ESPE Abstracts

Background: Gynaecomastia (GM) is common in boys with Klinefelter syndrome (KS) during adolescence due to the higher diurnal oestradiol–testosterone ratio in early-to-mid puberty. The physiological mid-late pubertal rise in testosterone (T) causes the GM to disappear in chromosomally normal boys, but GM persists in boys with KS if this rise in T is blunted.Aims and objectives: We aimed to examine the effect of routine T supplementation in boys with ...

Intro: Gender variance is becoming more common in young people. International guidelines recommend GnRH analogues (GnRHa) for gender variant young people from Tanner stage 2 onwards and cross-sex hormones (CSH) from age 16yr onwards. However, no good evidence exists how these affect growth. This first report aims to determine the impact of GnRHa and CSH on growth in young transgender adolescents to help inform prescribing in this patient cohort.Methods: ...

Background: Adolescents presenting with persistent gender dysphoria (GD) may undergo pubertal suspension via the use of GnRH analogues such as triptorelin (Gonapeptyl Depot) to allow further consideration of the dysphoria. Locally, a standard monthly dose of this drug is administered for an initial target duration of 12 months prior to re-assessment.Objective and hypotheses: The need to obtain full gonadotrophin and sex hormone suppression to ensure accu...

Introduction: Very little is known about the development of the immune system during puberty. Autoimmune diseases, like juvenile onset systemic lupus erythematosus (jSLE), have an unexplained female bias and a higher incidence after puberty. IFN alpha (IFNα) is a potent antiviral cytokine, and jSLE has a strong IFNα transcriptional signature. Toll like receptors 7 and 9 (TLR7/9) sense viral RNA and DNA respectively, and trigger plasmacytoid dendritic cells (pDC) to p...

Introduction: There are well described sex differences in the immune system. It has been shown in both innate and adaptive immunity that females have a more robust response than males. Various autoimmune diseases have a strong sex bias towards females. It is the accepted dogma that oestrogen in females relates to an increased risk of autoimmunity, but evidence to this end is scarce. Interferon alpha (IFNα) is a potent anti-viral innate cytokine, and many autoimmune diseas...

Background: The QEPS-growth-model, developed and validated in GrowUpGothenburg cohorts, used for developing growth references and investigating healthy/pathological growth, lacks external validation from other longitudinal cohorts of healthy individuals.Objective: To investigate if the QEPS-model fits the longitudinal Edinburgh growth study of another design than GrowUpGothenburg cohorts. To compare growth patterns in tw...

Introduction: Pituitary imaging is important for the evaluation of hypothalamo-pituitary axis defects in patients diagnosed with childhood-onset growth hormone deficiency (CO-GHD). Published evidence shows that there is a close relationship between structural changes in the pituitary gland and growth hormone deficiency.Aim: To evaluate the relationship between clinical, laboratory and magnetic resonance imaging of the pi...

Context: Growth analyses have traditionally been done by either non-structural descriptive statistics or by fitting models. While we usually describe height and weight separately, we assume reciprocity of weight and height on each other. We utilize ML to predict ages 7–18 y height based on height and weight data up to age 6y.Methods: After pre-processing the height and weight, primary and secondary features (height SDS, BMI, growth velocity) of 1596...

Background: GnRH analogue and subsequent oestradiol treatments are indicated to alleviate gender dysphoriain adolescent male to female young people (MtF; transgirls). Side effects include impairments in gonadal histology that may cause infertility or biological sterility. Current guidelines encourage professionals to address potential infertility risk and fertility preservation options with transgender youth and their families before starting these treatments.<p class="abs...

Background: Chromosome analysis is always indicated in disorders of sex development (DSD), but the need for karyotyping in gender dysphoria (GD) is less clear.Aims and objectives: We therefore aimed to review the place of routine chromosome analysis in the management of GD in children and adolescents.Patients and methods: 490 children and adolescents with GD have been referred to the two endocrine clinics forming part of the joint ...