Paediatric endocrinology

Endocrinology is a vast field and there are a lot of symptoms of the endocrine system malfunction. As far as children are concerned, the occurrence of the following symptoms should certainly be the reason to consult an endocrinologist:

• slow growth of the child – it is not always a pathological symptom (low height for some time is characteristic for premature babies, for example), but it may also indicate endocrine disorders: hypothyroidism or growth hormone deficiency.
• rapid growth of the child – if your son or daughter is significantly higher than their peers, it is also worth seeking advice of a paediatric endocrinologist. Often such a symptom accompanies obesity. Excess body fat can lead to faster maturation.
• too low or too high weight of the child – especially the latter, if untreated, can lead to obesity and type 2 diabetes.
• skin problems – rashes, itching and hair loss. They do not always only indicate dermatological diseases – sometimes this is the effect of hypothyroidism or hyperthyroidism.
• too slow maturation – lack of development of genital glands in girls over the age of thirteen and lack of changes in the appearance of genitals in boys over the age of fourteen may be a symptom of endocrine disorders.
• too fast maturation – if a few years old child has enlarged breasts, pubic hair, acne or the unpleasant sweat odour, it is necessary to quickly consult a paediatric endocrinologist.
• child’s mood changes – tearfulness, hyperactivity, irritability or the opposite – lack of concentration, sadness and apathy, may be a sign of endocrine disorders due to strong links between the endocrine system and the psyche.

It is good to consult a paediatric endocrinologist who will decide whether these symptoms are related to the endocrine system. On this basis, they will prescribe specific blood tests and decide on the form of further treatment. Most often this is pharmacological treatment.

Specialist consultations with a paediatric endocrinologist consist primarily of taking a detail history from the child’s parents. The doctor measures and weighs a young patient and checks the condition of their skin. On this basis they can give an initial diagnosis. However, in order to confirm it, detailed blood tests will probably be needed, as well showing their results to a doctor during the next visit.

The first visit to a paediatric endocrinologist does not require any special preparations, except for determining precisely which symptoms in the child are most alarming to the parents. Test results should be brought for the next visit. Usually, endocrine therapy requires at least a few visits to determine how the prescribed drugs work. Unfortunately, in the case of chronic diseases of the endocrine system, there is a need for continuous pharmacological treatment under the supervision of an endocrinologist.

In such situations, cooperation between an endocrinologist and GP, who can prescribe regularly taken drugs if a specialist is temporarily unavailable, is important.

Hormone diagnosis is so extensive that it is difficult to examine everything on one’s own – the first visit is needed to determine what specific tests need to be done. Some of the endocrine tests for technical reasons are performed in hospital, but the patient stays there usually only one day and no more than several days.

Thanks to the above-mentioned tests, a paediatric endocrinologist can diagnose many diseases such as:

• thyroid diseases (hyperthyroidism, hypothyroidism, goitre, tumours, inflammation, etc.),
• parathyroid gland diseases (hypoparathyroidism, hyperparathyroidism),
• pituitary gland diseases (tumours, hypopituitarism, hyperpituitarism, Cushing’s disease),
• adrenal gland diseases (hyperadrenalism, hypoadrenalism, tumours, Addison’s disease, etc.),
• pancreas diseases (tumours, diabetes).

Regular check-ups with a paediatric endocrinologist are very important. The endocrinologist may decide to reduce or increase the dose of drugs, change them or stop them altogether. Therefore, periodic visits should not be neglected – especially as the child’s body changes intensively over time.