Endocrine Abstracts

Adolescence is a critical period of development, during which the immature child acquires physical and emotional maturity. The pituitary undergoes characteristic changes in physical appearance and function that help orchestrate these developmental changes. Adolescents may have congenital pituitary insufficiency affecting single hormones, or insufficiency of all anterior and posterior anterior pituitary hormones, most commonly in the context of septo-optic dysplasia. Adolescence with septo-optic dysplasia may also experience visual impairment, special educational needs and autism, requiring particular attention and consideration at the time of transition to adult services. Acquired pituitary conditions include pituitary adenomas, most commonly prolactinoma in girls in the adolescent age group, and pituitary insufficiency due to brain injury or brain tumours and their treatment. Craniopharyngioma and germinoma show a peak in incidence during the adolescent years, while the cognitive and endocrine consequences of radiotherapy for brain tumours affecting younger children may become evident during this time. The experience of a life-threatening condition, and its treatment, pose unique challenges during adolescence when peer relationships become increasingly important together with a move towards independence from parents. Tumour treatment, lost time from school, time away from friends and greater dependence on parents may disrupt normal patterns of emotional, psychological and physical development. In this talk, we will use a case of a young patient diagnosed with a germinoma in early adolescence, to discuss the evolution of pituitary insufficiency and its treatment in the context of normal pituitary function during adolescence and consider how the disease and its treatment affects such patients as they move towards adult life.