Cover Page

Practical Endocrinology and Diabetes in Children

Fourth Edition

Malcolm D.C. Donaldson MD, FRCP, FRCPCH, DCH

Honorary Senior Research Fellow

Glasgow University School of Medicine

Honorary Consultant Paediatrician

Royal Hospital for Children

Glasgow, UK

John W. Gregory MBChB, MD, FRCP, DCH, FRCPCH

Professor in Paediatric Endocrinology & Honorary Consultant

Division of Population Medicine, School of Medicine

Cardiff University

Cardiff, Heath Park, Cardiff, UK

Guy Van Vliet MD

Staff Endocrinologist

CHU Sainte‐Justine and Professor of Pediatrics

University of Montreal

Montreal, QC, Canada

Joseph I. Wolfsdorf MB, BCh, MA, DCH, FCP, FAAP

Attending Physician in Endocrinology

Boston Children’s Hospital Chair in Endocrinology

Professor of Pediatrics, Harvard Medical School

Boston, Massachusetts, U.S.A.

Guest chapter “An Endocrinologist’s Guide to Genetics in the Age of Genomics” contributed by

Johnny Deladoëy MD, PhD

Staff Endocrinologist

CHU Sainte‐Justine and Associate Professor of Pediatrics

University of Montreal

Montreal, QC, Canada


logo.gif



Malcolm Donaldson, John Gregory, Guy Van Vliet and Joseph Wolfsdorf would like to dedicate this fourth edition to their long‐suffering wives: Julia, Katrin, Chantal, and Gail, with love and thanks for their support.

Preface to the Fourth Edition

It was Dr Joseph Raine, Consultant Paediatrician at The Whittington Hospital in London, who recognized the gap between the large detailed endocrine reference books and short reviews of topics in paediatric endocrinology and diabetes. Practical Endocrinology and Diabetes in Children was Joe's brainchild, aiming to provide a practical, concise and up‐to‐date account of paediatric endocrinology and diabetes in a readable, user‐friendly and portable format.

The first edition of the book featured an all‐British cast of co‐editors – Joe Raine, Malcolm Donaldson, John Gregory, and Martin Savage. Following its debut and favourable reception, the need to appeal to a wider readership was recognized, and Raymond Hintz (1939–2014) from Stanford University in California was invited to help with the second edition in 2007. For the third edition in 2011, Guy Van Vliet from Montreal in Canada joined the team to replace Martin Savage, further reinforcing the book's transatlantic credentials. Joe Raine has decided to stand down before this fourth edition and in his place Joseph Wolfsdorf from Harvard University has joined the team, taking on the diabetes and hypoglycaemia chapters.

Despite the addition of two North American editors, the book remains rooted in UK practice but with increasing North American and global emphasis. The accumulation of more data to impart, particularly in the field of diabetes, has resulted in a slightly longer book but it nevertheless retains the spirit of user‐friendliness and conciseness of Joe Raine's original vision.

As with previous editions, space has been given to describe the practical management of diabetes in detail. The trend towards consensus guidelines over the past decade is reflected in this new edition and at the end of each chapter there are sections on when to contact a specialist centre, controversial areas, transition, potential pitfalls, and future developments.

At the end of the chapters there are also four to five interesting cases which illustrate diagnostic difficulties and management choices. These ‘grey cases’ are intended to be helpful for those studying for postgraduate examinations.

The book is aimed primarily at paediatricians in general hospitals and at junior paediatric staff with an interest in paediatric endocrinology and diabetes. Nurses working in paediatric endocrinology wards, diabetic nurse specialists, and medical students should also find it useful. Three of the four editors (MD, JG, GVV) have been on the teaching faculty of the European Society for Paediatric Endocrinology (ESPE) Winter School. This experience has made us conscious of the practical difficulties encountered by doctors in resource‐limited countries and we hope that the text of our book reflects this awareness.

Finally, we are delighted to welcome Johnny Deladoëy from Montreal, Canada, who has contributed a guest chapter on genomics for the paediatric endocrinologist, in recognition of the importance of the area to modern practice, and the need for trainees and clinicians to have a basic working knowledge of molecular diagnosis.

MDCD, JWG, GVV, JIW

December 2018

Acknowledgements

The authors would like to thank Dr David Neumann, Faculty of Medicine in Hradec Kralove and University Hospital Hradec, Czech Republic, Ms Karen Smith, Department of Biochemistry, Glasgow Royal Infirmary, Dr Jane McNeilly, Department of Biochemistry, Royal Hospital for Children, Glasgow, Dr Robert Lindsay, British Heart Foundation Cardiovascular Research Centre, Glasgow, Dr Heather Maxwell, Department of Nephrology, Royal Hospital for Children, Glasgow, Dr Jarod Wong, Glasgow University School of Medicine, Dr Avril Mason, Royal Hospital for Children, Glasgow, Dr Esther Kinning, West of Scotland Department of Medical Genetics, Glasgow, Dr Judith Simpson, Neonatal Department, Queen Elizabeth Hospital, Glasgow, Dr Renuka Dias, Birmingham Children's Hospital, Professor Michael Preece, Institute of Child Health, London, Professor Tim Cole, UCL Institute of Child Health, London, Professor Peter Hindmarsh, University College London Hospitals and Great Ormond Street Hospital for Children, London, Professor Martin Savage, London Clinic Centre for Endocrinology, Queen Mary, University of London, Professor Juliane Léger, Hôpital Universitaire Robert Debré, Paris, Professor Marc Nicolino, Hôpital Mère‐Enfant de Lyon, France, Dr Asmahane Ladjouze, CHU Bab El Oued, Algiers, Algeria, Dr Philippe Campeau Medical Genetics Service, Hôpital Sainte‐Justine, Montréal, Canada, and Dr Nina Ma, Boston Children's Hospital, USA, for their help and advice with different sections of the book.

Abbreviations

ACEI
angiotensin converting enzyme inhibitor
ACMG
American College of Medical Genetics
ACR
albumin:creatinine ratio
ACTH
adrenocorticotrophic hormone
AER
albumin excretion rate
AFP
alpha‐foetoprotein
AHO
Albright’s hereditary osteodystrophy
AIRE
autoimmune regulator
AIS
androgen insensitivity syndrome
ALD
adrenoleukodystrophy
ALS
acid‐labile subunit
ALT
alanine amino transferase
AME
apparent mineralocorticoid excess
AMH
anti‐Müllerian hormone
APECED
autoimmune polyendocrinopathy with endocrinopathy and cutaneous ectodermal dystrophy
AR
androgen receptor
ARB
angiotensin receptor blocker
ARDS
adult respiratory distress syndrome
ATA
American Thyroid Association
ATD
anti‐thyroid drug
ATP
adenosine triphosphate
AVP
arginine‐vasopressin
β‐hCG
β‐human chorionic gonadotrophin
BDR
background diabetic retinopathy
BMI
body mass index
BOHB
beta‐hydroxybutyrate
BP
blood pressure
CAH
congenital adrenal hyperplasia
CAI
central adrenal insufficiency
CAIS
complete androgen insensitivity syndrome
cAMP
cyclic adenosine monophosphate
CBG
cortisol binding globulin
CDC
Centers for Disease Control and Prevention
CDGA
constitutional delay in growth and adolescence
CF
cystic fibrosis
CFRD
cystic fibrosis‐related diabetes
CGH
comparative genomic hybridization
CGM
continuous glucose monitoring
cGy
centi‐Gray units
CNS
central nervous system
CPEG
Canadian Pediatric Endocrine Group
CPP
central precocious puberty
CRH
corticotrophin‐releasing hormone
CRP
C‐reactive protein
CSII
continuous subcutaneous insulin infusion
CT
computerized tomography
CVD
cardiovascular disease
CYP
cytochrome P450
DAX‐1
dosage‐sensitive sex reversal adrenal hypoplasia critical region on chromosome X, gene 1
DCCT
Diabetes Control and Complications Trial
DDAVP
desamino‐D‐arginine‐vasopression
DEND
developmental delay, epilepsy, diabetes mellitus
DEXA
dual X‐ray absorptiometry
DHEAS
dehydroepiandrosterone sulphate
dHPLC
denaturing high‐performance liquid chromatography
DHT
dihydrotestosterone
DI
diabetes insipidus
DIDMOAD
diabetes insipidus, diabetes mellitus, optic atrophy, and deafness
DIT
diiodotyrosine
DKA
diabetic ketoacidosis
DMD
Duchenne muscular dystrophy
DME
diabetic macular oedema
DNA
deoxyribonucleic acid
DNE
diabetes nurse educator
DNS
diabetes nurse specialist
DOC
deoxycorticosterone
DSD
differences in sex development
DUOX2
dual oxidase 2 enzymes
DXA
dual X‐ray absorptiometry
DZ
dizygotic
ECF
extracellular fluid
ENaC
epithelial sodium channel
EPP
ectopic posterior pituitary
ER
endoplasmic reticulum
ESPE
European Society for Paediatric Endocrinology
ESR
erthyrocyte sedimentation rate
FASD
foetal alcohol spectrum disorder
FBC
full blood count
FFA
free fatty acids
FGD
familial glucocorticoid deficiency
FGFR3
fibroblast growth factor receptor‐3
FISH
fluorescent in situ hybridization
FNA
fine needle aspiration
FSH
follicle‐stimulating hormone
FT3
free triiodothyronine
FT4
free thyroxine
GABA
gamma‐aminobutyric acid
GAD
glutamic acid decarboxylase
GC
guanine‐cytosine
GH
growth hormone
GHBP
growth hormone binding protein
GHD
growth hormone deficiency
GHRH
growth hormone releasing hormone
GI
glycaemic index
GNAS
G‐protein stimulatory alpha subunit
GnRH
gonadotrophin‐releasing hormone
GP
general practitioner
GSD 0
glycogen synthase deficiency
GSD 1
glucose‐6‐phosphatase deficiency
HbA1c
glycosylated haemoglobin
hCG
human chorionic gonadotrophin
HDL
high‐density lipoprotein
hGH
human growth hormone
HGVS
Human Genome Variation Society
HHS
hyperglycaemic hyperosmolar state
HLA
human leukocyte antigen
HMG‐CoA
3‐hydroxy‐3‐methylglutaryl coenzyme A
H‐P
hypothalamo‐pituitary
HSD
hydroxysteroid dehydrogenase
IA2
insulinoma‐associated antigen‐2 17‐OHP 17‐hydroxyprogesterone
1GF‐1
insulin‐like growth factor 1
im
intramuscular
IGFBP
insulin‐like growth factor‐binding protein
INS
insulin gene locus
IQ
intelligence quotient
ISCN
International System for Human Cytogenetic Nomenclature
ISPAD
International Society for Pediatric and Adolescent Diabetes
ISS
idiopathic short stature
ITT
insulin‐tolerance test
IUGR
intrauterine growth restriction
IV
intravenous
JIA
juvenile idiopathic arthritis
K
potassium
LDL
low‐density lipoprotein
LDLR
low‐density lipoprotein receptor
LH
luteinizing hormone
MAF
minimum allele frequency
MASS
mitral valve prolapse, aortic enlargement, skin and skeletal
MC‐1R
melanocortin‐1 receptor
MDI
multiple daily injections
MEN
multiple endocrine neoplasia
MHC
major histocompatibility complex
MIT
monoiodotyrosine
MKRN3
Makorin ring finger protein 3
MODY
maturity onset diabetes of the young
MPH
mid‐parental height
MR
mineralocorticoid receptor
MRAP
melanocortin 2 receptor accessory protein
MRI
magnetic resonance imaging
MTC
medullary thyroid carcinoma
MZ
monozygotic
NAFLD
non‐alcoholic fatty liver disease
NASH
non‐alcoholic steatohepatitis
NC‐21‐OHD
non‐classical 21‐hydroxylase deficiency
NCHS
National Center for Health Statistics
NF
neurofibromatosis
NGS
next generation sequencing
NHS
National Health Service
NIS
sodium iodide symporter
NPH
neutral protamine Hagedorn
OGTT
oral glucose tolerance test
PAIS
partial androgen insensitivity syndrome
PALS
paediatric advanced life support
PCOS
polycystic ovarian syndrome
PCR
polymerase chain reaction
PDR
proliferative diabetic retinopathy
PG
plasma glucose
PGA
polyglandular autoimmune
PHA
pseudohypoaldosteronism
PHV
peak height velocity
PNDM
permanent neonatal diabetes mellitus
POMC
proopiomelanocortin
POR
P450‐oxidoreductase
PPARγ
peroxisome proliferator‐activated receptor gamma
PPGL
phaeochromocytoma and paraganglioma
PTH
parathyroid hormone
PTHrP
parathyroid hormone‐related peptide
PTU
propylthiouracil
PUVA
psoralen plus ultraviolet A
PWS
Prader–Willi Syndrome
RCPCH
Royal College of Paediatrics and Child Health
RET
receptor tyrosine
RFLP
restriction length polymorphisms
RNA
ribonucleic acid
sc
subcutaneous
SDS
standard deviation score
SED
spondylo‐epiphyseal dysplasia
SF‐1
steroidogenic factor 1
SGA
small for gestational age
SHBG
sex hormone‐binding globulin
SHOX
Short Stature Homeobox
SIADH
syndrome of inappropriate antidiuretic hormone secretion
SMBG
self‐monitoring of blood glucose
SOD
septo‐optic dysplasia
SRY
sex‐determining region of the Y chromosome
StAR
steroidogenic acute regulatory (protein) T3 triiodothyronine
SV 21‐OHD
simple virilizing 21‐hydroxylase deficiency
SW 21‐OHD
salt‐wasting 21 hydroxylase deficiency
T3
triiodothyronine
T4
thyroxine
TBG
thyroid‐binding globulin
TDD
total daily dose
td
three times a day
TFT
thyroid function tests
Tg
thyroglobulin
TH
transient hypothyroxinaemia
TNDM
transient neonatal diabetes mellitus
TPO
thyroid peroxidase
TRH
thyrotrophin‐releasing hormone
TSH
thyroid‐stimulating hormone
TSHR
thyroid‐stimulating hormone receptor
TZD
thiazolidinedione
U&E
urea and electrolytes
UIC
urinary iodine concentration
UPD
uniparental disomy
VO2
peak oxygen consumption
WBC
white blood cells
WES
whole exome sequencing
WHO
World Health Organization
ZnT8A
zinc transporter 8