Endocrine Disorders In Children Research Articles

Endocrine Disorders in Children with Primary Mitochondrial Diseases: Single-Center Experience.

Endocrine abnormalities may represent the only clinical manifestation of primary mitochondrial disorders. This study aimed to evaluate the endocrinological characteristics of mitochondrial disease in our cohort. A total of twenty-six pediatric patients diagnosed with mitochondrial disease were categorized on the basis of their specific genetic abnormalities. The auxologic data, pubertal development, and, based on their clinical symptoms, hormonal profiles were obtained. Twelve of the cohort of 26 patients (46%) were female. In 15 of the patients (57.6%), their mitochondrial disease (MD) was caused by nuclear DNA mutations (nDNA group). Four patients had Leigh syndrome, 2 patients had LHON syndrome, 2 patients had MELAS, and 1 patient had KSS clinical phenotype. The median age at diagnosis was 2.91 (0.59-16.8) years, and the median age at first endocrinologic evaluation was 4.62 (1.26-18) years. The mean height SDS was -1.34 ± 2.12, and the mean BMI SDS was -0.82 ± 1.96 for all patients. Of the 26 patients, 6 (23%) had a range of hormonal deficits. Ovarian insufficiency, central adrenal insufficiency, central hypothyroidism, diabetes mellitus, and critical illness-related adrenal insufficiency were all observed. Three of the patients were initially monitored in the endocrine clinic for hormone deficiencies but it was later determined that the hormonal abnormalities were caused by underlying mitochondrial disease. Individuals diagnosed with mitochondrial disease, particularly those with specific genetic abnormalities, are considered a high-risk group for developing hormonal deficits. Endocrine diseases could be one of the primary mitochondrial disorders' early warning symptoms.

BELUGA WHALE LION OPTIMIZATION IN DEEP-NETS FOR HUMAN AGE ESTIMATION USING HAND X-RAY

Bones undergo significant changes in size and shape with the growth of the child, and bone age estimation is crucial for determining the growth, genetic and endocrine disorders in children. Hand X-ray images are extensively utilized for diagnosing disorders in children. The variation in the chronological age and bone age indicates the presence of endocrine disorders, genetic problems, and growth abnormalities. Traditionally, bone age is estimated manually by inspecting the X-ray images, which is extremely time-consuming and prone to error. Further, the accuracy of the bone estimate depends on the experience of the medical practitioner, and thus it suffers from intra- and inter-observer variability. Hence, to overcome these issues, it is essential to devise automatic methods that can estimate the bone with high accuracy and in a short duration. In this work, bone age is estimated using a Deep Residual Network (DRN), whose learnable factors are adjusted using the devised Beluga Whale Lion Optimization (BWLO) algorithm. Further, the BWLO_DRN is examined for its superiority considering metrics, like accuracy, True Positive Rate (TPR), and True Negative Rate (TNR), and the corresponding values of 89.8%, 86.8%, and 90% are found to be achieved from the experimental results.

Clinical profiles and molecular genetic analyses of 98 Chinese children with short statures.

Short stature is one of the most prevalent endocrine disorders in children, and its genetic basis is a complex and actively researched subject. Currently, there is limited genetic research on exome sequencing for short stature, and more large-scale studies are necessary for further exploration. The retrospective study entailed investigation of 98 Chinese children with short statures (height SDS ≤ -2.5) of unknown etiologies recruited between 2017 and 2021. Whole-exome sequencing (WES) was performed on these patients to identify the potential genetic etiologies. The clinical data were reviewed retrospectively to assess the pathogenicity of the identified mutations. Additionally, 31 patients consented to and received recombinant human growth hormone (rhGH) therapy for 12 months. The short-term effects of rhGH treatment were evaluated across different etiologies of patients with short statures. The WES results were used to identify 31 different variants in 18 genes among 24 (24.5%) patients. Individuals with more severe short statures were more likely to have underlying genetic etiologies. Short stature accompanied by other phenotypes had significantly higher diagnostic yields than simple severe short stature. The rhGH therapy demonstrated efficacy in most children. Nevertheless, the treatment response was suboptimal in a boy diagnosed with 3M syndrome. WES is an important approach for confirming genetic disorders in patients with severe short statures of unknown etiologies, suggesting that it could be used as a primary diagnostic strategy. The administration of rhGH may not be suitable for all children with short statures, and the identification of the genetic cause of short stature by WES has significant guidance value for rhGH treatment.

Prevalence of Selected Polymorphisms of Il7R, CD226, CAPSL, and CLEC16A Genes in Children and Adolescents with Autoimmune Thyroid Diseases.

Hashimoto's thyroiditis (HT) and Graves' disease (GD) are common autoimmune endocrine disorders in children. Studies indicate that apart from environmental factors, genetic background significantly contributes to the development of these diseases. This study aimed to assess the prevalence of selected single-nucleotide polymorphisms (SNPs) of Il7R, CD226, CAPSL, and CLEC16A genes in children with autoimmune thyroid diseases. We analyzed SNPs at the locus rs3194051, rs6897932 of IL7R, rs763361 of CD226, rs1010601 of CAPSL, and rs725613 of CLEC16A gene in 56 HT patients, 124 GD patients, and 156 healthy children. We observed significant differences in alleles IL7R (rs6897932) between HT males and the control group (C > T, p = 0.028) and between all GD patients and healthy children (C > T, p = 0.035) as well as GD females and controls (C > T, p = 0.018). Moreover, the C/T genotype was less frequent in GD patients at rs6897932 locus and in HT males at rs1010601 locus. The presence of the T allele in the IL7R (rs6897932) locus appears to have a protective effect against HT in males and GD in all children. Similarly, the presence of the T allele in the CAPSL locus (rs1010601) seems to reduce the risk of HT development in all patients.

Meta-analysis of machine learning models for the diagnosis of central precocious puberty based on clinical, hormonal (laboratory) and imaging data.

Central precocious puberty (CPP) is a common endocrine disorder in children, and its diagnosis primarily relies on the gonadotropin-releasing hormone (GnRH) stimulation test, which is expensive and time-consuming. With the widespread application of artificial intelligence in medicine, some studies have utilized clinical, hormonal (laboratory) and imaging data-based machine learning (ML) models to identify CPP. However, the results of these studies varied widely and were challenging to directly compare, mainly due to diverse ML methods. Therefore, the diagnostic value of clinical, hormonal (laboratory) and imaging data-based ML models for CPP remains elusive. The aim of this study was to investigate the diagnostic value of ML models based on clinical, hormonal (laboratory) and imaging data for CPP through a meta-analysis of existing studies. We conducted a comprehensive search for relevant English articles on clinical, hormonal (laboratory) and imaging data-based ML models for diagnosing CPP, covering the period from the database creation date to December 2023. Pooled sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR-), summary receiver operating characteristic (SROC) curve, and area under the curve (AUC) were calculated to assess the diagnostic value of clinical, hormonal (laboratory) and imaging data-based ML models for diagnosing CPP. The I2 test was employed to evaluate heterogeneity, and the source of heterogeneity was investigated through meta-regression analysis. Publication bias was assessed using the Deeks funnel plot asymmetry test. Six studies met the eligibility criteria. The pooled sensitivity and specificity were 0.82 (95% confidence interval (CI) 0.62-0.93) and 0.85 (95% CI 0.80-0.90), respectively. The LR+ was 6.00, and the LR- was 0.21, indicating that clinical, hormonal (laboratory) and imaging data-based ML models exhibited an excellent ability to confirm or exclude CPP. Additionally, the SROC curve showed that the AUC of the clinical, hormonal (laboratory) and imaging data-based ML models in the diagnosis of CPP was 0.90 (95% CI 0.87-0.92), demonstrating good diagnostic value for CPP. Based on the outcomes of our meta-analysis, clinical and imaging data-based ML models are excellent diagnostic tools with high sensitivity, specificity, and AUC in the diagnosis of CPP. Despite the geographical limitations of the study findings, future research endeavors will strive to address these issues to enhance their applicability and reliability, providing more precise guidance for the differentiation and treatment of CPP.

Hormonal profile changes under the influence of environmental factors in children residing in the Aral environmental disaster region

BACKGROUND: Since the mid 20th century, the Southern Aral Sea Region is notorious as a region of ecological disaster, where anthropogenic influence led to the desiccation of the Aral Sea. Aridization of these territories is the cause of accumulation of endocrine disrupting chemicals — pesticides and toxic metals in soil and water.
 AIM: The aim of this study was to assess the changes in hormonal profile under the influence of environmental factors in prepubertal children living at different distances from the epicenter of the Aral ecological disaster.
 MATERIALS AND METHODS: The study included 58 male children aged 11–13 years. All children from birth lived in two regions of the Aral Sea Region and were divided into two groups depending on their place of residence. The group “North” (unfavorable conditions) consisted of 27 children from Muynak, Kungrad, Karauzyak, Takhtakupyr districts. The “Nukus” group (relatively favorable conditions) included 31 volunteers from Nukus city. All children were determined the concentration of IGF-1 — Insulin-like growth factor 1, GH — growth gormone, TT — total testosterone, E2 — estradiol, FSH — follicle-stimulating hormone, LH — luteinizing hormone, TSH — thyroid-stimulating hormone, TT3 — total triiodothyronine in blood sample. The statistical significance of the differences of the mentioned hormones in children from the “North” and “Nukus” groups was checked using the Mann–Whitney test.
 RESULTS: This analysis revealed statistically significantly higher values of TT, FSH and LH in children from the “Nukus” group compared to their peers from the “North” group. The concentrations of IGF-1, GH, E2, TTG and T3 in blood plasma in volunteers from both groups were not statistically significantly different.
 CONCLUSIONS: The environment of the Aral ecological disaster region with increased content of organochlorine compounds, pesticides and heavy metals changes the endocrine status in local prepubertal children. This is expressed in a moderate decrease in the activity of androgens (but not estrogens) and gonadotropic hormones. This research work can be considered as a pilot study, which determines the need for further monitoring of endocrine disorders in children and adults living in negative environmental conditions.

A decrease in serum dihydrotestosterone levels in 9-year-old Vietnamese children from a dioxin exposure area.

Dioxin is an environmental pollutant as well as an endocrine disruptor in humans. Our longitudinal study wants to clarify the relationship between dioxin exposure and endocrine disorders in children living in the Vietnamese dioxin hotspot. Seventeen congeners of polychlorinated dibenzo-p-dioxins/polychlorinated dibenzo-furans (PCDDs/PCDFs) in maternal breast milk and seven serum steroid hormones in children of 43 and 46 mothers and their 9-year-old children from the non-exposure and the hotspot areas were measured, respectively. The steroid metabolic enzyme ratios were calculated based on the hormone level ratio. Most dioxin/furan congeners and toxic equivalents (TEQs) levels were significantly higher in the hotspot than in the non-exposure area, except for 2,4,7,8-TeCDF. The height and weight of girls from the hotspot area were substantially lower and inversely correlated with dioxin congener levels/total TEQs level dioxin. The dihydrotestosterone (DHT) levels in the hotspot were markedly lower than those in non-exposed in both genders. The cortisol concentrations were significantly higher in the hotspot than those from the non-exposure area only in the girls. The DHT/testosterone ratios that exhibited the 5α- or 5β-reductase activity declined by 50% in the hotspot area for both genders. The DHT levels showed strong inverse correlations with almost the PCDDs/PCDFs congeners and total TEQs dioxin in breast milk. This finding suggests that dioxin exposure in maternal breast milk might impact children's endocrine system until 9 years old, especially on the DHT biosynthesis.

Diabetic ketoacidosis and cognitive impairment in children and adolescents

The aim of the literature review was to highlight modern scientific sources on the formation and clinical manifestations of cognitive impairment in children and adolescents with type 1 diabetes mellitus (DM) after diabetic ketoacidosis (DKA). Type 1 DM is one of the most prevalent endocrine disorders in childhood and adolescence. DKA is the most common acute complication of type 1 DM that may cause cognitive impairment. Cerebral edema is the main cause of cerebral vascular insufficiency in patients with DKA. However, the mechanisms underlying the development of cognitive dysfunction in DKA have not been fully elucidated.The leading hypotheses include development of neuroinflammation, oxidative stress, disruption of neurogenesis, and neurodegeneration. Hypoxic – ischemic injury and changes in the brain neuroanatomy may also cause cognitive dysfunction. Disruption of some brain structures has been reported after DKA episodes, primarily affecting the white matter. Clinical studies in the pediatric population support the presence of a correlation between the severity and frequency of DKA and the severity of cognitive impairment. Cognitive dysfunction in children and adolescents after a DKA episode can manifest through decreased attention, impaired memory and executive function, and reduced IQ. The earliest possible diagnosis of cognitive impairment in pediatric patients with symptoms of DKA in the context of type 1 DM can improve the treatment prognosis for this endocrinopathy.

Stretched Penile Length in Boys - A Cross-sectional Single Centre Study

Introduction: Stretched penile length is the most relevant measurement to define the size of the penis, which varies in various ages, geographical regions and ethnicities. Thus, a population specific normative data on stretched penile length helps in early diagnosis of penile abnormalities and endocrine disorders in children.
 Methods: A cross sectional study was done in 501 healthy boys from neonatal period till 12 years of age. Boys with abnormalities of external genitalia, suspected endocrine disorders, suspected syndromes, chronic diseases were excluded from the study. Stretched penile length was measured with a transparent ruler from the pubic ramus till the tip of the glans penis excluding the foreskin. Height and weight of the boys were also recorded. Spearman’s rank correlation coefficient test was used to find the correlation of stretched penile length vs height and weight of the boys. P < 0.05 was considered significant.
 Results: The median, 5th, 95th percentiles of stretched penile length were calculated. The median stretched penile length of the boys ranged from 3.01 (2.32, 3.06) cm in infancy to 6.33 (6.04, 6.62) cm by 12 years. The correlation of stretched penile length vs height and weight showed a statistically significant positive correlation. (rs = 0.979, p < 0.001; rs = 0.971, P < 0.001 respectively).
 Conclusions: Our study provides normative data on stretched penile length from neonatal period till 12 years of age. There was a significant positive correlation between stretched penile length and height and weight of the boys.

School Performance Among a Sample of Type1 Diabetic Children and Adolescents in Erbil City

Background: Type 1 diabetes mellitus (T1DM) is the most common endocrine disorder in children. The glycated haemoglobin (HbA1C) level was found to be correlated with the academic skills and classroom attention in children with T1DM. Left untreated both high and low blood sugar levels can affect the child’s ability to concentrate on schoolwork and participate in school activities. Methodology: In Laila Qasim diabetic center from June to August 2022, a questionnaire survey was used for this cross-sectional study. The sample included 120 diabetic children for case group. All primary and secondary school pupils with type 1 diabetes were included in the study population. Result: In the present study, the correlation between diabetes and poor performance is clear in mathematics, english and science. The highest rate of fair followed not pass was found in uncontrolled HbA1c level (greater than 7) in all subjects except kurdish and found that students with type 1 diabetes had significantly lower overall academic grades than their nondiabetic classmates. Conclusion: Diabetes is associated with reduced neuronal function, which ultimately results in cognitive impairment in areas such as intelligence, learning, memory, information processing, attention, executive function, visual motor integration, and academic performances. Keywords: Type 1 diabetes mellitus; Children and adolescents; Academic performance; School

Endocrine Disorders in Children with Brain Tumors: At Diagnosis, after Surgery, Radiotherapy and Chemotherapy.

Brain tumors are the second most frequent type of all pediatric malignancies. Depending on their localization, patients with brain tumors may present neurological or ophthalmological symptoms, but also weight anomalies and endocrine disorders ranging from growth hormone deficiency, anomalies of puberty, diabetes insipidus to panhypopituitarism. Immediately at diagnosis, all patients with brain tumors require a complete assessment of the hypothalamic-pituitary function in order to address eventual endocrine disorders. Moreover, children and adolescents undergoing brain surgery must receive peri- and postoperative hydrocortisone stress therapy. Post-operative disorders of water homeostasis are frequent, ranging from transient diabetes insipidus, as well as syndrome of inappropriate antidiuretic hormone secretion to persistent diabetes insipidus. Late endocrine disorders may result from surgery near or within the hypothalamic-pituitary region. Pituitary deficits are frequent after radiotherapy, especially growth hormone deficiency. Thyroid nodules or secondary thyroid cancers may arise years after radiotherapy. Gonadal dysfunction is frequent after chemotherapy especially with alkylating agents. Early detection and treatment of specific endocrine disorders at diagnosis, perioperatively, and during long-term follow-up result in improved general and metabolic health and quality of life.

Pattern of presentation of paediatric endocrine disorders in a Nigerian tertiary institution: an 11-year survey.

There is need to generate epidemiological data regarding paediatric endocrine disorders (PEDs) in sub-Saharan Africa, since little attention has been given endocrine disorders in children in this sub-region over the years. The aim of the study was to determine the sociodemographic characteristics of children with endocrine disorders in our paediatric endocrinology clinic, as well as the pattern of presentation of these disorders. This study included paediatric patients who presented to the endocrine clinic over an 11-year period. Data of patients seen during the study period were retrieved from the case notes and were analyzed using SPSS version 23. A total of 188 patients were seen over the study period, with an almost equal male:female ratio. Five of thepatients (2.7%) could not be classified into any gender because of genital ambiguity. The age of the patients at diagnosis ranged from 0 to 18 years of age with a median age of 9.03 (9.94) years. All the 14 subdivisions of paediatric endocrine disorders were documented among the patients, with thyroid disorders ranking highest among thePEDs seen. Type 1 diabetes mellitus, obesity and pubertal disorders were the most prevalent PEDs (in descending order), after thyroid disorders. Congenital hypothyroidism accounted for 14.3% of patients with thyroid disorders. Thyroid disorders, type 1 diabetes mellitus and obesity rank highest among the PEDs in our locality. There is the need to create awareness among healthcare workers and the general public regarding these disorders, in order to improve appropriate and timely presentation of patients to the clinic.

Impact of virtual care on health-related quality of life in children with diabetes mellitus: a systematic review protocol

IntroductionDiabetes mellitus is the most common endocrine disorder in children, and the prevalence of paediatric type 1 and type 2 diabetes continue to rise globally. Diabetes clinical care programs pivoted...

Features of the Hospitalized Incidence and Prevalence of Pediatric and Adolescent Endocrine Disorders in the Orenburg Region

Background: The incidence of endocrine diseases, eating and metabolic disorders has been increasing recently. The prevalence and structure of pediatric and adolescent endocrine disorders are significantly different from those in adults and have specific regional features. Objective: To study the frequency, structure, and long-term changes in the rates of hospitalization of the child population for diseases of the endocrine system in the Orenburg Region and to assess local features of disease incidence and prevalence. Materials and methods: We analyzed data on all pediatric cases (aged 0–18) of hospital care for endocrine disorders provided by the regional office of the Federal Compulsory Medical Insurance Fund for 2016–2020. We also applied the Ward’s hierarchical clustering method to establish local peculiarities and to group municipalities by the rates and dynamics of endocrine diseases in children. Results: The average rate of hospitalization for endocrine disorders was 3.8 cases per 1,000 children and accounted for almost 3.9 % of all types of hospital care. The proportion of inpatients among children aged 0 to 14 years was higher than that among adolescents. Metabolic disorders (34.0 %), insulin-dependent diabetes mellitus (22.3 %), hypofunction and other pituitary disorders (12.6 %), obesity and other types of overnutrition (7.1 %), and undernutrition (5.7 %) prevailed in all hospitalized children. The patterns of pediatric and adolescent inpatients differed significantly. The analysis of the prevalence of endocrine disorders in children and its long-term changes enabled clustering of the territories of the Orenburg Region.Conclusions: Three distinct clusters of territories were established in the analysis of local rates of endocrine diseases in children. The first cluster was characterized by moderate disease rates, while the second and the third clusters demonstrated high and low incidence and prevalence rates of pediatric and adolescent endocrine disorders.

Comorbidity of endocrine disorders in children with chronic liver disease visiting Children’s hospital of Tabriz University of Medical Sciences

Introduction: Many studies over the last two decades have dealt with the comorbidity of chronic liver disease (CLD) and endocrine disorders. Nevertheless, regional differences can affect the prevalence and etiology of diseases and their complications. Objectives: Since no similar study has been conducted in Tabriz (a populous city in Iran), this study aimed to address the comorbidity of hormonal disorders in children with CLD visiting Children’s hospital of Tabriz (a center in northwest Iran). Patients and Methods: This descriptive cross-sectional study was conducted on children (2-18 years old) with CLD who visited Children’s hospital of Tabriz in 2019-2020. Of them, 60 children were randomly selected as the sample. First, the status of endocrines was examined, and then its association with CLD was determined. Results: The mean Insulin-like growth factor (IGF 1) of participants in all age groups was lower than the standard range. There was no significant difference between participants with different endocrine disorders in the levels of calcium, phosphorus, albumin, parathyroid hormone (PTH), total protein, cholesterol, triglyceride, growth hormone, and fasting blood sugar as well as the results of thyroid function tests. However, there was a significant difference between participants with different types of endocrine disorders in terms of IGF 1 (P=0.018). The highest and the lowest mean values of IGF 1 were observed in patients with primary sclerosing cholangitis (PSC) (520.59±12.52 ng/dL) and patients with primary biliary cirrhosis (142.95±3.96 ng/dL), respectively. Conclusion: Autoimmune hepatitis was the most common chronic disease among the participants of this study. CLD causes a decrease in IGF1 level and it is responsible for about one-third of all bone fractures; however, overt diabetes and thyroid diseases were not observed in these patients.

Метод секвенирования нового поколения в дифференциальной диагностике сахарного диабета у детей

In addition to type 1 and 2 diabetes mellitus (DM), endocrine disorders in children include hereditary forms of diabetes, such as maturity onset diabetes of the young (MODY). Since pathogenic mechanisms of chronic hyperglycemia in MODY are different from those in DM1 and DM2, it requires other therapeutic approaches. The diagnosis of MODY is confirmed by expensive molecular testing, such as next generation sequencing (NGS). Therefore, the strategy of choosing candidates for NGS is very important. Objective. To optimize the algorithm of choosing patients for NGS testing for DM type verification. Patients and methods. This study included 97 patients aged 1–18 years suspected of having MODY. We used NGS to confirm the diagnosis and identify polymorphisms in MODY-associated genes. Results. Fifty-three patients were found to have polymorphisms in MODY-associated genes, including GCK gene (MODY2) (n = 44), NHF1A gene (MODY3) (n = 8), and PAX4 gene (MODY9) (n = 1). Comparison of family histories of patients with MODY-associated polymorphisms and those in whom clinical diagnosis of MODY was not confirmed by NGS demonstrated significant differences: children with verified MODY were more likely to have first-degree relatives with some carbohydrate metabolism disorder (CMDs). Clinical, laboratory, and anthropometric parameters, as well as levels of insulin secretion and carbohydrate metabolism were similar in both groups. However, patients with non-confirmed MODY received insulin therapy more frequently than those with verified MODY as the majority of them were on a diet. Conclusion. NGS confirms the diagnosis of MODY in patients with different CMDs. A tailored approach should be used to choose patients for NGS to confirm MODY. Key words: monogenic diabetes mellitus in children, diabetes mellitus, next generation sequencing, GCK, HNF1A, MODY

Diseases of the Endocrine System in the Population of the Orenburg Region

Introduction. The increase in the rates of diseases of the endocrine system has been observed in the Russian Federation for many years. Unfavorable trends, including increasing growth rates and rising incidence and prevalence, are also registered in the Orenburg Region. The prevalence and structure of endocrine disorders in children and adolescents differ significantly from those in adults. The objective of our study was to establish regional features of the structure, dynamics and rates of endocrine morbidity in the population of the Orenburg Region. Materials and methods. We conducted correlation and regression analyses of data extracted from summary statistical reports for 2006–2019 issued by the State Budgetary Health Care Institution for the Orenburg Region “Medical Information and Analytical Center”. Results. In 2006–2019, the incidence rate of diseases of the endocrine system increased by 1.6 and 1.7 times in the Russian Federation and the Orenburg Region, respectively. In 2019, the growth rate in the Orenburg Region was 2.6 %. We observed age-specific differences in disease growth rates: the prevalence in the adult population increased by 1.7 times while in children aged 0–14 years this increase was already by 2.4 times. The incidence rate of endocrine disorders in the population of the Russian Federation and the Volga Federal District increased by 1.2 times, and in the Orenburg Region – by 1.5 times. By 2024, there is a 95 % probability that the prevalence of diseases of the endocrine system will range from 124.3 to 143.3 % while the incidence rates might range from 20.6 to 38.6 % with the same confidence level. Conclusions. Our findings indicate unfavorable trends in the rates of diseases of the endocrine system among both adults and children.

SARS-CoV-2 infection and paediatric endocrine disorders: Risks and management considerations.

BackgroundCoronavirus‐19 (COVID‐19) is a disease caused by the SARS‐CoV‐2 virus, the seventh coronavirus identified as causing disease in humans. The SARS‐CoV‐2 virus has multiple potential pathophysiologic interconnections with endocrine systems, potentially causing disturbances in glucose metabolism, hypothalamic and pituitary function, adrenal function and mineral metabolism. A growing body of data is revealing both the effects of underlying endocrine disorders on COVID‐19 disease outcome and the effects of the SARS‐CoV‐2 virus on endocrine systems. However, comprehensive assessment of the relationship to endocrine disorders in children has been lacking.ContentIn this review, we present the effects of SARS‐CoV‐2 infection on endocrine systems and review the current literature on complications of COVID‐19 disease in underlying paediatric endocrine disorders. We provide recommendations on management of endocrinopathies related to SARS‐CoV‐2 infection in this population.Summary and outlookWith the surge in COVID‐19 cases worldwide, it is important for paediatric endocrinologists to be aware of the interaction of SARS‐CoV‐2 with the endocrine system and management considerations for patients with underlying disorders who develop COVID‐19 disease. While children and adults share some risk factors that influence risk of complications in SARS‐CoV‐2 infection, it is becoming clear that responses in the paediatric population are distinct and outcomes from adult studies cannot be extrapolated. Evidence emerging from paediatric studies provides some guidance but highlights the need for more research in this area.

Serum ferritin levels and endocrine disorders in children with thalassemia major

Background Endocrine disorders in thalassemia major children patients occur due to iron overload and hemosiderosis in endocrine organs. Early detection is needed to prevent complications and improve the quality of life. An association between serum ferritin and endocrine disorders in thalassemia patients has been inconclusive to date.
 Objective To analyze for possible associations between serum ferritin and endocrine disorders (short stature, delayed puberty, delayed bone age, hypothyroidism, impaired glucose tolerance, and diabetes mellitus) and the incidence of each disorder in thalassemia major.
 Methods There were 115 thalassemia major patients aged 10-18 years involved in our cross-sectional study from June 2019 - June 2020 in the Pediatrics Department, DR. M Hosein Hospital, Palembang, South Sumatera. Anthropometry and socioeconomic status informations were collected from physical examination and interview. Ferritin, FT4, TSH, Hb and glucose levels measured by using standard methods for each item in the laboratory, mean while the skeletal age assessment was determined by using FELS method. 
 Results This study included 83 (72.2%) girls and 32 (27.8%) boys. There were 89 (77.4%) subjects with short stature, 74 (64.4%) with delayed bone age, 30 (26.1%) with impaired glucose tolerance, 25 (21.7%) with delayed puberty, 4 (3.5%) with diabetes mellitus (DM), and none with hypothyroidism. Bivariate and multivariate analyses revealed no associations between serum ferritin and short stature, delayed bone age, impaired glucose tolerance, delayed puberty, and DM.
 Conclusion There is a high prevalence of endocrine disorders in pediatric thalassemia patients, especially short stature and delayed bone age. However, there are no associations between serum ferritin and endocrine disorders in these patients.

SELENIUM LEVELS IN PEDIATRIC PATIENTS WITH ENDOCRINE DISEASES: EVIDENCE FROM A SYSTEMATIC REVIEW

Selenium (Se) is essential micronutrient involved in several physiological processes. In many regions around the world, a suboptimal intake of Se has been reported in several health conditions, also in pediatric age. Studies on association between Se level and diseases in children reported contrasting results. We took an aim to perform a systematic review of literature and provide evidence-based conclusion on the magnitude of Se deficit in endocrine diseases in children. PubMed, ISI WoS, and Scopus databases were searched to identify eligible studies, published until July 25, 2019. Methodological quality was assessed using Newcastle–Ottawa Scale. After careful selection, 13 eligible studies were included. Majority were conducted in Turkey (n=5) and Iran (n=5), and sample size varied from 61 to 628 children, with a mean (±SD) age of cases from 5.1±1.6 months up to 13.8±4.5 years. Eleven studies focused on different thyroid diseases, and two on children with type 1 diabetes mellitus (T1DM). In goitrous patients, Se level ranged from mean (±SD), 25.71±20.68 μg/L to 114.9±34.1 μg/L, while in patients with T1DM was 20.9±12.9 μg/mL and mean (95% CI)=58.4 μg/L (55.0–63.09). We may conclude that goiter and thyroid dysfunction are prominent signs of Se deficiency in children. Although deficiency of iodine and selenium are usually combined in some area, our systematic review showed that Se deficiency is important goitrogenic factor in school children. Further randomized controlled trials are needed to adequately explore the role of Se in endocrine disorders in children, across different populations and regions.