Pediatric Endocrinology

Pediatric endocrinology is a medical specialty that studies the glands that produce hormones, known as the endocrine system
,
examines the functions of hormones and investigates the mechanisms that regulate hormone secretion.

The endocrine system consists of hormone-secreting glands located in various organs of the body. These glands include structures such as the pituitary, thyroid, pancreas, adrenal glands, gonads (testes and ovaries) and parathyroid glands.

Endocrinologists assess whether these glands are working properly and, if there is any change in hormone levels, diagnose and treat it.

Problems caused by disorders in the production or function of hormones that are vital for children's growth, development and maturation fall within the field of pediatric endocrinology. Pediatric endocrinologists diagnose and treat endocrine diseases in infants, children and adolescents from the newborn period up to the age of 18. The main conditions include:

1-Growth disorders
:

Short stature: A condition in which children do not grow as expected for their age; its causes include

isolated growth hormone deficiency, pituitary insufficiency and hypothyroidism, as well as malnutrition, genetic syndromes (such as Turner syndrome) or familial short stature.

Tall stature: Children may be taller than their peers due to excess growth hormone (caused by tumors or genetic factors) or for familial reasons. Children with early puberty and those with congenital adrenal hyperplasia may be taller than their peers at the onset of the disease, yet their adult height may remain short.

2-Disorders of sexual development
: A range of problems arising from hormonal irregularities during the development of the sexual organs or during puberty.

3-Adrenal gland disorders
: The adrenal glands produce cortisol and other hormones and regulate the stress response. Problems in the adrenal glands, such as Addison's disease or Cushing's syndrome, can cause growth, development and metabolic problems in children.
Deficiencies in adrenal hormone production resulting from genetic disorders can also disrupt sexual development.

4-Bone metabolism disorders
: In children, irregularities in calcium, phosphorus and vitamin D levels can affect bone development and health.

Rickets, which is caused by vitamin D deficiency or resistance and is characterized by softening of the bone

epiphyses and bowing of the bones; bone loss (osteopenia–osteoporosis), excessive bone hardening (osteosclerosis) and brittle bone disease (osteogenesis imperfecta) are among the diseases in this group.

Likewise, the parathyroid gland's inability to produce hormone (hypoparathyroidism), the failure of the parathyroid hormone produced to work (pseudohypoparathyroidism) and excessive parathyroid hormone production (hyperparathyroidism) are also diseases that affect bone metabolism.

5-Hypoglycemia:
Hypoglycemia, known as low blood sugar, can affect energy levels and metabolism in children. Although it is more common in the newborn period, it can occur at any age.

6-Diabetes:
A group of diseases in which carbohydrate, protein and fat metabolism is affected because blood sugar levels remain high, either because the pancreas cannot produce the hormone insulin or because the insulin produced does not work properly.
Type 1 diabetes due to insulin deficiency, type 2 diabetes caused by insulin resistance and genetically inherited MODY diabetes are the most common forms of diabetes.

7-Obesity
: Most commonly, exogenous obesity is seen as a result of overeating and physical inactivity. In only 1–5%

of patients is obesity caused by genetic

disorders, Cushing's syndrome, hypothyroidism, parathyroid hormone disorders and certain syndromes.

8-Excess hair growth (hirsutism)

and menstrual disorders
: Genital and/or underarm hair growth before the age of eight in girls and nine in boys may be the first sign of certain genetic diseases or of tumors that secrete androgens (male hormones). In young girls, male-pattern body hair growth and menstrual disorders may result from conditions such as polycystic ovary syndrome, ovarian tumors and congenital adrenal hyperplasia.

Menstrual disorders: Never having a period, having no period for at least three months after periods have started,

and frequent or excessive menstrual bleeding can also have hormonal causes.

9-Thyroid diseases
: Hormonal disorders that result from the thyroid gland working too much (hyperthyroidism) or too little (hypothyroidism). These diseases can cause growth and development problems in children.

10-Puberty disorders
: The onset of signs of puberty before the age of 8 in girls and 9 in boys is considered early (precocious) puberty. Likewise, if there are no signs of puberty by the age of 13 in girls and 14 in boys, this is considered delayed puberty.

11-Diseases caused by chromosomal abnormalities
: In conditions such as Turner syndrome, Klinefelter syndrome, Down syndrome and other trisomies, numerous endocrine disorders, particularly short stature and thyroid diseases, are more common.

Our children, who are not simply small adults and who are in a continuous process of growth and development, differ greatly from adults in their physiological and psychological characteristics. Endocrine and hormonal problems that may appear early in childhood can lead to serious consequences later in life if they are not treated appropriately. Endocrine system problems in children aged 0–18 should always be followed up and treated by a pediatric endocrinologist.