Endocrine Disorders in Children: A Comprehensive Guide
T(-)
Causes
prenatal exposre to Radioiodone
-Mother is Taking Anti Thyroid X
Sx
-Asx
-prolonged jaundice
-wide fontanelle
-macroglosia(tongue)
-umbelical hernia
-hypotonia
-abd distentiation
Dx
Failure to Tx Mental retardation
CRitinism
-TSH ,HIGH
-FreeT4, LOW
2nd -4th day of life
Tx:
Levothyroxine
T++
Causes
Graves in mother
Materal Trasnplacental IgG pass
Sx
Kg loss
sweating
heat intolerance
agiatiation
goitre
-Autoantibodies of TSH
-TSH
-freeT4
-US , Sctigraphy
Tx
-Antithyroid X, thiamasol
-Beta blockers
-diazepam
-thyriodectomy
Tyroid Cancer:
– irradiation
– Arising as a 2nmalignancy following
radiotherapy
– Genetic (inherited as part of MEN-2A, MEN-2B or
familial medullary
DX
-US
-scitigraphy
-BEST : FNA
Tx
thyriodectomy
Radio iodine Tx
(make sure tha thyroglobulin levels are undetectable before surgery)
Long term :
maintain TSH level <0.5 mmol/L
**Adrenal Insuff:
cause
21OG/17Og/11BOH
↑ Adrogen(+)
↓
cortisol & Aldosterone
Congenital adrenal hyperplasia
-Meningococcal septicaemia
– Haemorrhage into the adrenal glands
– Cessation of glucocorticoid therapy
– Adrenoleucodystrophy
Mutation ALD gene, Xq28chromosome
o ALD protein may be to transport VLCFA-COA synthetase
CF
Cerebral sclerosis
o Decrease visual acuity, blindnes
o Cognitive loss
o Ataxia
o Dementia,
o Adrenal inssufficiency
Vomiting without diarrhea
Drowsiness, fainting
Signs of shock, hypotension, tachycardia,
Dehydration
Dx
Glucose (hypoglycaemia)
-Electrolytes (hyponatremia)
– Acidosis
– Cortisol
– Adrenal steroids
– ACTH
Tx
^^^Hypothyrodism
Causes
prenatal exposre to Radioiodone
-Mother is Taking Anti Thyroid X
Sx
-Asx
-prolonged jaundice
-wide fontanelle
-macroglosia(tongue)
-umbelical hernia
-hypotonia
-abd distentiation
Dx
Failure to Tx Mental retardation
CRitinism
-TSH ,HIGH
-FreeT4, LOW
2nd -4th day of life
Tx:
Levothyroxine
HYperthyrodism:
Causes
Graves in mother
Materal Trasnplacental IgG pass
Sx
Kg loss
sweating
heat intolerance
agiatiation
goitre
-Autoantibodies of TSH
-TSH
-freeT4
-US , Sctigraphy
Tx
-Antithyroid X, thiamasol
-Beta blockers
-diazepam
-thyriodectomy
Tyroid Cancer:
– irradiation
– Arising as a 2nmalignancy following
radiotherapy
– Genetic (inherited as part of MEN-2A, MEN-2B or
familial medullary
DX
-US
-scitigraphy
-BEST : FNA
Tx
thyriodectomy
Radio iodine Tx
(make sure tha thyroglobulin levels are undetectable before surgery)
Long term :
maintain TSH level <0.5 mmol/L
**Adrenal Insuff:
cause
21OG/17Og/11BOH
↑ Adrogen(+)
↓
cortisol & Aldosterone
Congenital adrenal hyperplasia
-Meningococcal septicaemia
– Haemorrhage into the adrenal glands
– Cessation of glucocorticoid therapy
– Adrenoleucodystrophy
Mutation ALD gene, Xq28chromosome
o ALD protein may be to transport VLCFA-COA synthetase
CF
Cerebral sclerosis
o Decrease visual acuity, blindnes
o Cognitive loss
o Ataxia
o Dementia,
o Adrenal inssufficiency
Vomiting without diarrhea
Drowsiness, fainting
Signs of shock, hypotension, tachycardia,
Dehydration
Dx
Glucose (hypoglycaemia)
-Electrolytes (hyponatremia)
– Acidosis
– Cortisol
– Adrenal steroids
– ACTH
Tx
What to check in Blood in DKA ?
DM I —>type A and B
-Autoimmune GAD 65 immune marker
-IA2(antiphosphatase,IA2)
-Insulin Zinc trnaspoter 8 ( ZNT)
-ISL antibodiesother Autoimmune Disease with DKA Children!
-GRAVES
-HASHIMOTO(thyroditis)
-Celiac Disease——–>Antitrasnlutminase Ab)
-Addison (adrneal insuff)
-vetiligo(white spots of skin )
^^Tx target for children:
-HbA1c 7%)
^^Acute complication in DM(CHILDREN)
-Hypoglecemia + DKA(ADULTs :HHS/ DKA/Hypoglycemia/Lactci Acidcis)
^^Chronic complication in DM :
Same as Adult!!!
GH Def Dx?
-Height
-Stadiometer
-Body propr
-Referance Scale
SHORT
ENDOCRINE
NON endocrine
T(-)
PTG(-)
CAHGH(-)
Gonad(-)
-Constiutional Growth delay
-familial
-Genetic
Turner
Noonanprader willi
Constinal Gtowth:
– parents N
-history of catch up
-BA<CA ,
Familial:
-All Family members are Short
-Child always been short
-BA=CA
-Parallel to Curve !
-Normal development all Fine
TEST:
XRAY (LEFT HAND)
CMP
CBC
IGF-1 (for GH determination)
-Karytype (45XO turner)
Tx:
Soamtotropic
CASE:
1- Delayed Growth2-Dx:GH/GHRH /parents/androgen /Testosterone3- HEight :mom + dad+/13 Divide by 24-Lab result:DNA /Cortisol /GH /LH /FSH/ TSH /T3/T45-Special Test:
CA>BA , GHRH/Testosteone/ Ct/ MRI(Contiuinal age> Bone AGE)