data.

Age of; patient; in years	Reason; for referral	Pubertal staging			Laboratory evaluation
		Testes; Length in cm	Tanner; Stage Pubic hair	Penis	FSH IU/L; (normal range) [1]	LH; IU/L; (normal range) [1]	Testosterone; nmol/L; (normal range) [2]
Case 1: 16	Short; stature	2	3	Adult	15.03; (0.16–3.7)	12.04; (0.25–2.7)	14.65 (<0.17)
Case 2: 16.5	Gynecomastia	3.2	4	Adult	37.5; (0.18–12)	28.2; (0.34–5.0)	11.24 (<5.79)
Case 3: 19	Delayed; puberty	3	4	Adult	14.6; (0.18–12)	17; (0.34–5.0)	13.15 (<5.79)
Case 4: 17	Germ cell; tumor and; small testes	2.5	5	Adult	16.13; (0.18–12)	32; (0.34–5.0)	4.788 (<5.79)

Legend: testes <2.5 cm are prepubertal [3] and 2.5–3.2 cm represent first stage of puberty. Normal ranges of FSH, LH, and testosterone in parenthesis are 2.5th to 97.5th percentile values for corresponding testicular pubertal stage. Though all patients are of similar age range, their testicular pubertal stage is different and hence their normal testosterone levels are different.