Pediatric Endocrinologist
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endocrinology Endocrinology (from ''endocrine system, endocrine'' + ''wikt:-logy#Suffix, -ology'') is a branch of biology and medicine dealing with the endocrine system, its diseases, and its specific secretions known as hormones. It is also concerned with the ...
(
British British may refer to: Peoples, culture, and language * British people, nationals or natives of the United Kingdom, British Overseas Territories and Crown Dependencies. * British national identity, the characteristics of British people and culture ...
: Paediatric) is a medical subspecialty dealing with disorders of the
endocrine gland The endocrine system is a network of glands and organs located throughout the body. Along with the nervous system, it makes the neuroendocrine system, which controls and regulates many of the body's functions. Endocrine glands are ductless gland ...
s, such as variations of physical
growth Growth may refer to: Biology *Auxology, the study of all aspects of human physical growth *Bacterial growth *Cell growth *Growth hormone, a peptide hormone that stimulates growth *Human development (biology) *Plant growth *Secondary growth, growt ...
and sexual development in childhood,
diabetes Diabetes mellitus, commonly known as diabetes, is a group of common endocrine diseases characterized by sustained high blood sugar levels. Diabetes is due to either the pancreas not producing enough of the hormone insulin, or the cells of th ...
and many more. By age, pediatric endocrinologists, depending upon the age range of the patients they treat, care for patients from infancy to late adolescence and young adulthood. The most common disease of the specialty is
type 1 diabetes Type 1 diabetes (T1D), formerly known as juvenile diabetes, is an autoimmune disease that occurs when the body's immune system destroys pancreatic cells (beta cells). In healthy persons, beta cells produce insulin. Insulin is a hormone require ...
, which usually accounts for at least 50% of a typical clinical practice. The next most common problem is growth disorders, especially those amenable to
growth hormone treatment Growth hormone therapy refers to the use of growth hormone (GH) as a prescription medication—it is one form of hormone therapy. Growth hormone is a peptide hormone secreted by the pituitary gland that stimulates growth and cell reproduction. ...
. Pediatric endocrinologists are usually the primary physicians involved in the medical care of infants and children with
intersex Intersex people are those born with any of several sex characteristics, including chromosome patterns, gonads, or genitals that, according to the Office of the United Nations High Commissioner for Human Rights, "do not fit typical binar ...
disorders. The specialty also deals with
hypoglycemia Hypoglycemia (American English), also spelled hypoglycaemia or hypoglycæmia (British English), sometimes called low blood sugar, is a fall in blood sugar to levels below normal, typically below 70 mg/dL (3.9 mmol/L). Whipple's tria ...
and other forms of hyperglycemia in childhood, variations of
puberty Puberty is the process of physical changes through which a child's body matures into an adult body capable of sexual reproduction. It is initiated by hormonal signals from the brain to the gonads: the ovaries in a female, the testicles i ...
, as well other
adrenal The adrenal glands (also known as suprarenal glands) are endocrine glands that produce a variety of hormones including adrenaline and the steroids aldosterone and cortisol. They are found above the kidneys. Each gland has an outer cortex which ...
,
thyroid The thyroid, or thyroid gland, is an endocrine gland in vertebrates. In humans, it is a butterfly-shaped gland located in the neck below the Adam's apple. It consists of two connected lobes. The lower two thirds of the lobes are connected by ...
, and
pituitary The pituitary gland or hypophysis is an endocrine gland in vertebrates. In humans, the pituitary gland is located at the base of the brain, protruding off the bottom of the hypothalamus. The pituitary gland and the hypothalamus control much of th ...
problems. Many pediatric endocrinologists have interests and expertise in bone metabolism, lipid metabolism, adolescent gynecology, or
inborn errors of metabolism Inborn errors of metabolism form a large class of genetic diseases involving congenital disorders of enzyme activities. The majority are due to defects of single genes that code for enzymes that facilitate conversion of various substances ( substr ...
. Most pediatric endocrinologists in North America and many from around the world can trace their professional genealogy to
Lawson Wilkins Lawson Wilkins (March 6, 1894 - September 27, 1963) was an American pediatric endocrinologist. He is known along with John Money for pioneering surgeries for visibly intersex newborns. At the time, intersex anatomy was understood virtually exclus ...
, who pioneered the specialty in the pediatrics department of
Johns Hopkins School of Medicine The Johns Hopkins University School of Medicine (JHUSOM) is the medical school of Johns Hopkins University, a private research university in Baltimore, Maryland. Established in 1893 following the construction of the Johns Hopkins Hospital, th ...
and the Harriet Lane Home in Baltimore in between the late 1940s and the mid-1960s.


Professional training

In the United States and Canada, pediatric endocrinology is a subspecialty of the
American Board of Pediatrics American(s) may refer to: * American, something of, from, or related to the United States of America, commonly known as the "United States" or "America" ** Americans, citizens and nationals of the United States of America ** American ancestry, p ...
or the
American Osteopathic Board of Pediatrics The American Osteopathic Board of Pediatrics (AOBP) is an organization that provides board certification to qualified Doctors of Osteopathic Medicine (D.O.) who specialize in the diagnosis and treatment of medical diseases in infants, children, ...
, with board certification following fellowship training. It is a relatively small and primarily cognitive specialty, with few procedures and an emphasis on diagnostic evaluation. Training for pediatric endocrinology consists of a 3-year fellowship following completion of a 3-year pediatrics residency. The fellowship, and the specialty, are heavily research-oriented and academically based, although less exclusively now than in past decades.


Professional organizations

The principal North American professional association was originally named the Lawson Wilkins Pediatric Endocrine Society, now renamed the Pediatric Endocrine Society. Other longstanding pediatric endocrine associations include the European Society for Paediatric Endocrinology, the British Society for Paediatric Endocrinology, the Australasian Paediatric Endocrine Group and the Japanese Society for Pediatric Endocrinology. Professional associations of the specialty continue to proliferate.


Controversial treatment guidelines

In 2021, the Pediatric Endocrine Society offered updated recommendations for use of growth-promoting hormone therapy and related medications in children. The Guidelines for Growth Hormone and Insulin-Like Growth Factor-1 Treatment in Children and Adolescents were updated from 2003 and reflect the continuing controversy over how to diagnose, categorize and treat growth failure in children. The guideline was developed following the
GRADE approach The GRADE approach (Grading of Recommendations Assessment, Development and Evaluation) is a method of assessing the certainty in evidence (also known as quality of evidence or confidence in effect estimates) and the strength of recommendations in ...
(Grading of Recommendations, Assessment, Development, and Evaluation). In 2021, the Pediatric Endocrine Society released a position statement in support of
Gender Affirming Care Transgender health care includes the prevention, diagnosis and treatment of physical and mental health conditions which affect transgender individuals.Gorton N, Grubb HM (2014). General, Sexual, and Reproductive health. In L. Erickson-Schroth. ...
(GAC). In it the society states, "Puberty suppression and/or gender-affirming hormone therapy is recommended within this evidence-based approach on a case-by-case basis as medically necessary and is potentially lifesaving." This position is at odds with the position of England's National Health Service (
NHS The National Health Service (NHS) is the term for the publicly funded health care, publicly funded healthcare systems of the United Kingdom: the National Health Service (England), NHS Scotland, NHS Wales, and Health and Social Care (Northern ...
) which maintains that evidence for puberty blockers and hormone treatment for gender transition wholly is inadequate, and has decided to stop routine prescribing of puberty blockers.


See also

*
Robert Lustig Robert H. Lustig (born 1957) is an American pediatric endocrinologist. He is professor emeritus of pediatrics in the division of endocrinology at the University of California, San Francisco (UCSF), where he specialized in neuroendocrinology and ...
, an American pediatric endocrinologist *
Melvin Grumbach Melvin Malcolm Grumbach (December 21, 1925 – October 4, 2016) was an American pediatrician and academic who specialized in pediatric endocrinology. Called Edward B. Shaw Distinguished Professor of Pediatrics, Emeritus at the University of Calif ...
, an American pediatric endocrinologist


References

* {{Authority control Endocrinology, Pediatric Endocrinology Medicine Diabetes Hormones Medical controversies Thyroid