Skip to main content
SpringerLink
Log in

Transitions in Care of the Adolescent with Pituitary Dysfunction

  • Chapter
  • First Online:
Pituitary Disorders throughout the Life Cycle

  • 321 Accesses

Abstract

Adolescents and young adults (AYAs) with hypopituitarism make up a small but increasing number of patients who will require transition to adult endocrinology care, in part due to increased survivability of childhood cancers. AYAs with hypopituitarism have a high risk for developmental delays and disproportionate barriers to care including limited insurance coverage, parental dependence, and mental health concerns, which may complicate transition to adult care. Specific circumstances to care need to be considered, such as the long-term use of growth hormone (GH) therapy and concerns of fertility that will affect quality of life in adulthood. Due to limited adult resources, specialists in adult endocrinology and likely primary care providers will need a coordinated effort to continue appropriate treatment and care into adulthood.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Regal M, Páramo C, Sierra SM, Garcia-Mayor RV. Prevalence and incidence of hypopituitarism in an adult Caucasian population in northwestern Spain. Clin Endocrinol. 2001;55:735–40.

    Article  CAS  Google Scholar 

  2. Alyahyawi N, Dheensaw K, Islam N, Aroichane M, Amed S. Pituitary dysfunction in pediatric patients with optic nerve hypoplasia: a retrospective cohort study (1975–2014). Horm Res Paediatr. 2018;89:22–30.

    Article  CAS  PubMed  Google Scholar 

  3. Castinetti F, Reynaud R, Saveanu A, Quentien M-H, Albarel F, Barlier A, Enjalbert A, Brue T. Clinical and genetic aspects of combined pituitary hormone deficiencies. Ann Endocrinol (Paris). 2008;69:7–17.

    Article  CAS  Google Scholar 

  4. Kurtoğlu S, Özdemir A, Hatipoğlu N. Neonatal hypopituitarism: approaches to diagnosis and treatment. J Clin Res Pediatr Endocrinol. 2019;11:4–12.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Heather NL, Jefferies C, Hofman PL, Derraik JGB, Brennan C, Kelly P, Hamill JKM, Jones RG, Rowe DL, Cutfield WS. Permanent hypopituitarism is rare after structural traumatic brain injury in early childhood. J Clin Endocrinol Metab. 2012;97:599–604.

    Article  CAS  PubMed  Google Scholar 

  6. Lawson SA, Horne VE, Golekoh MC, Hornung L, Burns KC, Fouladi M, Rose SR. Hypothalamic-pituitary function following childhood brain tumors: analysis of prospective annual endocrine screening. Pediatr Blood Cancer. 2019;66:e27631.

    Article  PubMed  Google Scholar 

  7. Chemaitilly W, Li Z, Huang S, et al. Anterior hypopituitarism in adult survivors of childhood cancers treated with cranial radiotherapy: a report from the St Jude lifetime cohort study. J Clin Oncol. 2015;33:492–500.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Howlader N, Noone AM, Krapcho M, Miller D, Brest A, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, CK, editors. SEER cancer statistics review, 1975–2017. Bethesda: National Cancer Institute; 2019. https://seer.cancer.gov/csr/1975_2017/, based on November 2019 SEER data submission, posted to the SEER web site, Apr 2020.

  9. Robison LL, Hudson MM. Survivors of childhood and adolescent cancer: life-long risks and responsibilities. Nat Rev Cancer. 2013;14:61–70.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  10. Gurney JG, Kadan-Lottick NS, Packer RJ, et al. Endocrine and cardiovascular late effects among adult survivors of childhood brain tumors: childhood cancer survivor study. Cancer. 2003;97:663–73.

    Article  PubMed  Google Scholar 

  11. Brignardello E, Felicetti F, Castiglione A, Chiabotto P, Corrias A, Fagioli F, Ciccone G, Boccuzzi G. Endocrine health conditions in adult survivors of childhood cancer: the need for specialized adult-focused follow-up clinics. Eur J Endocrinol. 2013;168:465–72.

    Article  CAS  PubMed  Google Scholar 

  12. Kim SY. Diagnosis and treatment of hypopituitarism. Endocrinol Metab (Seoul, Korea). 2015;30:443–55.

    Article  CAS  Google Scholar 

  13. Klose M, Feldt-Rasmussen U. Hypopituitarism in traumatic brain injury-a critical note. J Clin Med. 2015;4:1480–97.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Zacharin M. Pubertal induction in hypogonadism: current approaches including use of gonadotrophins. Best Pract Res Clin Endocrinol Metab. 2015;29:367–83.

    Article  CAS  PubMed  Google Scholar 

  15. Swee DS, Quinton R. Managing congenital hypogonadotropic hypogonadism: a contemporary approach directed at optimizing fertility and long-term outcomes in males. Ther Adv Endocrinol Metab. 2019;10:2042018819826889.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Raivio T, Wikström AM, Dunkel L. Treatment of gonadotropin-deficient boys with recombinant human FSH: long-term observation and outcome. Eur J Endocrinol. 2007;156:105–11.

    Article  CAS  PubMed  Google Scholar 

  17. Reed ML, Merriam GR, Kargi AY. Adult growth hormone deficiency – benefits, side effects, and risks of growth hormone replacement. Front Endocrinol (Lausanne). 2013;4:64.

    Article  Google Scholar 

  18. Oprea A, Bonnet NCG, Pollé O, Lysy PA. Novel insights into glucocorticoid replacement therapy for pediatric and adult adrenal insufficiency. Ther Adv Endocrinol Metab. 2019;10:2042018818821294.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Rose SR, Horne VE, Howell J, Lawson SA, Rutter MM, Trotman GE, Corathers SD. Late endocrine effects of childhood cancer. Nat Rev Endocrinol. 2016;12:319–36.

    Article  CAS  PubMed  Google Scholar 

  20. Tercyak K, Mays D, Johnson A, Murphy S, Shad AT. Oncofertility and quality of life among adolescent and young adult survivors of childhood cancer. J Clin Oncol. 2016;34:222.

    Article  Google Scholar 

  21. Practice Committee of the American Society for Reproductive Medicine. Fertility preservation in patients undergoing gonadotoxic therapy or gonadectomy: a committee opinion. Fertil Steril. 2019. https://doi.org/10.1016/j.fertnstert.2019.09.013.

  22. Pfeilschifter J, Diel IJ. Osteoporosis due to cancer treatment: pathogenesis and management. J Clin Oncol. 2000;18:1570–93.

    Article  CAS  PubMed  Google Scholar 

  23. Baroncelli GI, Bertelloni S, Sodini F, Saggese G. Osteoporosis in children and adolescents: etiology and management. Paediatr Drugs. 2005;7:295–323.

    Article  PubMed  Google Scholar 

  24. Miljić D, Popovic V. Metabolic syndrome in hypopituitarism. Front Horm Res. 2018;49:1–19.

    Article  PubMed  CAS  Google Scholar 

  25. Butler MG. Prader-Willi syndrome: obesity due to genomic imprinting. Curr Genomics. 2011;12:204–15.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Lustig RH. Hypothalamic obesity after craniopharyngioma: mechanisms, diagnosis, and treatment. Front Endocrinol (Lausanne). 2011;2:60.

    Article  Google Scholar 

  27. Deepak D, Furlong NJ, Wilding JPH, MacFarlane IA. Cardiovascular disease, hypertension, dyslipidaemia and obesity in patients with hypothalamic-pituitary disease. Postgrad Med J. 2007;83:277–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. van Iersel L, Brokke KE, Adan RAH, Bulthuis LCM, van den Akker ELT, van Santen HM. Pathophysiology and individualized treatment of hypothalamic obesity following craniopharyngioma and other suprasellar tumors: a systematic review. Endocr Rev. 2019;40:193–235.

    Article  PubMed  Google Scholar 

  29. Khera R, Murad MH, Chandar AK, Dulai PS, Wang Z, Prokop LJ, Loomba R, Camilleri M, Singh S. Association of pharmacological treatments for obesity with weight loss and adverse events: a systematic review and meta-analysis. JAMA. 2016;315:2424–34.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Horne VE, Bielamowicz K, Nguyen J, Hilsenbeck S, Lindsay H, Sonabend R, Wood AC, Okcu F, Sisley S. Methylphenidate improves weight control in childhood brain tumor survivors with hypothalamic obesity. Pediatr Blood Cancer. 2020;67:1–6.

    Article  CAS  Google Scholar 

  31. Grimberg A, SA DV, Polychronakos C, Allen DB, Cohen LE, Quintos JB, Rossi WC, Feudtner C, Murad MH, Drug and Therapeutics Committee and Ethics Committee of the Pediatric Endocrine Society. Guidelines for growth hormone and insulin-like growth factor-I treatment in children and adolescents: growth hormone deficiency, idiopathic short stature, and primary insulin-like growth factor-I deficiency. Horm Res Paediatr. 2016;86:361–97.

    Article  CAS  PubMed  Google Scholar 

  32. Stanhope R. Transition from paediatric to adult endocrinology: hypopituitarism. Growth Hormon IGF Res. 2004;14 Suppl A:S85–8.

    Article  Google Scholar 

  33. Hindmarsh PC, Swift PGF. An assessment of growth hormone provocation tests. Arch Dis Child. 1995;72:362–7; discussion 367–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Kołtowska-Haggstrom M, Hennessy S, Mattsson AF, Monson JP, Kind P. Quality of life assessment of growth hormone deficiency in adults (QoL-AGHDA): comparison of normative reference data for the general population of England and Wales with results for adult hypopituitary patients with growth hormone deficiency. Horm Res. 2005;64:46–54.

    PubMed  Google Scholar 

  35. Mohney BG, Young RC, Diehl N. Incidence and associated endocrine and neurologic abnormalities of optic nerve hypoplasia. JAMA Ophthalmol. 2013;131:898–902.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Li L, Liu J. The effect of pediatric traumatic brain injury on behavioral outcomes: a systematic review. Dev Med Child Neurol. 2013;55:37–45.

    Article  PubMed  Google Scholar 

  37. Kao K-T, Stargatt R, Zacharin M. Adult quality of life and psychosocial outcomes of childhood onset hypopituitarism. Horm Res Paediatr. 2015;84:94–101.

    Article  CAS  PubMed  Google Scholar 

  38. Roddy E, Mueller S. Late effects of treatment of pediatric central nervous system tumors. J Child Neurol. 2015. https://doi.org/10.1177/0883073815587944.

  39. Frobisher C, Lancashire ER, Winter DL, Jenkinson HC, Hawkins MM, British Childhood Cancer Survivor Study. Long-term population-based marriage rates among adult survivors of childhood cancer in Britain. Int J Cancer. 2007;121:846–55.

    Article  CAS  PubMed  Google Scholar 

  40. Memmesheimer RM, Lange K, Dölle M, Heger S, Mueller I. Psychological well-being and independent living of young adults with childhood-onset craniopharyngioma. Dev Med Child Neurol. 2017;59:829–36.

    Article  PubMed  Google Scholar 

  41. Zebrack BJ, Gurney JG, Oeffinger K, et al. Psychological outcomes in long-term survivors of childhood brain cancer: a report from the childhood cancer survivor study. J Clin Oncol. 2004;22:999–1006.

    Article  PubMed  Google Scholar 

  42. Kahalley LS, Winter-Greenberg A, Stancel H, Ris MD, Gragert M. Utility of the General Ability Index (GAI) and Cognitive Proficiency Index (CPI) with survivors of pediatric brain tumors: comparison to full scale IQ and premorbid IQ estimates. J Clin Exp Neuropsychol. 2016;38:1065–76.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Children’s Oncology Group. Guidelines for survivors of childhood, adolescent, and young adult cancer long-term follow-up guidelines, version 4.0. 2013. p. 1–241. http://www.survivorshipguidelines.org/. Accessed on 24 May 22.

  44. Fidler MM, Ziff OJ, Wang S, et al. Aspects of mental health dysfunction among survivors of childhood cancer. Br J Cancer. 2015;113:1121–32.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Lu D, Fall K, Sparén P, Ye W, Adami H-O, Valdimarsdóttir U, Fang F. Suicide and suicide attempt after a cancer diagnosis among young individuals. Ann Oncol. 2013;24:3112–7.

    Article  CAS  PubMed  Google Scholar 

  46. Lown EA, Phillips F, Schwartz LA, Rosenberg AR, Jones B. Psychosocial follow-up in survivorship as a standard of care in pediatric oncology. Pediatr Blood Cancer. 2015;62(Suppl 5):S514–84.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Strauser D, Klosky JL, Brinkman TM, Wong AWK, Chan F, Lanctot J, Ojha RP, Robison LL, Hudson MM, Ness KK. Career readiness in adult survivors of childhood cancer: a report from the St. Jude Lifetime Cohort Study. J Cancer Surviv. 2015;9:20–9.

    Article  PubMed  Google Scholar 

  48. Schulte F, Russell KB, Pelletier W, Scott-Lane L, Guilcher GMT, Strother D, Dewey D. Screening for psychosocial distress in pediatric cancer patients: an examination of feasibility in a single institution. Pediatr Hematol Oncol. 2019;36:125–37.

    Article  PubMed  Google Scholar 

  49. McManus MA, Pollack LR, Cooley WC, McAllister JW, Lotstein D, Strickland B, Mann MY. Current status of transition preparation among youth with special needs in the United States. Pediatrics. 2013;131:1090–7.

    Article  PubMed  Google Scholar 

  50. Overholser LS, Moss KM, Kilbourn K, Risendal B, Jones AF, Greffe BS, Garrington T, Leonardi-Warren K, Yamashita TE, Kutner JS. Development of a primary care-based clinic to support adults with a history of childhood cancer: the tactic clinic. J Pediatr Nurs. 2015;30:724–31.

    Article  PubMed  Google Scholar 

  51. Tonorezos ES, Hudson PMM, Edgar AB, Kremer LC, Sklar PCA, Wallace PWHB, Oeffinger KC. Screening and management of adverse endocrine outcomes in adult survivors of childhood and adolescent cancer. Lancet Diabetes Endocrinol. 2015;3:545–55.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Poplack DG, Fordis M, Landier W, Bhatia S, Hudson MM, Horowitz ME. Childhood cancer survivor care: development of the passport for care. Nat Rev Clin Oncol. 2014;11:740–50.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Oeffinger KC, Hudson MM. Long-term complications following childhood and adolescent cancer: foundations for providing risk-based health care for survivors. CA Cancer J Clin. 2004;54:208–36.

    Article  PubMed  Google Scholar 

  54. Holmgren AJ, Patel V, Adler-Milstein J. Progress in interoperability: measuring US hospitals’ engagement in sharing patient data. Health Aff (Millwood). 2017;36:1820–7.

    Article  Google Scholar 

  55. Freyer DR, Brugieres L. Adolescent and young adult oncology: transition of care. Pediatr Blood Cancer. 2008;50:1116–9.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Baylor College of Medicine, Department of Pediatrics, Section of Pediatric Diabetes and Endocrinology, Houston, TX, USA

    Vincent E. Horne & Alfonso Hoyos-Martinez

Authors
  1. Vincent E. Horne
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alfonso Hoyos-Martinez
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Vincent E. Horne .

Editor information

Editors and Affiliations

  1. Mayo Clinic, Jacksonville, FL, USA

    Susan L. Samson

  2. Emory University School of Medicine, Atlanta, GA, USA

    Adriana G. Ioachimescu

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Horne, V.E., Hoyos-Martinez, A. (2022). Transitions in Care of the Adolescent with Pituitary Dysfunction. In: Samson, S.L., Ioachimescu, A.G. (eds) Pituitary Disorders throughout the Life Cycle. Springer, Cham. https://doi.org/10.1007/978-3-030-99918-6_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-99918-6_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-99917-9

  • Online ISBN: 978-3-030-99918-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation