Endocrine Diseases in Children

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Endocrine Diseases in Children
Endocrine Diseases in Children_Obese Children

Everybody knows what a pediatrician is, but a pediatric endocrinologist arouses interest in many. What are the most common endocrine diseases in children?

Whatever the age of a little human would be, in order to be perfectly healthy, appropriately growing, to have a good memory, and to become a strong, hard-working grown-up, who could gift the world with someone alike, he/she needs a normal function of endocrine glands: thyroid gland, pancreas, adrenal glands, gonads as well as hypophysis. Disturbed function of these very small glands, which produce extremely active substances – hormones - can cause a number of health problems and requires the attention of pediatric endocrinologists.

Are These Diseases Common in Children?

Quite common. Children of various ages experience a faster rhythm of life, stress and huge loads at school more often these days and all of this can interfere with the function of  their endocrine glands. Quite a few endocrine diseases are inherited: if there was someone in the family with thyroid problems, diabetes mellitus, there is also a higher probability for their children or grandchildren to have these diseases also.

Can We Predict if Children from these Families will have Endocrine Disorders?

Unfortunately, we cannot. Some countries have started genetic research, which may suspect some sort of probability of these diseases, but we have to be careful and notice even the smallest signs of an endocrine disease. For example, in the families with diabetes mellitus, a child with increased thirst, frequent urination, dry skin and decreasing weight should raise concerns. In the families, who had cases of thyroiditis or nodules in the thyroid gland, general practitioners should be aware of the thyroid glands of their children. Thyroid gland palpation should be a routine examination during every visit of a child; ultrasound examination can also be useful, as it visualizes early changes in the thyroid gland.

Which Complaints of a Child Should Raise the Parents’ Concern in the Child’s Thyroid Gland?  

There are two possible disorders of the thyroid gland function: increased or decreased function. In case of the first disorder, the child becomes irritable, cannot concentrate, sleeps not well, has difficulties at school, feels palpitations and sweating. If the thyroid gland function is decreased the children tire faster, their memory worsens, they feel sleepy, have constipations and put on weight. Quite often even a good specialist cannot tell if it is a chronic fatigue or a beginning of a serious disease. Only special examinations and early treatment bring these children back to their usual life.
It is important that the earlier the thyroid gland function is interrupted the bigger changes the child will experience in height, puberty as well as ossification processes.  

When Should Height Retardation be Treated?

Low height is a major children’s psychological problem, sometimes even causing suicidal thoughts. It is important to evaluate a child’s height objectively, because sometimes even having normal height a child feels small. In other cases real height retardation might be missed. It is extremely important to evaluate the cause of height retardation, the height of the parents, past diseases and speed of ossification. Quite often special examinations are needed, because early diagnosed endocrine disorders can be successfully treated nowadays. It is very important to diagnose an endocrine disorder as early as possible: teenagers, who have stopped growing come to physicians quite often but their ossification zones are already closed and physicians can no longer help them. 

There is an Increased Number in Obese Children. Are They also Treated by Endocrinologists?

Obesity is not only an esthetic problem. Obese children tire faster, they are more passive, sluggish and late in puberty. Statistics show that obese children have 10 times greater risk to get hypertonic disease, diabetes mellitus and other diseases. Usually obesity is a consequence of irrational diet and familial tendency towards obesity. However, cases of obesity of endocrine origin are also frequent, when the weight is increasing because of serious disorders of adrenal glands, brain or gonads. These conditions usually require aggressive treatment.

How do Gonads’ Disorders Manifest?

They can manifest in a variety of symptoms. Inborn abnormalities are not rare, and the most frequent is undescended testis. It is important to diagnose and treat this disorder during the first two years of life, because later the treatment may be too late – infertility and sexual disorders may develop. In this case parents usually go to surgeons for help, but the function of the testes should be firstly evaluated by a pediatric endocrinologist. They can prescribe a treatment, which gives better distant results, and the child would not need any surgery.

Often girls experience early or late puberty. In both cases special tests are required.

How to Know if a Specialist Consultation is Needed?

In truth, the range of endocrine disorders is very broad. All parents should remember to listen carefully to children’s complaints and take their ailments seriously. As I always say, it is better to consult ten children who would not be confirmed having an endocrine disease, than to miss one or diagnose it too late.

   

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