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Pediatric Endocrinology

Hormones are molecules that facilitate communication within the body, along with the central nervous system. Thanks to our endocrine system, many metabolic processes such as physical growth, puberty development control, metabolism rate, blood sugar regulation, and more are kept under control. Pediatric Endocrinology is the branch of science that examines the basic normal development and hormonal diseases of newborns, infants, children, and adolescents from birth to 18 years old.

The main areas of interest in pediatric endocrinology include:

  • Short stature
  • Pubertal issues (Early or delayed puberty, polycystic ovary syndrome, gynecomastia)
  • Obesity
  • Disorders of glucose metabolism (Diabetes and hypoglycemia)
  • Thyroid gland disorders (Hypothyroidism, hyperthyroidism, thyroid nodules)
  • Adrenal gland problems (Adrenal insufficiency and Cushing’s disease)
  • Disorders related to sexual development (penile smallness in males, undescended testes, or ambiguous genitalia)
  • Disorders of bone and calcium metabolism (parathyroid hormone disorders, low or high calcium, Rickets, Vitamin D deficiency, Osteogenesis imperfecta)

Thyroid Disorders in Children The thyroid gland, located in the neck region, is the organ where thyroid hormones, which play a role in almost all metabolic functions, are synthesized. Thyroid hormones affect the body’s metabolic rate. Insufficient production of thyroid hormones is called “hypothyroidism,” while excessive production is called hyperthyroidism. Enlargement of the entire thyroid gland is referred to as “goiter.” Thanks to newborn screening programs, cases of congenital hypothyroidism receive early diagnosis at a very young age, and treatments can be started without neurological impairment. In children who show no symptoms until a certain age, and then develop symptoms such as weakness, fatigue, hair loss, weight gain, growth retardation, and low academic performance, acquired (later-developed) hypothyroidism should be considered and investigated accordingly.

Early Puberty Puberty is the transition from childhood to adulthood. In recent years, it has been proven that the age of puberty is shifting backward. This phenomenon is referred to as the trend of the century. The average age of puberty onset is 11 in girls and 12 in boys. However, each child does not begin puberty at the same age. It is considered normal for signs of puberty to start appearing after the age of 8 in girls and 9 in boys. The time between the first signs of puberty in girls, such as breast budding, and the first menstrual bleeding is approximately 2-3 years. Menarche (first menstruation) occurring after the age of 10 is considered medically normal. In boys, the first sign is testicular enlargement. Early puberty can lead to short stature and psychosocial problems during the pubertal transition period. Moreover, studies on adults have shown that early menstruation increases the risk of certain gynecological problems in the future. Therefore, if puberty signs begin before the age of 8 in girls or before the age of 9 in boys, or if puberty signs progress rapidly, evaluation by a pediatric endocrinologist is recommended. Treatment methods to slow down puberty are available if deemed necessary.

Polycystic Ovary Syndrome (PCOS) in Adolescents Polycystic ovary syndrome (PCOS) is a common condition characterized by increased hair growth and menstrual irregularity. PCOS is generally seen in individuals with weight problems, but obesity is not a prerequisite for the development of the disease. Symptoms may be subtle at the onset of puberty, and menstrual irregularities can occur for up to 3 years after menarche (first menstruation), making diagnosis delays possible. Additionally, differential diagnosis of PCOS should exclude conditions such as hyperprolactinemia and congenital adrenal hyperplasia. If signs of PCOS are found in girls under the age of 16 after testing (evidence of insulin resistance, excess androgens, polycystic appearance on ultrasound, etc.), early treatment can be initiated. Buruni University Hospital’s Pediatric Endocrinology Department provides services with an academic team of physicians and up-to-date treatments.

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