Child with primary amenorrhoea with negative progesterone challenge test but positive combined progesterone and estrogen test. Diagnosis may be :
Ans. is d i.e. Prolactinoma This child is presenting with - Primary amenorrhea with : Negative progesterone challenge test - which rules out PCOD - (otherwise too, PCOD is a cause of secondary amenorrhea). When next step was done i.e., estrogen, progesterone combined test - It comes out to be positive i.e., compament I system (uterus, endometrium and outflow tract) is normal if properly stimulated by estrogen which rules out mullerian agenesis and ashermann syndrome. Positive estrogen progesterone combined test means the defect is in the production of estrogen i.e., either ovaries, pitutary or hypothalmus. So from the given options we have to look for a cause which involves either of the above sites. which in this case is prolactinoma.
Mullerian agenesis
PCOSD
Asherman syndrome
Prolactinoma