The classical definition of hypogonadism, used in adult medicine, as gonadal failure resulting in deficient steroid and gamete production, and its classification into hypergonadotropic and hypogonadotropic refer to primary gonadal and hypothalamic-pituitary disorders respectively and may lead to under- or misdiagnosis in pediatrics. Indeed, in children with primary gonadal failure, gonadotropin levels may be within the reference range for age. Conversely, since gonadotropins and steroids are normally low during childhood, it may prove impossible to show the existence of a hypogonadotropic state before pubertal age. Anti-Müllerian hormone (AMH) and inhibin B arise as more adequate biomarkers to assess gonadal function and increase the possibility of making an earlier diagnosis of hypogonadism in children, which may positively impact on timely management.

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儿科健康中的性腺机能减退：成人医学概念失败

成人医学中使用的性腺功能减退症的经典定义是导致类固醇和配子生成不足的性腺功能衰竭，并将其分为促性腺激素过多症和促性腺激素过少症，分别是指原发性性腺疾病和下丘脑-垂体疾病，可能导致儿科诊断不足或误诊。事实上，在原发性性腺功能衰竭的儿童中，促性腺激素水平可能在年龄的参考范围内。相反，由于儿童时期促性腺激素和类固醇水平通常较低，因此可能无法证明青春期前存在促性腺激素减退状态。抗苗勒管激素 (AMH) 和抑制素 B 作为更充分的生物标志物来评估性腺功能并增加早期诊断儿童性腺功能减退症的可能性，