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Puberty in chronically diseased patients.

Dominique Simon1

  • 1Service d'Endocrinologie et Diabétologie Pédiatriques, Hôpital Robert Debré, Paris, France. dominique.simon@rdb.ap-hop-paris.fr

Hormone Research
|June 18, 2002
PubMed
Summary

Chronic diseases disrupt puberty and growth through nutritional issues, hormonal imbalances, and medications like corticosteroids. These factors collectively impair pubertal development and growth spurts in affected individuals.

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Area of Science:

  • Pediatric Endocrinology
  • Chronic Disease Management
  • Growth and Development

Background:

  • Chronic diseases frequently lead to delayed puberty and diminished pubertal growth spurts.
  • The causes of abnormal puberty in chronic illness are complex and multifactorial.
  • Nutritional deficits, increased energy demands, and disease-specific factors contribute to these issues.

Purpose of the Study:

  • To explore the multifactorial basis of abnormal puberty and growth in patients with chronic diseases.
  • To identify key factors including nutritional status, hormonal axes, and medication effects.

Main Methods:

  • Review of literature on growth and puberty in chronic conditions like renal failure, cystic fibrosis, Crohn's disease, and juvenile idiopathic arthritis.
  • Analysis of the impact of nutritional deficiencies, energy requirements, and inflammatory cytokines.
  • Assessment of the role of the growth hormone (GH)-insulin-like growth factor (IGF)-1 axis and gonadotrophin secretion.

Main Results:

  • Nutritional deficiencies, including malabsorption and eating disorders, significantly impact growth and pubertal timing.
  • Chronic diseases affect the GH-IGF-1 axis and gonadotrophin secretion, disrupting normal development.
  • Inflammatory cytokines and corticosteroid medications are identified as contributors to delayed puberty and impaired growth.

Conclusions:

  • Abnormal puberty and growth in chronic diseases result from a combination of nutritional, hormonal, inflammatory, and iatrogenic factors.
  • Understanding these multifactorial influences is crucial for managing growth and pubertal development in pediatric patients with chronic illnesses.

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