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Mandy Whitehead Children’s Endocrine Specialist Nurse Leeds General Infirmary Overview The Endocrine System Growth and growth hormone Puberty Adrenal glands and adrenal crisis The Endocrine System Feedback mechanism in the endocrine system ICP phases of growth Thyroid Nutritio n & Love Growth Hormone Oestrogen & Testosterone What is normal growth? Growth is a luxury Accurate measurements Serial measurements Growth charts Parental heights are important Growth hormone Secreted by the pituitary gland, pulsatile fashion. Growth Metabolic hormone Sugar and fat metabolism Body composition (lean/fat mass) Bone health ? Cardiac muscle effect What factors may affect growth in DBA? Chronic illness Regular blood transfusions Steroid treatment ? Other factors Growth hormone deficiency Small for parents Falling away from centiles Cherubic features Mid facial hypoplasia Excess adipose tissue Puberty Release of GnRH Pulsatile release of LH and FSH Stimulates gonads to release sex hormones What is delayed puberty? Absence of development of secondary sexual characteristics by: 13yrs in girls (breast development) 14yrs in boys (testicular enlargement) Pubertal arrest Hypogonadotropic hypogonadism/delayed puberty Treatment and fertility Adrenal glands Sit on top of each kidney Essential for life Extremely complex Produce cortisol Help to maintain blood sugar and blood pressure Regulate salt balance Sex hormones, testosterone and oestradiol Adrenal Insufficiency AdrenoCorticoTropic Hormone (ACTH) deficiency (pituitary) Feedback mechanism High dose steroids Replacement (hydrocortisone/prednisolone) What is an adrenal crisis? When the bodies physiological need for cortisol outstrips its ability to produce it Potentially fatal Illness Injury Surgical procedure How to recognize an adrenal crisis Hypoglycaemia Pallor Sweating Irritable/confused Nausea and/or vomiting Seizures Hypotension Lightheaded/dizziness Headache Conscious level Shock How to avoid it / treat it Extra steroids when unwell (double/treble) Glucogel Hydrocortisone injections Education Medic alerts Questions?