Evaluation of the hypothalamic-pituitary-adrenal axis function in childhood and adolescence.
The hypothalamic-pituitary-adrenal (HPA) axis plays an important role in the maintenance of basal and stress-related homeostasis. The hypothalamus controls the secretion of adrenocorticotropic hormone (ACTH) from the anterior pituitary, which in turn stimulates the secretion of glucocorticoids from the adrenal cortex. Glucocorticoids, the final effectors of the HPA axis, regulate a broad spectrum of physiologic functions essential for life and exert their effects through their ubiquitously distributed intracellular receptors. Alterations in the activity of the HPA axis may present with symptoms and signs of glucocorticoid deficiency or excess. Detailed endocrinologic evaluation is of primary importance in determining the diagnosis and/or etiology of the underlying condition. We review the most common endocrinologic investigations used in the evaluation of the HPA axis integrity and function.
Chrousos
George P
GP
Division of Endocrinology and Metabolism, Clinical Research Center, Biomedical Research Foundation of the Academy of Athens, Athens, Greece.
Kino
Tomoshige
T
Charmandari
Evangelia
E
D000293:Adolescent; D002648:Child; D019411:Clinical Laboratory Techniques / Q000592:standards / Q000639:trends; D003940:Diagnostic Techniques, Endocrine / Q000592:standards / Q000639:trends*; D004700:Endocrine System Diseases / Q000175:diagnosis* / Q000503:physiopathology; D005938:Glucocorticoids / Q000032:analysis / Q000378:metabolism*; D006801:Humans; D007028:Hypothalamic Hormones / Q000032:analysis / Q000378:metabolism; D007030:Hypothalamo-Hypophyseal System / Q000254:growth & development / Q000503:physiopathology*; D009490:Neurosecretory Systems / Q000254:growth & development / Q000503:physiopathology*; D010912:Pituitary-Adrenal Function Tests / Q000379:methods / Q000592:standards / Q000639:trends; D010913:Pituitary-Adrenal System / Q000254:growth & development / Q000503:physiopathology*
D005938:Glucocorticoids; D007028:Hypothalamic Hormones