Paediatric Endocrinology in Clinical Practice

266 Pages·1984·16.39 MB·English

PAEDIATRIC
ENDOCRINOLOGY
IN CLINICAL
PRACTICE
P AEDIAT RIC
ENDOCRINOLOGY
IN CLINICAL
PRACTICE
Edited by
A. AYNSLEY-GREEN
James Spence Professor of Child Health
The Children's Clinic
Royal Victoria Infirmary
Newcastle upon Tyne
England
Proceedings of the Royal College oj Pfrysicians'
Paediatric Endocrinology Conference
held in London
20-21 October 1983
~c_~ MTP PRESS LIMITED
d a member of the KLUWER ACADEMIC PUBLISHERS GROUP
• LANCASTER / BOSTON / THE HAGUE / DORDRECHT
Published in the UK and Europe by
MTP Press Limited
Falcon House
Lancaster, England
British Library Cataloguing in Publication Data
Paediatric endocrinology in clinical practice
1. Pediatric endocrinology
I. Aynsley-Green, A.
618.92'4 RJ418
ISBN-13 :978-94-01 0-8974-6 e-ISBN-13 :978-94-009-561 0-0
DOl: 10.1 007/978-94-009-5610-0
Published in the USA by
MTP Press
A division of Kluwer Boston Inc
190 Old Derby Street
Hingham, MA 02043, USA
Library of Congress Cataloging in Publication Data
Paediatric Endocrinology Conference (1983: London, England)
Paediatric endocrinology in clinical practice
Includes bibliographical references and index.
1. Pediatric endocrinology-Congresses.
I. Aynsley-Green, A. II. Royal College of Physicians of. III. Title.
[DNLM: 1. Endocrine Diseases-in infancy & childhood-congresses.
2. Endocrine Glands-physiology-congresses. WS 330 Pl265c 1983]
RJ418.P34 1983 618.92'4 84-11275
Copyright © 1984 MTP Press Limited
Softcover reprint of the hardcover 1s t edition 1984
All rights reserved. No part of this publication may be reproduced, stored in a
retrieval system, or transmitted in any form or by any means, electronic, mechanical,
photocopying, recording or otherwise, without prior permission from the publishers.
CONTENTS
Page
Preface IX
List of Chairmen X
List of Contributors Xl
SECTION 1 NEONATAL ENDOCRINOLOGY
Chairman: THE PRESIDENT
The effects of maternal endocrine disease on the fetus and
neonate 3
J. A. H. WASS
2 Normal and abnormal pancreatic endocrine function in the
fetus and neonate 19
A. AYNSLEy-GREEN
SECTION 2 THE THYROID GLAND
Chairman: DR D. I. JOHNSTON
3 Congenital hypothyroidism: pathogenesis, screenmg and
prognosIs 45
D. B. GRANT
4 Clinical aspects of acquired thyroid disease in childhood 55
N. D. BARNES
v
PAEDIATRIC ENDOCRINOLOGY IN CLINICAL PRACTICE
Page
SECTION 3 DISORDERS OF SEXUAL DEVELOPMENT
Chairman: DR D. A. PRICE
5 Pathogenesis and investigation of ambiguous genitalia 75
M. O. SAVAGE
6 Medical and psychological management of congenital
adrenal hyperplasia 83
I. A. HUGHES
7 Surgical management of intersex in childhood 117
J. DEWHURST
8 The Teale Lecture 1983
Fetal growth: the role of insulin and related pep tides 125
R. D. G. MILNER
SECTION 4 NORMAL AND ABNORMAL GROWTH
Chairman: DR P. H. W. RAYNER
9 Normal growth in infancy, childhood and adolescence 149
M. A. PREECE
10 Investigation and management of abnormal growth 161
M. A. PREECE
SECTION 5 NORMAL AND ABNORMAL PUBERTY
Chairman: DR C. C. FORSYTH
11 Endocrine aspects of normal pubertal development 175
P. C. SIZONENKO
12 The effects of chemotherapy and radiotherapy for malignant
disease on growth and sexual development 183
S.M. SHALET
VI
CONTENTS
Page
SECTION 6 MISCELLANEOUS DISORDERS
Chairman: PROFESSOR J. W. F ARQ.UHAR
13 Some aspects of the genetics of paedia tric endocrinology 203
R. HARRIS
14 HLA-DR expression on endocrine cells: a new way to look
at autoimmunity 219
G. F. BOTTAZZO and D. DONIACH
15 Controversies in diabetes mellitus 227
J. D. BAUM
16 Practical management of disorders of calcium homeostasis 241
J. ALLGROVE
Index 265
VII
PREFACE
This book is made up of 16 papers delivered during the Paediatric
Conference convened by the Royal College of Physicians of London on
20th and 21st October 1983.
The main intention oft he conference was to allow each contributor to
deliver a personal review of his own field, indicating recent develop-
ments and current practice. This volume, representing the proceedings
of that meeting, is not intended as a comprehensive textbook of paedi-
atric endocrinology but rather as a series of personal narratives.
I wish to express my thanks to the Chairmen, who so ably stimulated
discussion, and to Miss Gillian Andrew, Conference Secretary of the
Royal College of Physicians, and her colleagues, for providing invalu-
able help in the organization of the conference.
I am also grateful to the staff ofMTP Press Limited for their help in
producing the book.
A. Aynsley-Green
IX
LIST OF CHAIRMEN
Professor R. Hoffenburg PRCP Dr D. I. Johnston MD FRCP
President Queen's Medical Centre
Royal College of Physicians Nottingham
London
Dr D. A. Price FRCP
Professor J. W. Farquhar MD Royal Manchester Children's
FRCP(Ed) Hospital
Department of Child Life and Health Pendlebury
University of Edinburgh Manchester
Edinburgh
Dr P. H. W. Rayner FRCP
Dr C. C. Forsyth MD FRCP Institute of Child Health
Department of Child Health University of Birmingham
University of Dundee Birmingham
Dundee
x
LIST OF CONTRIBUTORS
Dr J. Allgrove MRCP Dr D. B. Grant MD FRCP
East Birmingham Hospital The Hospital for Sick Children
Birmingham Great Ormond Street
London
Professor A. Aynsley-Green
DPhil FRCP
Professor R. Harris MD FRCP
Department of Child Health
Department of Medical Genetics
University of Newcastle upon Tyne
St Mary's Hospital
Newcastle upon Tyne
Manchester
Dr N. D. Barnes FRCP
Department of Paediatrics Dr I. A. Hughes MD FRCP
Addenbrooke's Hospital Department of Child Health
Cambridge Welsh National School of Medicine
Cardiff
Dr J. D. Baum. MD FRCP
Department of Paediatrics Professor R. D. G. Milner MD
University of Oxford FRCP
Oxford Departmen t of Paediatrics
University of Sheffield
Dr G. F. Bottazzo MD MRCP Sheffield
Department of Immunology ( Teale Lecturer)
The Middlesex Hospital
London
Dr M. A. Preece MD FRCP
Institute of Child Health
Professor Sir John Dewhurst
FRCOG 30 Guilford Street
London
Queen Charlotte's Maternity Hospital
London
Dr M. O. Savage MD MRCP
Professor D. Doniach MD FRCP Department of Child Health
Department of Immunology St Bartholomew's Hospital
The Middlesex Hospital Medical Queen Elizabeth Hospital for
School Children
London London
xi
PAEDIATRIC ENDOCRINOLOGY IN CLINICAL PRACTICE
Dr S. M. Shalet MD MRCP Dr J. A. H. WassMDMRCP
Christie Hospital and Holt Radium Department of Endocrinology
Institute St Bartholomew's Hospital
Withington London
Manchester
Professor P. C. Sizonenko MD
Division de Biologie de la Croissance
et de la Reproduction
Hopital Cantonal Universitaire
Geneva
Switzerland
XII