Evaluation of the hypothalamic-pituitary-adrenal axis function in childhood and adolescence

George P. Chrousos, Tomoshige Kino, Evangelia Charmandari

Research output: Contribution to journalReview article

41 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)272-283
Number of pages12
Issue number5
Publication statusPublished - Jun 2009
Externally publishedYes



  • CRH test
  • Dexamethasone suppression test
  • Glucocorticoids
  • Hypothalamic-pituitary-adrenal axis
  • Synacthen test

ASJC Scopus subject areas

  • Endocrinology
  • Immunology
  • Endocrine and Autonomic Systems
  • Neurology

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