Pediatric endocrinology

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Short description: Medical subspecialty

Pediatric endocrinology (British: Paediatric) is a medical subspecialty dealing with disorders of the endocrine glands, such as variations of physical growth and sexual development in childhood, diabetes and many more.[1]



Professional training

In the United States and Canada, pediatric endocrinology is a subspecialty of the American Board of Pediatrics or the American Osteopathic Board of Pediatrics, with board certification following fellowship training. It is a relatively small and primarily cognitive specialty, with few procedures and an emphasis on diagnostic evaluation.[2]

Training for pediatric endocrinology consists of a 3-year fellowship following completion of a 3-year pediatrics residency. The fellowship, and the specialty, are heavily research-oriented and academically based, although less exclusively now than in past decades.

Professional organizations

The principal North American professional association was originally named the Lawson Wilkins Pediatric Endocrine Society,[3] now renamed the Pediatric Endocrine Society. Other longstanding pediatric endocrine associations include the European Society for Paediatric Endocrinology, the British Society for Paediatric Endocrinology, the Australasian Paediatric Endocrine Group and the Japanese Society for Pediatric Endocrinology. Professional associations of the specialty continue to proliferate.

Controversial treatment guidelines

In 2021, the Pediatric Endocrine Society offered updated recommendations for use of growth-promoting hormone therapy and related medications in children. The Guidelines for Growth Hormone and Insulin-Like Growth Factor-1 Treatment in Children and Adolescents were updated from 2003 and reflect the continuing controversy over how to diagnose, categorize and treat growth failure in children.[4] The guideline was developed following the GRADE approach (Grading of Recommendations, Assessment, Development, and Evaluation).[5]

In 2021, the Pediatric Endocrine Society released a position statement in support of Gender Affirming Care (GAC). In it the society states, "Puberty suppression and/or gender-affirming hormone therapy is recommended within this evidence-based approach on a case-by-case basis as medically necessary and is potentially lifesaving."[6] This position is at odds with the position of England's National Health Service (NHS) which maintains that evidence for puberty blockers and hormone treatment for gender transition wholly is inadequate,[7] and has decided to stop routine prescribing of puberty blockers.[8]

See also

  • Robert Lustig, an American pediatric endocrinologist
  • Melvin Grumbach, an American pediatric endocrinologist

References

  1. Huhtaniemi, Ilpo; Martini, Luciano (2018). Encyclopedia of Endocrine Diseases. 5 (2nd ed.). San Diego: Elsevier Science & Technology. ISBN 978-0-12-812200-6. 
  2. "Specialties & Subspecialties". American Osteopathic Association. http://www.osteopathic.org/inside-aoa/development/aoa-board-certification/Pages/specialty-subspecialty-certification.aspx. 
  3. "Pediatric Endocrine Society". http://www.lwpes.org. 
  4. "Idiopathic Short Stature Addressed in Guidelines". 2021-06-28. https://www.medcentral.com/endocrinology/best-approaches-manage-idiopathic-short-stature-addressed-new-guidelines. 
  5. Grimberg, Adda; DiVall, Sara A.; Polychronakos, Constantin; Allen, David B.; Cohen, Laurie E.; Quintos, Jose Bernardo; Rossi, Wilma C.; Feudtner, Chris et al. (2016-11-25). "Guidelines for Growth Hormone and Insulin-Like Growth Factor-I Treatment in Children and Adolescents: Growth Hormone Deficiency, Idiopathic Short Stature, and Primary Insulin-Like Growth Factor-I Deficiency". Hormone Research in Paediatrics 86 (6): 361–397. doi:10.1159/000452150. ISSN 1663-2818. PMID 27884013. https://doi.org/10.1159/000452150. 
  6. "Medical Association Statements in Support of Health Care for Transgender People and Youth | GLAAD" (in en-US). 2023-06-21. https://glaad.org/medical-association-statements-supporting-trans-youth-healthcare-and-against-discriminatory/. 
  7. "Evidence for puberty blockers and hormone treatment for gender transition wholly inadequate | BMJ". 10 April 2024. https://www.bmj.com/company/newsroom/evidence-for-puberty-blockers-and-hormone-treatment-for-gender-transition-wholly-inadequate/. 
  8. O’Dowd, Adrian (2024-03-14). "NHS services in England are told to stop routine prescribing of puberty blockers". BMJ 384: q660. doi:10.1136/bmj.q660. ISSN 1756-1833. PMID 38485137. https://www.bmj.com/content/384/bmj.q660. 




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