About growth disorders
Growth disorders are a number of different that can cause your child to have an unexpected height and/or size for his or her age and sex. Some reasons for abnormal height that may be traced to endocrine disorders, including too little of the growth or thyroid hormones and Cushing’s disease.
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Growth disorder care at Children’s
Because not all growth problems are related to the endocrine system, we will first track your child’s growth over time. We will also conduct blood tests to measure hormone levels and to rule out other problems. Often, we take X-rays of your child’s wrists, as we use these to determine expected growth. We may also order scans of your child’s pituitary gland. If we detect a growth problem and the source of the problem is endocrine, we often recommend hormone replacement therapy. This includes daily or weekly injections of growth hormone to help restore balance. Our specialists are sensitive to you and your child’s needs and will work to ensure everyone is comfortable with your child’s treatment and informed of progress.
About thyroid problems
The thyroid is key in managing how energy from the food you eat is used by your body. It plays a role in maintaining proper blood pressure and in regulating the growth of bones and nerves. The thyroid even can affect reproduction. If it makes too little of its hormone (as in hypothyroidism), the body’s energy efficiency goes down and your child will be tired, cold, and may gain weight. But if the thyroid makes too much of its hormone (as in hyperthyroidism), the opposite occurs. Your child may feel warm and be very sensitive to heat. He or she will burn food too quickly and may lose weight, have an accelerated heartbeat and bulging eyes. A swollen thyroid can also make it hard for your child to swallow.
Thyroid care at Children’s
Thyroid problems in children should be treated immediately, as they may affect long-term growth and reproduction. Typically, all we need to diagnose a thyroid problem is a simple physical exam and some blood tests. Occasionally, other tests like X-rays may be needed if the condition is more serious. Both hypo and hyperthyroidism are usually treated with medication, but surgery may necessary in the latter case, if problems do not go away after a couple of years. The good news is that these conditions are seldom life-threatening. Our goal is to allow your child to enjoy just being a kid without thyroid problems or treatment getting in the way.
About early or late puberty
Puberty can already be a trying time for your child, but sometimes a disorder makes this period extra challenging. Precocious and delayed puberty mean that the changes of sexual maturity come early or late in your child. Precocious (early) puberty has two forms depending on whether the changes are related to the early release of sex hormones or not. Delayed (late) puberty is defined as late onset sexual development by age 13 in girls and age 14 in boys. Your child might already be self-conscious at this age and compare himself or herself to peers. If there is a genuine endocrine disorder causing a lack of sexual traits, we want to do everything we can to reassure and treat your teen.
Early or late puberty care at Children's
We begin by reviewing your child’s medical history and conducting a physical examination. Your child’s sexual maturity will be tracked and compared to other children of the same age and sex. If we detect early or late changes, we will, with your close involvement, develop a customized treatment path. If early puberty is detected, we may perform X-rays, ultrasounds, or an MRI of the adrenal glands and sex organs. We will also measure hormone levels in the blood and perform a gonadotropin-stimulating hormone (GuRH) stimulation test to determinet the early puberty type. The treatment for delayed (late) puberty follows much the same path, which includes blood tests, X-rays to determine maturity of the bones, CT (CAT) scans, and/or MRI. Hormone replacements and/or surgery may be recommended. We will do everything in our power to assist you in ease and assist your child’s transition into adulthood.
About adrenal gland problems
The adrenal glands are two paired, pyramid-shaped glands that each sit on top of one of the two kidneys. The glands have three, each layer producing a different hormone with a different purpose. One layer makes a hormone, aldosterone, which regulates the salt and potassium in your body; one makes a stress-related hormone; and one makes a male sex hormone. Problems occur when there is too much or too little of these hormones produced. Too much of the hormone aldosterone, in particular, can be very serious, as it may affect the electrical systems in your child’s body, like the heart and nerves.
Adrenal gland care at Children’s
We begin with blood and urine tests to confirm suspected adrenal gland problems. From there, we determine the best medications to treat the specific cause of imbalance. Treatments may include hormone therapy or surgery (if removal of a tumor is needed) and/or radiation or chemotherapy to shrink a tumor. We are committed to fully understanding and correcting your child’s adrenal imbalance.
About pituitary gland problems
The posterior pituitary, on the other hand, acts more like nerve tissue and is actually part of the brain. Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) happens when too much antidiuretic hormone (ADH, which causes the kidneys to retain water) is released into the bloodstream. This can lean to puffiness and bloating, among other more serious nervous system problems. When too little antidiuretic hormone is released, the kidneys flush out too much water, leading to dehydration and diabetes insipidus. This is a rare, but serious problem.
Pituitary gland care at Children’s
Because the pituitary gland regulates other glands in the body, it is very important that any problems be treated immediately. The first thing our specialists do is perform blood tests to confirm suspected pituitary gland problems. Blood tests measure the amount of hormones in your child’s blood. We may also request urine tests. From there, we determine the best medications to treat the specific cause of imbalance. Both hyper and hypopituitarism may be treated with hormone therapy or surgery (if removal of a tumor is needed) and/or radiation or chemotherapy to shrink a tumor, if present and growing. Fluid restriction is often used in SIADH treatment.
About calcium and bone problems
Because your child is growing, any problems concerning your child’s bones are serious. Juvenile osteoporosis is rare but, as in older people, it means their bones are not as dense and are more prone to breakage. This can be a real problem in active kids. The underlying cause may be hormonal, caused by a medication or unknown. In the endocrine program, we specialize in treating porous bones due to improper parathyroid function, as in hyperparathyroidism or because of hyperthyroidism or diabetes mellitus.
The hormones the parathyroid makes tell your body to absorb calcium and to store it in your bones or, alternately, to release calcium from your bones into your bloodstream. Hyperparathyroidism causes too much calcium to be pulled out of the bones. It is rare in children, but kids may experience worse pain, tiredness, and other symptoms than in adults. In hypoparatyroidism, too little calcium exists in the blood for proper functioning, which leads to painful nerve spasms. Hyperparathyroidism may appear by itself or as part of DiGeorge syndrome, which also includes heart defects, an underdeveloped or missing thymus, and cleft lip and/or palate.
Calcium and bone problem care at Children’s
As with every condition, we review your child and family’s medical history and perform a physical exam first. Our specialists assess your child’s bone density using our DXA Center (dual-energy x-ray absorptiometry). We also use blood tests to measure your child’s calcium and hormone levels. In consultation with you, we treat hyperparathyroidism by removing the problem tissue. Juvenile osteoporosis and Hypoparathyroidism by itself may be treated with calcium supplements and/or injections and Vitamin D. If your child has DiGeorge syndrome, coordination with other programs may be necessary to treat the entire condition and give your child the best outcome.