Update on Common Childhood Endocrine Disorders

Abstract

This issue focuses on a number of common childhood endocrine disorders. Dr. Stacy Meyer and her contributing colleagues have done an excellent job putting together a very readable overview of those disorders. The article begins with a topic that is “front and center” on most parents minds when they see their child’s primary clinician: is my child growing normally? Following the formula for estimating genetic linear growth potential (for both boys and girls) and tips on an appropriate physician examination when there are concerns about linear growth, Dr. Meyer reviews the differential diagnosis and treatment of children with short stature—including familial short stature and growth hormone deficiency. This practical approach for primary care clinicians continues throughout the article. Growth is followed by an overview of normal pubertal development, another common parental concern (for teens too!) in primary care. The management of precocious puberty (central and peripheral) and delayed puberty are addressed in this section. Dr. Meyer then reviews conditions that produce euthyroid states in which the efficacy of treatment is controversial—e.g., TSH elevation in obese children. Of course, there are numerous hypothyroid and hyperthyroid diseases of childhood that respond to therapy and Dr. Meyers carefully reviews important aspects of the management of these childhood diseases, including childhood thyroid cancer. As Dr. Meyer and her colleagues note in their conclusion, pediatric endocrinology is evolving with new effective treatment options for children with endocrine disorders. Because the presentation of pediatric endocrine disease can be quite variable the primary care clinician must have an index of suspicion to identify children who will benefit from therapy early in their disease. Within this issue Dr. Meyer and her contributing colleagues have given the primary care clinician the “gift” of a well organized, easily readable compendium of childhood endocrine disorders as well as an overview of normal growth and pubertal development. This issue is a valuable resource for all clinicians who provide primary health care to children and their families.