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Conditions spanning paediatric and adult endocrine practice--the adult perspective
1Department of Endocrinology, St Bartholomew's Hospital, London, UK.
Insights
Close collaboration between pediatric and adult endocrinologists is crucial for managing conditions like growth hormone deficiency (GHD) and other endocrine disorders. Integrated care ensures optimal long-term outcomes for patients transitioning from childhood to adulthood.
Area of Science:
- Pediatric Endocrinology
- Adult Endocrinology
- Clinical Medicine
Background:
- Effective management of various endocrine conditions necessitates seamless collaboration between pediatric and adult endocrinologists.
- The growing recognition of adult growth hormone deficiency (GHD) highlights the need for sustained follow-up of patients initially diagnosed in childhood.
- Liaison is also critical for congenital adrenal hyperplasia, precocious puberty, disorders of sexual development, thyroid dysfunction, diabetes mellitus, inherited neoplasia, and Cushing's syndrome.
Purpose of the Study:
- To review the diagnostic spectrum at the pediatric-adult endocrinology interface.
- To outline the rationale for an integrated approach to the treatment and follow-up of pediatric endocrine patients transitioning to adult care.
- To emphasize the importance of lifelong management for conditions requiring specialized endocrine expertise.
Main Methods:
- This is a brief review article.
- It synthesizes current understanding of conditions requiring pediatric and adult endocrinologist collaboration.
- The review focuses on the diagnostic challenges and management strategies across the age spectrum.
Main Results:
- The review details the diagnostic considerations for conditions managed across pediatric and adult endocrine practices.
- It underscores the necessity of continuous care for patients with conditions like GHD, congenital adrenal hyperplasia, and disorders of sexual development.
- The importance of recognizing adult-onset presentations of childhood conditions, such as Cushing's syndrome, is highlighted.
Conclusions:
- Integrated care and close liaison between pediatric and adult endocrinologists are essential for optimizing patient outcomes.
- Long-term follow-up is critical for conditions like GHD, even after linear growth is complete.
- A unified approach to diagnosis and management ensures comprehensive care throughout a patient's life.
Abstract:
Close liaison between paediatric and adult endocrinologists is essential for optimum care in a variety of clinical conditions. The increasingly recognized importance of growth hormone deficiency (GHD) in the adult is a further indication for maintaining long-term follow-up of patients with isolated GHD, which remains demonstrable when linear growth is complete, in addition to those patients presenting in childhood with evidence of structural pituitary disease and anterior pituitary failure. Additional areas in which liaison is desirable include congenital adrenal hyperplasia, precocious puberty, gonadal dysgenesis and other disorders of primary and secondary sexual development, thyroid dysfunction, diabetes mellitus, inherited neoplasia syndromes and those conditions, for example Cushing's syndrome, which present in childhood but are more common in adult clinical endocrine practice. In this brief review, the diagnostic spectrum of the paediatric/adult interface is described and the rationale for an integrated approach to treatment and follow-up is outlined.