Coimbatore, Tamil Nadu, India
Pediatric Endocrinology is an evolving specialty dealing with complex disorders of endocrine glands in the pediatric population. The Pediatric Endocrinologist at Sri Ramakrishna Hospital is dedicated to provide excellent, comprehensive and evidence based care for hormonal disorders in children from newborn period through childhood to adolescence.
Children are not just small adults. As growing individuals they have special needs related to growth and development. Endocrine disorders in children are often much different from their adult counterparts and can have varied clinical presentations. Early diagnosis and effective treatment often leads to normal growth and development.
The Pediatric Endocrinology experts offers insights on the various hormonal issues in children and the importance of early identification for better results.
The common endocrine disorders in children include Diabetes Mellitus – Type 1 and Type 2, Short stature and growth disorders, Obesity, Thyroid disorders and Puberty problems like precocious/early puberty and delayed puberty. It also includes various rare disorders of adrenal gland and bone metabolism.
Overview of Common Endocrine Disorders:
Type 1 Diabetes Mellitus:
The trend of 3-5% annual increase in the incidence of Type 1 Diabetes is of growing concern. Insulin deficiency due to autoimmune pancreatic damage is the cause for Type 1 diabetes. The children are treated with insulin, diet and lifestyle modifications.Education is the key to successful management of diabetes. The child and family are trained to take control of their diabetes by educating them regarding home management of diabetes including monitoring and recording of blood sugars, insulin administration, management of sick days, hypoglycemia and hyperglycemia.
Warning Signs:
- Excessive thirst
- Frequent urination
- Tiredness
- Unexplained weight loss
Obesity and Metabolic Syndrome:
Overweight and obesity is one of the most serious public health challenges worldwide. Childhood obesity is attributed to sedentary lifestyle, unhealthy eating habits and hormonal problems. Thorough assessment mandatory to address the core issue directly. Obese children grow into obese adults and are more likely develop metabolic syndrome like Type 2 Diabetes Mellitus, High Blood Pressure and High cholesterol levels at a younger age. Obesity and its related disorders are largely preventable and therefore needs high priority.
Warning Signs:
- Increased weight gain
- Shortness of breath with physical activity
- Snoring/sleep apnea
- Acanthosisnigricans (black velvety skin around neck and other areas)
Thyroid Disorders:
Thyroid disorders can present at birth in the form of congenital hypothyroidism which if not treated can result in severe growth and developmental defects. Children and adolescents too can develop hypothyroidism or hyperthyroidism with/without goiter which needs age appropriate therapy and regular reassessment. If treated early, they achieve normal growth and development.
Warning Signs:
- Slow growth/ short stature
- Weight gain/loss
- Goiter (neck swelling)
- Constipation
- Fatigue/tiredness
- Dry, rough skin
Growth Disorders:
Various systemic illness and hormonal problems solely manifest as growth failure which often goes unrecognized leading to unnecessarily delayed or missed diagnosis. These disorders can be diagnosed by regularly monitoring the growth of children and plotting the growth parameters on a growth chart. The causes of growth failure in children could be varied. The treatment depends on the cause. Most children with poor growth (subnormal weight and/or height gain) benefit from improvement in diet and activity. Those with a physiological causes of short stature are only monitored. Those with growth hormone deficiencies are amenable to therapy with growth hormone. When treatment is started early, the results are better.
Warning Signs:
- Slow growth – slow height and/or weight gain
- Tapering of growth centiles on growth chart
Puberty Disorders:
Adolescence is a crucial period of dramatic hormonal changes, growth acceleration and maturation of reproductive capacity resulting in physical and emotional changes which pose a great challenge in the diagnosis and management of problems related to puberty.
Early Puberty:
Identification of the cause of early puberty is important to plan treatment. Not all children to prevent the with precocious puberty require treatment. The goal of treatment production of sex hormones to prevent the early halt of growth, short stature in adulthood, emotional effects and social problems. If precocious puberty is caused by a specific medical problem, treating the underlying problem can often stop the progression of precocious puberty. In addition, medical treatment to block the hormones that cause puberty can be used to halt the progression of pubertal changes.
Warning Signs:
- Breast development in a girl before 8 years of age and testis enlargement in boys before 9 years of age.
- Growth spurt – Sudden increase in height/weight
- Acne/body odor in children
Delayed Puberty:
With delayed puberty or hypogonadism, treatment varies with the cause of the problem but may involve use of hormone replacement therapy as and when the need arises.
Warning Signs:
- No breast development before 13 years in girls and no enlargement of testis before 14 years of age
- Failure to menstruate by 16 years of age
Most of the hormonal disorders in children can be effectively treated when the condition is identified early and timely treatment is received. It is important that parents keep a close watch on their children’s physical growth and pubertal changes as it may help in early diagnosis and treatment for better outcomes.
The pediatric endocrinology experts at Sri Ramakrishna Hospital recommend to have regular visits to the doctor to ensure that the child is growing and developing appropriately.
