title: Early and late endocrine effects in pediatric central nervous system diseases.
abstract: Endocrinopathies are frequently linked to central nervous system disease, both as early effects prior to the disease diagnosis and/or late effects after the disease has been treated. In particular, tumors and infiltrative diseases of the brain and pituitary, such as craniopharyngioma, optic pathway and hypothalamic gliomas, intracranial germ cell tumor, and Langerhans cell histiocytosis, can present with abnormal endocrine manifestations that precede the development of neurological symptoms. Early endocrine effects include diabetes insipidus, growth failure, obesity, and precocious or delayed puberty. With improving prognosis and treatment of childhood brain tumors, many survivors experience late endocrine effects related to medical and surgical interventions. Chemotherapeutic agents and radiation therapy can affect the hypothalamic-pituitary axes governing growth, thyroid, gonadal, and adrenal function. In addition, obesity and metabolic alterations are frequent late manifestations. Diagnosing and treating both early and late endocrine manifestations can dramatically improve the growth, well-being, and quality of life of patients with childhood central nervous system diseases.
authors.affiliation: Department of Endocrinology, Children's Hospital and Research Center Oakland, Oakland, CA, USA.
authors.forename: Ivy R
authors.initials: IR
authors.lastname: Aslan
authors.affiliation: Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, CA, USA Department of Pediatrics, University of Southern California, Los Angeles, CA, USA.
authors.forename: Clement C
authors.initials: CC
authors.lastname: Cheung
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects; D001932:Brain Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D002493:Central Nervous System Diseases / Q000503:physiopathology*; D002648:Child; D004702:Endocrine Glands / Q000503:physiopathology*; D004700:Endocrine System Diseases / Q000139:chemically induced / Q000209:etiology; D006130:Growth Disorders / Q000209:etiology; D019382:Human Growth Hormone / Q000172:deficiency; D006801:Humans; D008297:Male; D009765:Obesity / Q000209:etiology; D011629:Puberty, Precocious / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects; D013733:Testicular Diseases / Q000209:etiology; D013959:Thyroid Diseases / Q000209:etiology
chemical_list: D000970:Antineoplastic Agents; D019382:Human Growth Hormone
keywords: Endocrinopathies; brain tumors; early effects; hypothalamus; late effects; pituitary