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Congenital adrenal hyperplasia
Primary adrenal insufficiency
Adrenal cortical carcinoma
Thyroglossal duct cyst
Thyroid eye disease (NORD)
Toxic multinodular goiter
Euthyroid sick syndrome
Subacute granulomatous thyroiditis
Growth hormone deficiency
Constitutional growth delay
Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Premature ovarian failure
Polycystic ovary syndrome
Androgen insensitivity syndrome
Autoimmune polyglandular syndrome type 1 (NORD)
Multiple endocrine neoplasia
Pancreatic neuroendocrine neoplasms
Opsoclonus myoclonus syndrome (NORD)
Adrenal insufficiency: Pathology review
Adrenal masses: Pathology review
Hyperthyroidism: Pathology review
Hypothyroidism: Pathology review
Thyroid nodules and thyroid cancer: Pathology review
Parathyroid disorders and calcium imbalance: Pathology review
Diabetes mellitus: Pathology review
Cushing syndrome and Cushing disease: Pathology review
Pituitary tumors: Pathology review
Hypopituitarism: Pathology review
Diabetes insipidus and SIADH: Pathology review
Multiple endocrine neoplasia: Pathology review
Neuroendocrine tumors of the gastrointestinal system: Pathology review
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precocious puberty in p. 55, 338
adrenal steroids and p. 338
leuprolide p. 680
McCune-Albright syndrome p. 55, 714
pinealoma p. 546
precocious p. 55, 338
Jennifer K. Gates
Amanda J. Grieco, Ph.D.
Sarah Clifford, BMBS, BSc (Hons)
Sam Gillespie, BSc
Puberty is the time in an individual’s life when they physically become sexually mature and able to have children. Precocious refers to puberty occurring at an earlier age than the average age among an individual’s peers. Generally, puberty is considered precocious if it begins before the age of 8 in females and the age of 9 in males.
The hypothalamic-pituitary-gonadal axis is a system of hormone signaling between the hypothalamus, pituitary gland, and gonads, either the testes or ovaries, to control sexual development and reproduction. Gonadotropin-releasing hormone is released by the hypothalamus into the hypophyseal portal system, which is a network of capillaries connecting the hypothalamus to the hypophysis, or the pituitary. When gonadotropin-releasing hormone reaches the pituitary gland, it stimulates cells in the anterior pituitary, called gonadotrophs, to release gonadotropin hormones — luteinizing hormone and follicle-stimulating hormone — into the blood. These gonadotropin hormones then stimulate the gonads to produce specific steroids, sex hormones.
Beginning at puberty, the Leydig cells of the testes respond to the luteinizing hormone by converting more cholesterol into testosterone. In addition, the Sertoli cells of the testes respond to follicle-stimulating hormone by producing more sperm.
Precocious puberty, also known as early puberty, refers to the occurrence of secondary sexual characteristics in children before the age of 8 in girls and before the age of 9 in boys. In some children, early development is triggered by a disease such as a tumor or injury of the brain. Precocious puberty can also be a result of other pathologies such as pinealoma, McCune-Albright syndrome, and 21-hydroxylase deficiency. Treatment for precocious puberty usually involves hormone therapy or medications to suppress the early activation of the hypothalamic-pituitary-gonadal axis.
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