title: [Puberty, fertility and chronic diseases].
abstract: The onset of puberty is the sum of complex and multifactorial mechanisms resulting from the action of both activating and inhibiting factors, leading to the maturation of the gonads and the ability to reproduce. Many contributors to pubertal development are involved in fat mass acquisition and their action is relayed through the hypothalamus. It is therefore easy to understand how chronic diseases can affect the development of puberty and fertility apart from the specific impact of their molecular alteration. We have chosen cystic fibrosis and chronic renal disease as examples of chronic disorders affecting puberty through distinct mechanisms. As drugs are undistinguishable from chronic diseases, we also describe the impact of corticosteroids and chemotherapy on reproductive function. Last, we describe the surveillance and care of pubertal delay and its consequences (growth and bone mineralization) of patients affected with chronic disorders during adolescence.
authors.affiliation: Service d'endocrinologie et diabétologie de l'enfant, université Paris 11, hôpital Bicêtre Paris-Sud, AP-HP, 78, avenue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France.
authors.forename: A
authors.initials: A
authors.lastname: Thébaut
authors.forename: M
authors.initials: M
authors.lastname: Amouyal
authors.forename: A
authors.initials: A
authors.lastname: Besançon
authors.forename: M
authors.initials: M
authors.lastname: Collet
authors.forename: E
authors.initials: E
authors.lastname: Selbonne
authors.forename: C
authors.initials: C
authors.lastname: Valentin
authors.forename: M
authors.initials: M
authors.lastname: Vonthron
authors.forename: M
authors.initials: M
authors.lastname: Zakariya
authors.forename: A
authors.initials: A
authors.lastname: Linglart
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D002908:Chronic Disease; D003550:Cystic Fibrosis / Q000150:complications / Q000503:physiopathology; D064420:Drug-Related Side Effects and Adverse Reactions; D005298:Fertility / Q000502:physiology*; D006058:Gonadal Disorders / Q000209:etiology; D006801:Humans; D007031:Hypothalamus / Q000503:physiopathology; D011627:Puberty / Q000502:physiology*; D011628:Puberty, Delayed / Q000150:complications; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000503:physiopathology
chemical_list: D000305:Adrenal Cortex Hormones