Answers To Case 45 Amenorrhea Primary Miillerian Agenesis

Summary: A 17-year-old nulliparous female, who may have only one kidney, presents with primary amenorrhea. She denies weight loss or excessive exercise. On examination, she is 5 ft 6 inches tall and weighs 140 lb. Her blood pressure is 1 10/60. Her thyroid gland is normal. She has appropriate Tanner stage IV breast development, axillary and pubic hair, and female external genitalia.

^ Most likely diagnosis: Miillerian (or vaginal) agenesis. ♦ Next step in diagnosis: Serum testosterone level or karyotype.

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