Endocrine Diseases in Adolescence

Byung-Kyu Suh

doi:10.5124/jkma.2009.52.8.758

Journal List > J Korean Med Assoc > v.52(8) > 1042190

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Suh: Endocrine Diseases in Adolescence

Focused Issue of This Month

Health Care in Adolescents

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2009; 52(8): 758-767.

Published online: 31 August 2009

DOI: https://doi.org/10.5124/jkma.2009.52.8.758

Endocrine Diseases in Adolescence

Byung-Kyu Suh, MD

Department of Pediatric Endocrinology, Catholic University of Korea, College of Medicine, Korea. suhbk@catholic.ac.kr

Abstract

Adolescence marks the transition from childhood to adult life and is characterized by a myriad of physical and emotional changes. The peak height velocity occurs during this period, secondary sexual characteristics emerge to accomplish sexual maturity, and the development of abstract thinking gives the child a fully independent person. Puberty begins with the activation of the hypothalamus-pituitary-gonadal axis, resulting in the release of gonadotropin-releasing hormone from the hypothalamus, and the subsequent production of the gonadotropins, luteinizing hormone and follicle-stimulating hormone, from the pituitary, and the sex hormones from the testes and ovaries. Increased levels of the sex hormones stimulate the production of growth hormone and insulin-like growth factor-I leading to the growth spurt. As a result, an endo-crine problem during puberty with a single hormone may lead to abnormalities of other hormones that are inextricably linked, culminating in disorders of growth and pubertal development. Common endocrine problems of childhood and adolescence, including thyroid disorders, precocious puberty, premature thelarche, which may be classified as a variant of precocious puberty, and gynecomastia, have been explained in some detail. Delayed treatment of thyroid disorders may lead to emotional disability and growth retardation. Possible causes of precocious puberty should be explored and treated in order to minimize endocrine complications. Potential cases of normal physiologic development such as premature thelarche and gynecomastia should be diagnosed accurately to avert a series of unnecessary diagnostic tests and attempts at treatment.

Keywords: Adolescent, Thyroid Diseases, Puberty, Precocious, Gynecomastia

References

1. Rosenfeld RL, Cooke DW, Radovick S. Sperling MA, editor. Puberty and its disorders in the female. Pediatr Endocrinology. 2008. 3rd ed. Philadelphia: WB sauners;530–609.

2. Weetman A. Braverman LE, Utiger RD, editors. Chronic autoimmune thyroiditis. Werner & Ingbar's the thyroid: a fundamental and clinical text. 2005. 9th ed. Philadelphia: Lippincott Williams & Wilkins;701–713.

3. Amino N, Hidaka Y. DeGroot LJ, Jameson JL, editors. Chronic(Hashimoto's)thyroiditis. Endocrinology. 2006. Fifth ed. Philadelphia: Elsevier Saunders;2055–2067.

4. Braverman LE, Farwell AP, Pearce EN. Thyroiditis. New Engl J Med. 2004. 348:2646–2655.

5. Simmonds MJ, Gough SC. Genetic insights into disease mechanisms of autoimmunity. Br Med Bul. 2004. 71:93–113.

6. Kontiainen S, Koskimies S, Nyberg M, Lautenschlager I, Menp J. Thyroid-infiltrating lymphocytes, thyroid function, and HLA-DR in juvenile autoimmune thyroiditis. Acta endocrinol. 1989. 121:573–577.

7. Badenhoop K, Pasquino AM, Pani MA, Segni M. Familial clustering of juvenile thyroid autoimmunity: higher risk is conferred by human leukocyte antigen DR3-DQ2 and thyroid peroxidase antibody status in fathers. J Clin Endocrinol Metab. 2002. 87:3779–3782.

8. Solcia E, Iannone AM, Cisternino M, De Silvestri A, Negrini R, Martinetti M, Calcaterra V, Larizza D. Helicobacter pylori infection and autoimmune thyroid disease in young patients: the disadvantage of carrying the human leukocyte antigen-DRB1*0301 allele. J Clin Endocrinol Metab. 2006. 91:176–179.

9. Turakulov RI, Chistiakov DA. CTLA-4 and its role in autoimmune thyroid disease. J Mol Endocrinol. 2003. 31:21–36.

10. Olson D, Sakai R, Buckingham B, Jordan SC. Studies of immune-complex glomerulonephritis mediated by human thyroglobulin. N Engl J Med. 1981. 304:1212–1215.

11. Karpatkin S, Lackner H, Blum M, Hymes K. Easy bruising, thrombocytopenia, and elevated platelet immunoglobulin G in Graves' disease and Hashimoto's thyroiditis. Ann Intern Med. 1981. 94:27–30.

12. Troncone R, Lombardi G, Petrone E, Paparo F, Micillo M, Gigante M, Scarpitta MT, Dorato M, Tommaselli AP, Savastano S, Valentino R. Prevalence of coeliac disease in patients with thyroid autoimmunity. Horm Res. 1999. 51:124–127.

13. Tyler FH, Rall JE, Keating FR, Dobyns BM, Rallison ML. Occurrence and natural history of chronic lymphocytic thyroiditis in childhood. J Pediatr. 1975. 86:675–682.

14. Hayashi Y, Tamai H, Fukata S, Hirota Y, Katayama S, Kuma K, Kumagai LF, Nagataki S. A long term clinical, immunological, and histological follow-up study of patients with goitrous chronic lymphocytic thyroiditis. J Clin Endocrinol Metab. 1985. 61:1172–1178.

15. Roth C, Scortea M, Stubbe P, Ruschenburg M, Zappel H, Becker W, Lakomek M. Autoimmune thyreoiditis in childhood-epidemiology, clinical and laboratory findings in 61 patients. Exp Clin Endocrinol Diabetes. 1997. 105:Suppl 4. 66–69.

16. Nelson JC, Johnson DE, Oddie TH, Fisher DA. The diagnosis of Hashimoto's thyroiditis. J Clin Endocrinol Metab. 1975. 40:795–801.

17. Nakajima H, Sato T, Taketani N, Inoue M. High incidence of chronic lymphocytic thyroiditis in apparently healthy school children: epidemiological and clinical study. Endocrinol Jpn. 1975. 22:483–488.

18. Lamberg BA, Gordin A. Spontaneous hypothyroidism in symptomless autoimmune thyroiditis. A long-term follow-up study. Clin Endocrinol. 1981. 15:537–543.

19. Clarke WL, Kaiser DL, Blizzard RM, Bright GM. Organ-specific autoantibodies in children with common endocrine diseases. J Pediatr. 1982. 100:8–14.

20. Aldige C, Abbassi V. Evaluation of sodium L-thyroxine (T4) requirement in replacement therapy of hypothyroidism. J Pediatr. 1977. 90:298–301.

21. DiGeorge AM, Rezvani I. Reassessment of the daily dose of oral thyroxine for replacement therapy in hypothyroid children. J Pediatr. 1977. 90:291–297.

22. Nakajima H, Inomata H, Sasaki N, Niimi H. Evaluation of L-thyroxine requirement in treatment of congenital hypothyroidism. Endocrinol Jpn. 1980. 27:733–738.

23. Davies TS. Braverman LE, Utiger RD, editors. Pathogenesis of Graves' disease. Werner & Ingbar's the thyroid: a fundamental and clinical text. 2005. 9th ed. Philadelphia: Lippincott Williams & Wilkins;457–473.

24. Pearce SHS, Kendell-Taylor P. Braverman LE, Utiger RD, editors. Genetic factors in thyroid disease. Werner & Ingbar's the thyroid: a fundamental and clinical text. 2005. 9th ed. Philadelphia: Lippincott Williams & Wilkins;407–421.

25. Zimmerman D, Hayles AB. Delange F, Fisher DA, Malvaux P, editors. Hyperthyroidism in children. Pediatric thyroidology. 1985. Basel; New York: Karger;223.

26. Pasquino AM, Pucarelli I, Mazzoncini B, Leonardi E, Segni M. Special features of Graves' disease in early childhood. Thyroid. 1999. 9:871–877.

27. Perrild H, Grüters-Kieslich A, Feldt-Rasmussen U, Grant D, Martino E, Kayser L, Delange F. Diagnosis and treatment of thyro-toxicosis in childhood. A European questionnaire study. Euro J Endocrinol. 1994. 131:467–473.

28. Dallas JS, Foley TP Jr. Lifshitz F, editor. Hyperthyroidism. Pediatric endocrinology. 1996. New York: M. Dekker;401–414.

29. Kunita H, Mizumoto H, Ikota A, Beniko M, Mashio Y. Treatment of hyperthyroidism with a small single daily dose of methimazole. Acta endocrinol Suppl (Copenh). 1988. 119:139–144.

30. Mashio Y, Beniko M, Matsuda A, Koizumi S, Matsuya K, Mizumoto H, Ikota A, Kunita H. Treatment of hyperthyroidism with a small single daily dose of methimazole: a prospective long-term follow-up study. Endocr J. 1997. 44:553–558.

31. Oettinger L, Jaffe HL, Starr P. Later results of 131-I treatment of hyperthyroidism in 73 children and adolescents: 1967 followup. J Nucl Med. 1969. 10:586–590.

32. Munro AJ, Fitzpatrick ML, Kam KC, Goolden AW. Oedema of the neck after ablation of the thyroid with radioactive iodine. Br J Radiol. 1986. 59:583–586.

33. Chin E, Gourin CG, Terris DJ. Minimally invasive thyroidectomy: basic and advanced techniques. Laryngoscope. 2006. 116:350–356.

34. Kogut MD, Weitzman JJ, Roe TF, Costin G, Buckingham BA. Hyperthyroidism in children. A reevaluation of treatment. Am J Dis Child. 1981. 135:112–117.

35. Clark OH, Duh Q, Siperstein A, Kebebew E, Ituarte P, Lal G. Should total thyroidectomy become the preferred procedure for surgical management of Graves' disease. Thyroid. 2005. 15:569–574.

36. Tanner JM, Marshall WA. Variations in pattern of pubertal changes in girls. Arch Dis Child. 1969. 44:291–303.

37. Hasemeier CM, Koch GG, Bhapkar MV, Bourdony CJ, Wasserman RC, Slora EJ, et al. Secondary sexual characteristics and menses in young girls seen in office practice: a study from the Pediatric Research in Office Settings network. Pediatrics. 1997. 99:505–512.

38. Oberfield SE, Kaplowitz PB. Reexamination of the age limit for defining when puberty is precocious in girls in the United States: implications for evaluation and treatment. Drug and Therapeutics and Executive Committees of the Lawson Wilkins Pediatric Endocrine Society. Pediatrics. 1999. 104:936–941.

39. Borges MF, Pereira GA, Ferreira BP, Reis JD, Lara BH, Resende EA. Assessment of basal and gonadotropin-releasing hormone-stimulated gonadotropins by immunochemiluminometric and immunofluorometric assays in normal children. J Clin Endocrinol Metab. 2007. 92:1424–1429.

40. Neely EK, Hintz RL, Olney RC, Habiby RL, Anhalt H, Bachrach LK, et al. A single-sample, subcutaneous gonadotropin-releasing hormone test for central precocious puberty. Pediatrics. 1996. 97:517–519.

41. Cutler GB, Feuillan PP, Jones JV, Barnes KM, Klein KO. Increased final height in precocious puberty after long-term treatment with LHRH agonists: the National Institutes of Health experience. J Clin Endocrinol Metab. 2001. 86:4711–4716.

42. Phillip M, Padoa A, Lazar L. Growth pattern and final height after cessation of gonadotropin-suppressive therapy in girls with central sexual precocity. J Clin Endocrinol Metab. 2007. 92:3483–3489.

43. Cerrone F, Cerroni F, Matrunola M, Segni M, Pucarelli I, Pasquino AM. Adult height in girls with central precocious puberty treated with gonadotropin-releasing hormone analogues and growth hormone. J Clin Endocrinol Metab. 1999. 84:449–452.

44. Grumbach MM, Kaplan SL, Mahachoklertwattana P. The luteinizing hormone-releasing hormone-secreting hypothalamic hamartoma is a congenital malformation: natural history. J Clin Endocrinol Metab. 1993. 77:118–124.

45. Grmbach MM, Kaplan SL, Kelch RP, Jenner MR. Hormonal changes in puberty: IV. Plasma estradiol, LH, and FSH in prepubertal children, pubertal females, and in precocious puberty, premature thelarche, hypogonadism, and in a child with a feminizing ovarian tumor. J Clin Endocrinol Metab. 1972. 34:521–530.

46. Cutler GB, Loriaux DL, Barnes KM, Hench KD, Pescovitz OH. Premature thelarche and central precocious puberty: the relationship between clinical presentation and the gonadotropin response to luteinizing hormone-releasing hormone. J Clin Endocrinol Metab. 1988. 67:474–479.

47. Carlson HE, Narula HS. Gynecomastia. Endocrinol Metab Clin N Am. 2007. 36:497–519.

TOOLS

Similar articles