Pediatric endocrinology is the medical specialty that focuses on hormonal system disorders and growth-developmental abnormalities in infants, children and adolescents from birth up to 18 years of age. Hormones secreted by the endocrine glands in our body (the pituitary gland, thyroid gland, pancreas, adrenal glands and ovaries) regulate vital functions such as growth, metabolism and sexual development.
Because childhood is a period of continuous growth, change and development, pediatric endocrinology is distinct from adult endocrinology. Physicians specialized in this field monitor children's stages of physical development, aiming to minimize the effects of hormonal imbalances on growth and to help ensure a healthy transition into adulthood.
What is Pediatric Endocrinology Department?
Pediatric endocrinology is a medical specialty that diagnoses and treats disorders of the endocrine system in children. The pediatric endocrinology department is not solely focused on diagnosing and treating diseases; it also serves a guiding role by monitoring a child’s growth curve (percentile) according to their age and sex.
Even the slightest imbalance in the hormonal system can directly affect bone development, mood, energy levels and the course of puberty. In the pediatric endocrinology department, a multidisciplinary approach is adopted, with close collaboration among nutrition specialists and psychologists, aiming to improve the child’s quality of life.
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What Diseases Does Pediatric Endocrinology Treat?
Pediatric endocrinology encompasses a wide range of conditions and primarily focuses on the diagnosis and management of hormonal disorders and abnormalities. Pediatric endocrinology department deals with conditions below:
Developmental delay and short stature: Children who have a slower growth rate compared to their peers or who fall below the percentile growth curve are evaluated.
- Early puberty (Precocious Puberty): It is the onset of puberty before the age of 8 in girls and before the age of 9 in boys.
- Delayed puberty: It is the failure of puberty to begin within the expected age range or its interruption.
- Childhood diabetes (Type 1 or Type 2): They are blood glucose regulation disorders and insulin resistance.
- Thyroid gland diseases: It includes conditions such as goiter, hypothyroidism (underactive thyroid) and hyperthyroidism (toxic goiter).
- Obesity and metabolic disorders: It refers to all hormonal imbalances that develop due to excessive weight gain.
- Adrenal gland diseases: It includes conditions such as congenital adrenal hyperplasia and Cushing syndrome.
- Disorders of sex development: It includes ambiguous genital structure or differences in sex development.
- Calcium and bone metabolism disorders: Rickets (Deficiency of D vitamin) and osteoporosis risk are evaluated.
What Are The Symptoms Of Growth Delay In Children?
Growth delay is a condition that is often noticed by families when their child’s clothing size does not change for a long time or when the child remains noticeably shorter than their classmates at school. In addition to hormonal deficiencies, genetic factors can also cause this condition. Early recognition of symptoms is important so that treatment can begin before the epiphyseal plates at the ends of the bones close.
The symptoms of growth delay that can be seen in children are as follows:
- Yearly growth rate of height being below the standards of age group
- Facial features that remain more baby-like than expected for the person’s age
- Delayed teething or delayed transition in tooth eruption and shedding
- Abnormal increase or decrease in body weight relative to height
What Are The Symptoms Of Childhood Diabetes?
Diabetes seen in children is usually in the form of Type 1 Diabetes, in which the pancreas does not produce enough insulin. In this condition, children need lifelong glucose management and metabolic monitoring. The symptoms of childhood diabetes that parents should be aware of are as follows:
- Excessively wanting to drink water
- Frequent urination
- Bedwetting in children who did not have bedwetting previously (polyuria)
- Unexplained weight loss despite increase in appetite
- Malaise and getting exhausted quickly
- Acetone smell in mouth
What Are The Symptoms Of Early Puberty?
Early puberty is a common endocrine problem today due to environmental factors and dietary habits. It can cause the bone age to advance rapidly, which may result in the child having a shorter adult height.
For the diagnosis of early puberty, a physical examination, bone age assessment (hand-wrist X-ray) and hormone tests are performed. Breast development in girls and an increase in testicular volume in boys are among the first clinical signs. In this process, physician evaluation is necessary to maintain a balance between psychosocial development and physical health.
What Are The Diagnostic Methods Used In Pediatric Endocrinology?
In pediatric endocrinology, laboratory tests and imaging techniques are used together to ensure an accurate diagnosis. Because children’s metabolic processes differ from those of adults, test results are interpreted according to age-specific reference ranges.
The primary diagnostic methods used in pediatric endocrinology department are as follows:
- Basal hormone measurements: These include measurements of thyroid (TSH, T4), growth factors (IGF-1, IGFBP-3) and blood glucose levels.
- HBA1C test: It is a parameter that shows the average blood sugar level over the past three months, used in the diagnosis and monitoring of diabetes.
- Electrolyte panel: Sodium, potassium, and calcium levels are evaluated to assess body fluid balance and adrenal gland function.
- Antibody tests: In conditions where the immune system attacks its own tissues (such as type 1 diabetes and Hashimoto’s disease), specific antibodies are screened.
- Growth hormone stimulation tests: Stimulating agents such as L-Dopa, Insulin or Glucagon are administered to check whether growth hormone reaches a peak response.
- LHRH (GnRH) test: It is used in the diagnosis of early or delayed puberty to assess the pituitary gland’s response in secreting puberty hormones.
- Oral glucose tolerance test (Glucose loading): It is performed to assess the pancreas’ response in cases of suspected insulin resistance or prediabetes.
- ACTH test: It is performed to evaluate the adrenal glands’ capacity to produce cortisol.
- Bone age determination: A left hand and wrist X-ray is taken to determine the degree of bone maturation; this is the most fundamental method for assessing growth potential.
- Thyroid ultrasonography: The volume of the thyroid gland and the presence of nodules are examined in a radiation-free manner.
- Pelvic and abdominal ultrasound: It is used to assess the size of the ovaries (gonads) and uterus in girls and to evaluate the condition of the testicles in boys.
- Pituitary MRI: It is a high-resolution imaging method preferred to determine whether there is a structural problem in the pituitary gland in cases of growth hormone deficiency or early puberty.
- Karyotype analysis: It is performed to detect numerical and structural chromosomal disorders (such as Turner syndrome).
- Molecular Genetic Tests: It is used in detection of specific gene mutations (such as Congenital Adrenal Hyperplasia).
- Newborn screening tests: Blood taken from the heel is used to screen for conditions requiring early intervention, such as phenylketonuria and congenital hypothyroidism.
