Pediatric ENDOCRINE DISORDERS

Pediatric ENDOCRINE DISORDERS

The endocrine system is made up of glands that make hormones. Hormones are the body’s chemical messengers. They carry information and instructions from one set of cells to another.

Endocrine System Function

Endocrine glands release hormones into the bloodstream. This lets the hormones travel to cells in other parts of the body.

Save your time - order a paper!

Get your paper written from scratch within the tight deadline. Our service is a reliable solution to all your troubles. Place an order on any task and we will take care of it. You won’t have to worry about the quality and deadlines

Order Paper Now

The endocrine hormones help control mood, growth and development, the way our organs work, metabolism , and reproduction.

The endocrine system regulates how much of each hormone is released. This can depend on levels of hormones already in the blood, or on levels of other substances in the blood, like calcium. Many things affect hormone levels, such as stress, infection, and changes in the balance of fluid and minerals in blood.

Too much or too little of any hormone can harm the body. Medicines can treat many of these problems.

ENDOCRINE SYSTEM

GROWTH DISORDERS

DISORDERS OF SEXUAL MATURATION

DISORDERS OF PUBERTY (INCLUDING PRECOCIOUS PUBERTY AND DELAYED PUBERTY)

THYROID DISORDERS

DISORDERS AFFECTING THE PITUITARY GLAND

DIABETES MELLITUS, TYPES 1 AND 2

DISORDERS AFFECTING THE ADRENAL GLAND

DISORDERS

OF

ENDOCRINE FUNCTION

 

 

 

 

 

 

 

GROWTH DISORDERS

Growth disorders are problems that prevent children from developing normal height, weight, sexual maturity or other features.

Very slow or very fast growth can sometimes signal a gland problem or disease.

The pituitary gland makes growth hormone, which stimulates the growth of bone and other tissues.

Children who have too little of it may be very short. Treatment with growth hormone can stimulate growth.

People can also have too much growth hormone. Usually the cause is a pituitary gland tumor, which is not cancer. Too much growth hormone can cause gigantism in children, where their bones and their body grow too much. In adults, it can cause acromegaly, which makes the hands, feet and face larger than normal. Possible treatments include surgery to remove the tumor, medicines, and radiation therapy.

Short Stature

Gigantism

DISORDERS OF PUBERTY

Puberty is an extremely important phase in the physical and psychosocial development of the adolescent.

Precocious puberty is pubertal onset before 8 years of age in girls and before 9 years of age in boys. Accelerated linear growth, breast development, penile enlargement, pubic hair

Usually idiopathic in girls; 30% of boys have CNS tumors

Delayed puberty is the absence of breast development in girls by 13 years of age and absence of testicular growth to at least 4 mL in volume or 2.5 cm in length in boys by 14 years of age

Early puberty and sexual development may be caused by tumors or growths of the ovaries, adrenal glands, pituitary gland, or brain.

A detailed history and physical examination are the first steps in the diagnostic evaluation of a normal variant or an abnormal puberty. Further evaluation includes:

Hormone levels.

Specific blood/urine studies for end products of abnormal metabolism.

Radiographic/imaging (bone age).

 

DIAGNOSIS OF ABNORMAL PUBERTY

Referral to pediatric endocrinologist

Hormonal replacement for hypogonadism.

Treatment Depends on underlying disorder, degree of advancement of bone age, can be effectively treated with medication.

PITUITARY GLAND DISORDERS

The pituitary gland is located in the brain and is known as the master gland because it produces hormones essential for daily functioning. These hormones stimulate the adrenal gland, the thyroid gland, the ovaries, and the testes.

In neonatal hypopituitarism (NH) an infant’s pituitary gland fails to develop properly.

Later in childhood, different types of tumors that may form in the pituitary gland, limiting its ability to function.

PITUITARY GLAND DISORDERS

SYMPTOMS

Infants with NH generally develop yellow skin or eyes (jaundice) and low blood sugar, and suffer from poor growth or lethargy.

Children and adolescents with pituitary tumors may suffer from poor growth, early or late puberty, over- or under-active thyroid or problems with their adrenal glands. In addition, they may experience excessive or decreased urination. Girls may discharge milk from the breasts without being pregnant.

Infants with NH can be treated with replacement pituitary hormones

 

Children and adolescents with pituitary tumors may be treated with microsurgery, radiation therapy, conventional surgery, drugs, or a combination of these approaches.

TREATMENT

 

 

ADRENAL GLAND DISORDERS

One adrenal gland lies above each kidney. These manufacture a number of hormones that are vital to many bodily functions. For example, they regulate the body’s response to stress, to cold, the heart rate and blood pressure, they manage blood sugar and sodium and potassium salt levels, and regulate sexual maturation during puberty.

When the adrenal glands produce too little or too much of one or more hormones significant health problems occur and these conditions are generally known as adrenal disorders.

CAUSES OF TOO LITTLE HORMONE

CAUSES OF TOO MUCH HORMONE

Autoimmune disease, infections, tumors, medications, genetic mutations or problems with other glands like the pituitary gland

Overproduction of hormones (like Cushing’s disease, hyperaldosteronism) may result from benign (non-cancerous) growths (adenomas) or cancerous tumors in the adrenal or pituitary glands.

ADRENAL GLAND DISORDERS CONT

SYMTOMS OF TOO LITTLE HORMONE

Fatigue, weight loss, decreased appetite, low blood pressure, nausea, vomiting, abdominal pain, and many other symptoms.

Obesity, a round or moon shaped face, slow growth, acne, bone and muscle weakness, exaggerated male characteristics (like excessive body hair, baldness, big muscles, faster growth, high blood pressure

SYMTOMS OF TOO MUCH HORMONE

MANAGEMENT

Hormone replacement/pediatric endocrinologist

Adrenal crisis is medical emergency

MANAGEMENT

Steroid doses if more than 7-10 days

Most common cause of preventable mental retardation

Untreated – irreversible brain damage, growth failure, deafness, neurological abnormalities

Newborn screening/thyroid replacement

The thyroid gland is in front of the neck and is shaped like a butterfly or bowtie.

The main job of the thyroid is to make thyroid hormones (T4 and T3).

Thyroid hormones help maintain normal metabolism, growth, and development.

A thyroid disorder may be present at birth (congenital) or might develop later in life.

The thyroid may make too little hormone (hypothyroidism) or too much (hyperthyroidism).

THYROID DISORDERS

HYPERTHYROIDISM SYMPTOMS

Weight loss, nervousness, tremors, excessive sweating, increased heart rate and blood pressure, protruding eyes, and a swelling in the neck from an enlarged thyroid gland (goiter)

Graves’ disease/autoimmune disease

Management

Antithyroid drugs, subtotal thyroidectomy, radioiodine.

 

 

 

 

HYPOTHYROIDISM SYMPTOMS

Fatigue, slow heart rate, dry skin In children: slower growth and delayed puberty

Hashimoto’s thyroiditis, which results from an autoimmune process that damages the thyroid and blocks thyroid hormone production, is the most common cause of hypothyroidism in kids.

Management

TBG deficiency – no treatment

Thyroid hormone replacement pills levothyroxine with frequent monitoring/more often in children <3 years.

 

 

THYROID DISORDERS

3rd most common chronic disease in childhood.

Occurs when the level of blood sugar is high (Darbre, 2018).

Glucose is the main source of energy

Insulin is responsible for maintaining blood sugar levels.

 

DIABETES

TYPE 1 DIABETES

Previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes

Type 1 diabetes develops when the body’s immune system destroys pancreatic beta cells.

This form of diabetes usually affects children and young adults

TYPE 2 DIABETES

Increased insulin resistance in tissues – hyperinsulinemia/hyperglycemia

Increased insulin demand – pancreas loses ability to secrete insulin effectively

Autoimmune destruction of beta cells does not occur

Growth hormone during puberty increases insulin resistance

Strong association with obesity, sedentary lifestyles, high-calorie, lipid-rich foods

 

Types of diabetes

The major types of diabetes involves type 1 and type 2 diabetes.

Type 1 diabetes is when the pancreases fails to produce enough insulin

Type 2 diabetes affects the way the body produces sugar

Gestation diabetes develops in pregnant women

 

15

Diabetes symptoms

 

Polydipsia,

Polyphagia

Polyuria, nocturia

Blurred vision

Weight loss or poor weight gain

Fatigue, lethargy

Ketonuria – abdominal pain,

Fruity smell to your breath

Weakness from dehydration,

Mental confusion

 

Polydipsia

Polyphagia

Polyuria

Nocturia/bed-wetting

Blurred vision

Obesity

Hyperpigmented, velvet-like rash

Frequent/slow-healing infections

Fatigue

Premature adrenarche

Sleep apnea

Family history of type 2 diabetes

TYPE 1 DIABETES

TYPE 2 DIABETES

Prevention and treatment of diabetes

PREVENTION

Eating healthy

Being active

Avoiding being sedentary for longer periods

TREATMENT

Exercising regularly

Insulin therapy

Monitoring blood sugar level

Eating healthy- eat food lower in fats and calories with higher fiber. Eat majorly fruits, vegetables and whole grains

Being active-exercise often

Losing weight

Avoiding being sedentary for longer periods

 

Eating healthy- eating fewer calories, fewer refined carbs, fewer foods containing saturated fats and eating more vegetables, fruits and foods with fiber

Losing weight- loosing 5-10% of body weight makes an impact on blood sugar levels

Exercising regularly- having aerobic exercises.

Insulin therapy- medications such s metformin, sulfonylureas, meglitinides and thiazolidinediones

Monitoring blood sugar level

Bariatric surgery

 

 

 

17

Obesity

 

BMI >95th percentile

Occurs due to excessive body fats

The condition increases the risks of other diseases such as diabetes, high blood pressure and heart diseases

Excessive calories intake results to the condition

Other causes may be genetic hormonal or behavioral

Refer to pediatric endocrinology if other endocrine disorders present

Prevention entails exercising regular, eating healthy, monitoring your weight regularly

Nutritional counseling

Lifestyle management

Weight maintenance, not loss

 

Conclusion

Endocrine system is responsible for production and release of hormones

The system affects metabolism growth and development, mood and sexual functions

Endocrine system disorders interfere normal body functions

Diabetes is the most common endocrine disorder

In concluding this presentation here is a recap of the main issues addressed

Endocrine system is responsible for production and release of hormones

The system affects metabolism growth and development, mood and sexual functions

Endocrine system disorders interfere normal body functions

Diabetes is the most common endocrine disorder

 

19

References

Darbre, P. D. (2018). Overview of air pollution and endocrine disorders. International Journal of General Medicine, 11, 191–207. https://doi.org/10.2147/IJGM.S102230

Endocrine disorders | | Blogs | CDC. (n.d.). Retrieved October 20, 2020, from https://blogs.cdc.gov/publichealthmatters/tag/endocrine-disorders/

Kalra, S., Gupta, L., Khandelwal, D., Gupta, P., Dutta, D., & Aggarwal, S. (2017). Ketogenic diet in endocrine disorders: Current perspectives. Journal of Postgraduate Medicine, 63(4), 242. https://doi.org/10.4103/jpgm.jpgm_16_17

Lause, M., Kamboj, A., & Fernandez Faith, E. (2017). Dermatologic manifestations of endocrine disorders. Translational Pediatrics, 6(4), 300–312. https://doi.org/10.21037/tp.2017.09.08

National Institute of Diabetes and Digestive and Kidney Diseases. (2019, December 18). Endocrine Diseases | NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/endocrine-diseases