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J Korean Med Assoc > Volume 52(8); 2009 > Article
Suh: Endocrine Diseases in Adolescence

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.

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