Development of secondary sexual characters in a case of idiopathic hypogonadotropic hypogonadism

We report a rare case of idiopathic hypogonadotropic hypogonadism in a 15 year old adolescent girl, who presented in gynecology outpatient clinic with complaint of primary amenorrhea and poor development of secondary sexual characters. Her clinical examination revealed small, underdeveloped breasts (Tanner stage II), absent axillary hair and sparse pubic hair (Tanner stage II). Ultrasound pelvis showed uterus of 4.76 x 2.29 x 1.25 centimeter, small and hypoplastic with very thin endometrial lining, bilateral ovaries were small with 1-2 small follicles. Magnetic Resonance Imaging (MRI) of the hypothalamic-pituitary unit showed no abnormality. Further workup was done to detect other causes of hypogonadism, which was normal, hence we concluded the patient to have idiopathic hypogonadotropic hypogonadism.