Practical Pediatric Endocrinology in a Limited Resource Setting

1st Edition

Editors: Margaret Zacharin
Hardcover ISBN: 9780124078222
eBook ISBN: 9780124079366
Imprint: Academic Press
Published Date: 10th May 2013
Page Count: 416
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Institutional Access


Practical Pediatric Endocrinology in a Limited Resource Setting provides a guide for managing pediatric endocrine problems in a limited resource setting, together with an outline of the bases for these disorders. The book outlines a plan for coming to a likely diagnosis in situations where resources are constrained, and suggests ways to access more sophisticated technologies for diagnostic confirmation and extension of available tools.

Further extending and complementing each chapter is a series of scenarios for use as teaching and learning tools. Together with a clinical question, all chapters include a suggested outline for assessment that assists readers facing similar situations in daily practice. Each scenario works through a typical series of deductive steps used to establish a working diagnosis, while considering both a differential diagnosis and reminding readers of current knowledge around the subject matter.

Key Features

  • Provides a working knowledge of pediatric endocrinology, from the viewpoint of practical application, for residents and clinicians practicing in settings with scarce material resources
  • Features clinically based chapters, empahsising workable diagnoses and management plans in limited resource situations
  • Includes information on Type 1 diabetes mellitus, given its increasing prevalence worldwide
  • Describes basic research techniques and planning, intended to foster collaboration between colleagues and other centers in clinical or basic research, which can inform clinical practice and drive innovation


Practicing clinicians or residents in endocrinology, pediatrics, family practice, and general medicine who work in developing countries or rural areas of developed countries with limited resources

Table of Contents




Chapter 1. Growth: Importance and Implications of Variations

Part 1: Normal Growth and Puberty

Part 2: Variations in Linear Growth

Specific Conditions Presenting with Short Stature and Growth Failure

Tall Stature

Specific Conditions Presenting with Tall Stature

References and Further Reading


Chapter 2. Puberty: Normal and Abnormal

Normal Puberty

Clinical Setting

Delayed Puberty

Growth Monitoring

Hypothalamic Pituitary Disorders (Secondary Hypogonadism)

Primary Hypogonadism

Precocious Puberty

Pathophysiology of Precocious Puberty

Management of Precocious Puberty


Other Disorders of the Breast


Further Reading

Chapter 3. Thyroid Disorders


Clinical Setting

Clinical Setting


Clinical Setting

Thyroid Nodules

Thyroid Cancer in Childhood


Chapter 4. Adrenal Disorders

Background: Pathophysiologic Considerations

Clinical Setting

Principles and Problems of Treatment Provision

Congenital Adrenal Hyperplasia

Diagnostic Approach to the Newborn with Suspected 21-Hydroxylase Deficiency (21-OHD)

11-Hydroxylase Deficiency (11β-OHD)

3β-Dehydrogenase Deficiency

17α-Hydroxylase Deficiency

Laboratory Investigations of CAH in the Neonatal Period

Diagnostic Approach to ‘Simple Virilising’ Forms of CAH Later in Childhood

Diagnostic Approach to Non-Classical CAH in Childhood

Management of a Child with Classical 21-OHD

Acquired Disorders of the Adrenal Cortex

Disorders of Mineralocorticoid Function

Hyperfunction of the Adrenal/Disorders of the Adrenal Corte


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About the Editor

Margaret Zacharin

A/Prof. Margaret Zacharin is a paediatric and adult endocrinologist, working at the Royal Children’s hospital, and the Peter MacCallum cancer hospital, Melbourne, Australia. Her clinical practice interests include disorders of puberty, bone health and long term effects of childhood cancer, with research in areas of primary and secondary bone disorders and hormone replacement. She has major teaching commitments in Europe, Africa and India and aims to help promulgate awareness of a need for improving access to and care of paediatric endocrine disorders in developing countries and in places where resources are constrained and reliance on clinical assessment and management strategies is paramount.

Affiliations and Expertise

Associate Professor, University of Melbourne; Pediatric and Adult Endocrinologist, Royal Children's Hospital, Parkville, Victoria, Australia