Endocrine Abstracts

Congenital adrenal hyperplasia (CAH) comprises a family of inherited autosomal recessive disorders of steroidogenesis, characterized by deficiency of cortisol and an accumulation of substrate precursors. CAH is most commonly caused by 21-hydroxylase deficiency, which causes virilisations of the external genitalia in females. In addition, deficiency of 11-hydroxylase and P450 oxidoreductase are also associated with virilisation of the external genitalia in females. Prenatal tre...

Glucose is essential for cerebral metabolism. Knowledge of the homeostatic mechanisms that maintain blood glucose concentrations within a tight range is the key for diagnosis and appropriate management of hypoglycemia. Neonatal hypoglycemia can be transient and is commonly observed in at-risk infants. A wide range of rare endocrine and metabolic disorders can present with neonatal hypoglycemia, of which congenital hyperinsulinism (CHI) is responsible for the most severe form o...

Glucocorticoids form the mainstay of many treatment modalities in paediatrics ranging from short term use in asthma to longer term use as anti-inflammatory agents in nephrotic syndrome and rheumatoid disorders. Long term use although effective brings with it the problems of adrenal suppression.When considering weaning a patient from glucocorticoid use consideration needs to be given to the type of glucocorticoid used, duration of treatment, dosage used a...

Key discussion points• Make sure you know what it is that you are treating – is this Graves’ hyperthyroidism (with associated TSH receptor antibodies) or simply a brief, hyperthyroid phase of autoimmune thyroid disease (without TSH receptor antibodies) that will settle down spontaneously?• Ideally obtain the result of the thyroid receptor antibody titre pre intervention with carbimazole.&#...

Hypocalcemia is defined as serum calcium (Ca) level below the lower limit of the normal range of 2.2–2.7 mmol/l. It may arise because of inadequate Ca supply (dietary deficiency, Vitamin D deficiency or resistance), impaired parathyroid hormone secretion or resistance (pseudohypoparathyroidism). Hypomagnesemia may lead to hypocalcemia due to impaired parathyroid hormone secretion and/or end organ resistance, and hence it is important to promptly recognize and treat it con...

Precocious pubertal development is generally defined as the clinical manifestation of secondary sex characteristics above the 99.6th centile for age. In the UK this corresponds to 8 years in girls and 9 years in boys. The UK growth charts divide at these ages to remind us that a child who plots on the left sided panel and who has pubertal signs is precocious and warrants medical review. The vertical puberty lines have reminders of precocity (and delay). Stage lines on the RCPC...

Continuous Glucose Monitoring and Flash Glucose Sensing are exciting new technologies popular with many patients and their parents who are keen to have access to such technologies. However such technologies are costly and it is important that clinicians identify patients who are most likely to benefit and ensure that families have appropriate training in order to optimise their use. The aims of this overview are firstly to review the evidence underpinning CGMS and to discuss t...