Pediatric Endocrinology
It deals with endocrine problems that occur in children. Apart from growth disorders, Thyroid and diabetes mellitus are also common. Children also suffer from a spectrum of pubertal disorders such as precocious puberty to delayed puberty. Obesity is now more common in children.
Common Disorders:- Short stature
- Delayed puberty
- Precocious puberty
- Abnormal breast development in children
- Childhood obesity
- Type 1 diabetes
- Thyroid problems
- Rickets
It is therefore necessary that any girl with pubertal changes before 8 years or boy before 9 years should be brought to medical attention. Hormone evaluation and bone age estimation are imperative to assess the stage of sexual development. Endocrinologists also do dynamic hormone testing called GnRH stimulation test or Leuprolide stimulation test in these children to see if the source of excess hormone is from the pituitary or from other site (ovaries or testis). Appropriate scanning (MRI of pituitary, Ultrasound of testis or ovaries) are the next line of tests once the source of hormone excess is confirmed in blood tests.
After diagnosis, treatment can be started to slow down the progression of puberty till the normal age of pubertal development (11-12 years). Effective medicines are available which may be used once in 3 months to get the desirable results. Periodic monitoring of hormone levels is essential during the treatment period. This treatment has an established good safety profile with no significant long term side-effects. Once the treatment is stopped, the child can resume a normal puberty at the right age without any hurdle. He or she will also have a significant height gain during this period as rate of bone growth is normalized from its rapid pace. Also the apprehension of the child as well as the parents can be relieved which leads to psychological well-being..