DR SIMON ATTARD MONTALTO
Short stature
endocrine:
constitutional delay
GH deficiency
hypothyroidism
cushing syndrome
non endocrine:
syndromes
chromosomal
orthopaedic
low birth weight
systemic disease
hereditary disease
psychological/deprivation
endocrine:
constitutional tall stature
GH excess
hyperthyroidism
androgen excess
precocious puberty
congenital adrenal hyperplasia (CAH)
non endocrine:
syndromes
chromosomal (Klinefelter)
orthopaedic
other (Soto, Marfan)
hereditary disease (homocystinuria)
endocrine:
constitutional delay
gonadotrophic deficiency
hypopituitarism
non endocrine: syndromes
chromosomal
congenital abnormalities
systemic disease
trauma
neoplasia
psychological/deprivation
endocrine:
idiopathic/physiological
gonadotrophin excess
excess steroids
androgen excess
CAH
non endocrine:
syndromes
congenital abnormalities/malformations
SOL
primary:
congenital
autoimmune (Hashimoto)
thyroiditis
infection
secondary:
iodine deficiency
pituitary deficiency (TSH)
surgery
neoplasia, radiotherapy
Excess:
autoimmune (Grave’s)
solitary nodule
exogenous T4
primary:
autoimmune
haemorrhage
infection
iatrogenic
secondary:
pituitary deficiency (ACTH)
post excess steroid therapy
trauma, surgery
neoplasia, radiotherapy
Excess (glucocorticoids)
Cushing disease
Cushing syndrome - iatrogenic, adrenal tumour, other tumour
Excess (mineralocorticoids)
CAH
HLA b8, B15, DR3, DR4
islet cell antibodies
autoimmune process
trigger (?viral)
associated with cystic fibrosis, pancreatitis
polyuria, polydipsia, weight loss, lassitude, dehydration
diabetic ketoacidosis (DKA) - 25%
hyperglycaemia + glycosuria +/- DKA
DKA
§ correct dehydration
§ correct electrolytes (esp K+)
§ correct acidosis
§ correct hyperglycaemia
Central
ADH deficiency
congenital adenoma
infection (meningitis)
iatrogenic (surgery)
trauma
local infiltration / neoplasia
congenital syndromes
Nephrogenic
X-linked disorder
tubular resistance to ADH
renal abnormalities
sickle cell disease