Some aspects of paediatric endocrinology

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Some aspects of paediatric endocrinology

• Luczay
• 15/09/2008

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Parathyroid gland
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GhRH GnRH TRH CRH ADH
GH FSH, LH TSH ACTH PRL
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SHORT STATURE
15 organic diseases 2 skeletal dysplasia 1
Turner syndrome 1 hypothyroidism 1 GHD
80 FSS PSD
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GHD

• micropenis, hypoglycaemia in newborns
• delay in dentation
• progressive growth delay
• bone age retardation
• low growth hormone peaks in GH stimulation test

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Causes of GHD 1.
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Diabetes insipidus

• ADH defficiency
• polyuria, polidipsia
• enuresis
• fever in infancy
• Hypernatraemia, low urine osmolarity

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Parathyroid gland
thyroxine, trijodthyronine
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Patology of the thyroid gland IHypothyroidism

• Congenital hypothyroidism
• 1/4000 live birth
• floppy infant, thick, protruding tongue,
• poor feeding, constipation,
• prolonged jaundice
• Mass screenig TSH ?
• L-thyroxine supplementation

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Patology of the thyroid gland IHypothyroidism II.

• Hashimoto thyreoiditis
• goiter
• Autoantibody positivity
• Inhomogen ultrasound structure
• Lympocytic infiltration in histology
• fatigue, constipation, short stature
• TSH?, fT4?
• L-thyroxine supplementation

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Patology of the thyroid gland IHyperthyroidism
II.

• Graves-Basedow thyroiditis

exophtalmus
tachycardia, weight loss, diarrhoea
TSH?, fT4, fT3?
methimasol, surgery, iodine isotope treatment
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Parathyroid gland
PTH
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Pathology of the parathyroid gland

• Hypoparathyroidism
• se Ca?, seizure, osteoporosis
• Hyperparahyroidism adenoma, hyperplasia
• se Ca?, nephrolithiasis,

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Parathyroid gland
glucocorticoids cortisol mineralocorticoids
aldosteron androgens androstendione
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Steroid biosynthesis
P450c21
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Congenital adrenal hyperplasia

• 95 21-OH deficiency
• ¾ salt waisting form- in girls - ambigous
  genitalia

- early pubic hair puberty in boys
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Parathyroid gland
testosterone
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47,XXY Klinefelter delayed puberty gynaecomastia m
ental retardation
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Parathyroid gland
estrogen progesterone
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Turner syndrome

• 1/2500 girls/year
• Lymphoedema of the hands and/or feet
• Pterygium colli, short stature, facial dysmorphy
• Coarctation of the aorta, renal malformation
• Sexual infantilism (streak gonad)
• Karyotype 45,X

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