Clinical Rounds in Endocrinology: Volume II - Pediatric by Anil Bhansali, Anuradha Aggarwal, Girish Parthan, Yashpal

By Anil Bhansali, Anuradha Aggarwal, Girish Parthan, Yashpal Gogate

This e-book on pediatric endocrinology covers attention-grabbing and but usually tough instances between pediatric sufferers in a distinct Question-Answer structure. Simulating the bed-side case discussions throughout the ward rounds, one query logically results in one other, thereby producing interest and selling evidence-based medication. Taking the readers in the course of the complete spectrum ranging from etiology and pathophysiology to medical presentation to administration ideas, every one query addresses one key element of the affliction. defined in a very easy and lucid narrative, this publication guarantees sound conceptual realizing whereas masking every one subject comprehensively. This quantity covers very important issues akin to brief stature, pubertal problems, thyroid issues, formative years Cushing syndrome, rickets and osteomalacia, affliction of sexual differentiation and diabetes within the younger. much less universal illness corresponding to a number of endocrine neoplasia has additionally been included. those instances aren't basically obvious through endocrinologists, yet also are controlled through paediatricians, internists, obstetricians and gynaecologists, orthopaedicians and surgeons.

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How to diagnose celiac disease? IgA tissue transglutaminase (IgA tTG) is a good screening test with a sensitivity of 98 % and specificity of 95 %, and if found positive diagnosis should be confirmed with duodenal biopsy before subjecting to gluten-free diet. However, if IgA tTG is negative in the presence of strong clinical suspicion of celiac disease, serum total IgA should be measured, as serum IgA levels are lower in 2–5 % of patients with celiac disease. Patients with a low serum IgA levels should be subjected to IgG-tTG estimation (with or without anti-deamidated gliadin peptide IgG antibody), and if any of these antibodies is found to be elevated, the patient should be subjected to duodenal biopsy.

A b c d Fig. 15 (a) A child with short stature due to spondylo-epi-metaphyseal dysplasia, (b–d) plain radiographs of the wrist with proximal hands, knee, and spine show extensive epi- and metaphyseal dysplasia, juxta-articular osteopenia, and anterior beaking involving the vertebral bodies 34 1 Disorders of Growth and Development: Clinical Perspectives 49. When to suspect celiac disease in a short child? Celiac disease is an immune-mediated enteropathy triggered by gluten and occurs in genetically susceptible individuals (HLA-DQ2 and DQ8).

The neuroendocrine hypothesis proposes that there is a set point in the brain for an individual’s growth termed as “sizo-stat,” and this allows the “catch-up” growth after a period of growth inhibition to achieve the age specified “preset” height of an individual. However, it was refuted later. The “growth plate” hypothesis reveals that during the period of growth inhibition, there is a slowing of chondrocyte senescence, followed by increased chondrocyte growth and proliferation during subsequent “catch-up” growth.

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Clinical Rounds in Endocrinology: Volume II - Pediatric by Anil Bhansali, Anuradha Aggarwal, Girish Parthan, Yashpal
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