[Puberty in certain chronic illness].

This paper is a literature review of puberty in certain chronic diseases. Abnormal puberty is often reported in children suffering from many chronic diseases, for example: asthma, cystic fibrosis, type 1 diabetes mellitus, inflammatory diseases, children with visual and hearing impairment, and others. Delay in the onset and progression through puberty have a deleterious effect on the normal pubertal growth spurt and contribute to the deficit in final adult height. Malnutrition, toxic substances, side effects of chronic therapy, emotional deprivation and stress are the most important mechanisms responsible for delayed puberty. Delayed puberty and growth failure frequently complicate the clinical course of this children. However, few studies confirm earlier puberty in children with sense organ impairment than in healthy children. The more severe the impairment of the sense organ, the earlier was the age at puberty--the earliest age at menarche was observed in deaf girls and blind girls. The earlier age of puberty may be the outcome of therapies applied during the treatments such as radiation of the central nervous system or surgeries. Further studies are needed to determine how growth and puberty in children with chronic illness are affected by clinical practice.