[Diagnosis of delayed puberty]. / Diagnostic des retards pubertaires.

Puberty is the phenomenon that conducts once to reproductive maturation. Delayed puberty (DP) is defined by the absence of testicular development in boys beyond 14 years old (or a testicular volume lower than 4 ml) and by the absence of breast development in girls beyond 13 years old. DP occurs in approximatively 3% of cases. Most cases are functional DP, with a large amount of constitutional delay of puberty. Others etiologies are hypogonadotrophic hypogonadism like Kallmann syndrome, or hypergonadotrophic hypogonadism. Turner syndrome is a diagnostic one should not forget by its frequency. Treatment is hormonal replacement therapy and of the etiology. During the last decade, many genes have been identified and elucidated the etiological diagnosis of some hypogonadotrophic hypogonadism syndrome. Further studies are required in collaboration with molecular biologists to better understand the mechanism of hypothalamic pituitary gonadal axis abnormalities and of the neuroendocrine physiology of the onset of puberty.

[Acute transverse myelitis associated with Mycoplasma pneumoniae infection in an eight year old boy]. / Myélite aiguë transverse a Mycoplasma pneumoniae chez un enfant de huit ans.

Many Mycoplasma pneumoniae extra respiratory infections have already been reported. The authors report the case of an eight year old child, presenting with acute transverse myelitis, with a PCR proven involvement of M. pneumoniae in CSF as well as the presence of specific IgM in blood. Acute transverse myelitis may have many causes, most of the time viral. The mechanisms of neurological involvement in M. pneumoniae infections are still unclear, but several points indicate an immune reaction. Corticotherapy first i.v. then per os has proved to be an efficient treatment for acute myelitis. Antibiotherapy is discussed because of the undocumented mechanisms of neurological involvement related to the mycoplasma.