ESPE Abstracts

Background: Precocious puberty is defined as the development of secondary sexual characteristics before the age of 8 years in girls and 9 years in boys. This condition results from a constant and complex interplay between predisposing genes and environmental factors. To date, the molecular analysis are all focused on reproductive-endocrine disorders such as Kallmann syndrome and hypogonadotropic hypogonadism, while the genetic bases of pubertal timing are still unclear.<p ...

Loss of function mutations in SGPL1 (sphingosine-1-phosphate lyase) give rise to a multisystemic syndrome with predominating features of primary adrenal insufficiency (PAI) and steroid resistant nephrotic syndrome. Retrospective analysis of our patient cohort and the wider literature also demonstrated primary gonadal insufficiency in a third of male patients with microphallus and bilateral cryptorchidism (all with concomitant adrenal disease and high mortality in infa...

Background: Pituitary apoplexy (PA) is a rare clinical emergency in pediatric population. In patients with apoplexy-like symptoms, clinical and imaging features of PA, caused by hemorrhage in a pre-existing macroadenoma, are sometimes difficult to distinguish from Rathke cleft cyst (RCC).Case presentation: A 14.5-year-old boy, with an uneventful past medical history except for mild COVID-19 infection six months earlier, ...

Management of type 1 diabetes in preschool children is a huge challenge for their caregivers. Age-specific factors (e.g. unpredictable food intake and physical activity, small insulin doses, high insulin sensitivity, frequent intercurrent infections, high variability in insulin requirements) increase the complexity of daily diabetes management. Furthermore, the preschool child depends completely on his/her caregiver. To meet recommended treatment targets while avoiding hypogly...

I review the mental health difficulties that transgender and gender diverse children and adolescents may present with, specifically emotional difficulties. Many studies reveal depression scores and parent and self-reported measures of emotional and behavioral problems that are comparable to mental health clinic referred populations. Children and adolescents who feel that they are acknowledged and supported in their gender diverse feelings, e.g. by receiving gender affirming me...

The phenotype of 45,X/46,XY mosaicism is heterogeneous ranging from females with Turner syndrome (TS) to apparently normal males. Cardinal features of TS include reduced final height and infertility. Apart from endocrine, renal and neurocognitive disorders, structural heart defects are frequently present (in 25% to 50%), also in TS patients with mosaicism 45,X/46,XY. Males with 45,X/46,XY frequently show stigmata typically associated with TS but data on cardiovascular patholog...

Central precocious puberty (CPP) may have endocrine and metabolic implications in adulthood. Long-term effects may be associated with the underlying neuroendocrine dysfunction leading to CPP, the GnRH analogue (GnRHa) therapy, or both. Data are conflicting on the long-term risk of polycystic ovarian syndrome in both treated and untreated women. Clinical hyperandrogenism has been more frequently reported in CPP women than in controls, with no significant difference between GnRH...

Anthropometrics is an important part of pediatrics and public health. Its non-invasiveness, simplicity and low cost makes anthropometry attractive for several purposes. It is a valuable method for the screening or assessment of growth disorders, as well as under- and over-nutrition. Furthermore, specific anthropometric measures can be used as indicators of general fitness or cardiovascular risk factors (insulin resistance and dyslipidemia) in (obese) children, as well as marke...

Puberty is defined by the appearance of secondary sexual characteristics and the maturation of reproductive function. It is driven by an increase in sexual steroid hormone synthesis under the control of the gonadotropic axis. The key event in puberty initiation is an increase in the pulsatile release of the GnRH by hypothalamic neurons, triggering the release of LH and FSH. This pubertal increase in GnRH secretion is associated with increases in glutamatergic inputs and decrea...

Patients with type 1 diabetes (T1D) and their caregivers continue to face the challenge of maintaining blood glucose levels in the near-normal range, preventing sustained hyperglycemia associated with long-term microvascular and macrovascular complications, and avoiding recurrent episodes of hypoglycemia, especially at young ages when they can adversely affect cognitive function. In a follow-up to the Diabetes Control and Complications Trial, the Epidemiology of Diabetes Inter...