Endocrinopathies (diseases caused by disruption of endocrine glands) that develop in children are not similar to endocrine pathologies in adults. It is also more difficult to identify childhood endocrine diseases at an early stage because parents mistake some symptoms for characteristics of child’s character and behavior. Therefore, it is necessary to pay attention to any non-standard complaints and manifestations from child’s side and seek specialized medical help.

Our department employs highly professional doctors and nurses. All doctors have high-quality theoretical training, rich clinical experience, master the latest technologies for diagnosing and treating endocrine diseases, work according to modern clinical international protocols, and constantly improve their professional level through participation in Israeli and international conferences, studying clinical research publications and direct participation in them.

Children with gender pathology are admitted to Pediatric Endocrinology Department at TAMC for treatment. Here they get the opportunity to take an integrated approach to the problem of sexual development disorders and gender determination. An entire multidisciplinary team works with such patients: endocrinologists, geneticists, pediatric gynecologists, urologists, psychologists, surgeons. The hospital has a special commission for determining gender in particularly difficult situations, which also selects a subsequent set of therapeutic (drug hormonal therapy, surgical gender reassignment) and rehabilitation measures.

The department concentrates the latest technologies in diabetes mellitus treatment in children, where the most modern techniques are used (installation of insulin pumps, artificial pancreas, continuous glucose monitoring). Diagnosis is carried out between different types of diabetes mellitus (type 1, type 2, MODY (maturity-onset diabetes of the young), secondary, component of a genetic syndrome, neonatal transient or persistent, etc.) – to select the optimal treatment with glucose-lowering drugs and select optimal insulin therapy (intensive, pump).

It is mandatory for specialists to train children and their parents in rules of pump or intensive insulin therapy, methods blood glucose levels monitoring, and first aid for acute diabetes complications, for example, hypoglycemia.

Treatment advantages in Pediatric Endocrinology Department of TAMC:

Active application of modern technologies in treatment of children with endocrine diseases.
Rapid introduction into practice of new diagnostics or treatment in endocrinology.
Individual approach to each child and his clinical case.
Treatment is complex using both medicinal and non-medicinal methods.
Development of individual rehabilitation programs.
A modern diagnostic department where you can undergo a comprehensive examination within 1-3 working days.
Comfortable conditions in the department are as close as possible to a home environment.
The opportunity for parents to be with child at all times, with the exception of surgical interventions.
Accompaniment by an employee of medical tourism department, interpreters services.
Reasonable prices for diagnostics and treatment, payment upon receipt of medical services.

Working with children. Qualified gentle professional pediatrician examining girls neck while his assistant standing nearby and noting what he saying

Practice spheres

Specialists of Pediatric Endocrinology Department at TAMC help all children without exception with pathologies of endocrine glands, both common and very rare diseases. Most often people come to our clinic with the following problems and diseases:

Disturbances in growth process and sexual development in children (delayed growth, sexual development or excessive growth and premature puberty).
Diabetes mellitus in a child and chronic complications of this disease. Our specialists always carry out a differential diagnosis between types of diabetes mellitus in children, since treatment depends on this (type 1, type 2, MODY, secondary, component of genetic syndrome, neonatal transient or persistent).
Hypoglycemic conditions in children in neonatal period, infancy and childhood.
Early and late forms of congenital adrenal cortex dysfunction (CAD), chronic adrenal insufficiency, mass malformations of adrenal glands with hormonal activity (pheochromocytoma, androsteroma, corticoandrosteroma). Differential diagnosis of transient and congenital dysfunction of adrenal cortex in newborns is carried out. Pathogenetic treatment is prescribed and hormonal status is corrected. Complications of VDCN are identified and monitored and, accordingly, their treatment is carried out.
Various forms of hyperandrogenism in children: establishing an accurate diagnosis, preoperative preparation and surgical intervention if necessary.
Autoimmune polyendocrine syndromes.
Diseases of pituitary gland – diabetes insipidus (differential diagnosis of central DI, nephrogenic DI and psychogenic polydipsia). Carrying out appropriate diagnostic tests.
Hormonally active tumors of pituitary gland, which do not require neurosurgical treatment, are managed by specialists in pediatric endocrinology sphere by compensating the hormonal status (prolactinomas, craniopharyngiomas, somatostatinomas).
Calcium and phosphorus metabolism disorders: hypoparathyroidism (decreased function of parathyroid glands), hyperparathyroidism (increased function of parathyroid glands).
Thyroid diseases: thyrotoxicosis syndrome: diffuse toxic goiter, toxic adenoma, stage of thyrotoxicosis with autoimmune thyroiditis, subacute thyroiditis, hypothyroidism syndrome: congenital primary hypothyroidism (associated with thyroid gland damage), acquired hypothyroidism against the background of autoimmune thyroiditis.
Violation of sexual differentiation in a child: establishing a diagnosis, choosing child’s civil gender; determining the tactics of medication and timing of surgical treatment in children with disorders of sexual differentiation.
Primary and secondary obesity in children. Oncological endocrinology – malignant neoplasms of endocrine glands (they are quite rare in children).

What diseases does Pediatric Endocrinology Department treat?

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Diagnostic methods in pediatric endocrinology

The entire diagnostic process in TAMC can be divided into 3 stages:

Initial consultation with a leading endocrinologist, development of a further examination plan.
Direct laboratory and instrumental diagnostics in Pediatric Endocrinology Department or Diagnostic Department of TAMC. Repeated consultation with a specialist, final diagnosis development and making up a treatment plan. If necessary, a multidisciplinary team of TAMC specialists can get involved at this stage.

The set of diagnostic laboratory and instrumental tests for each patient is individual and depends on expected diagnosis and age of child. As a rule, the following examinations may be prescribed:

A set of laboratory parameters, in particular, various hormones – hormones of thyroid and parathyroid glands (TSH, T4 free, ATPO, parathyroid hormone), sex hormones (LH, FSH, prolactin, testosterone, progesterone, estradiol), adrenal hormones (DHEA-S, cortisol), growth hormone, carbohydrate metabolism indicators (blood and urine sugar, HbA1c, C-peptide, insulin, HOMA index).
Instrumental techniques for medical imaging (digital X-ray, ultrasound, CT, MSCT, dopplerography, MRI and others).
Medical genetic counseling and molecular genetic tests to confirm hereditary types of endocrinological diseases. For example, diagnostics of genetic syndromes associated with diabetes mellitus (DIDMOAD syndrome, mitochondrial diabetes, severe insulin resistance syndromes, Down syndrome, etc.).
Diagnostic tests for differential diagnosis of various types of diabetes. To diagnose type 1 diabetes, as well as predict the risk of developing type 1 diabetes in close relatives, immunological studies are carried out: antibodies determination to islet cells (ICA), insulin (IAA), glutamate decarboxylase enzymes (GADA) and tyrosine phosphotase (IA2) , zinc transporter (ZnT8).

Important!

Pediatric endocrinologists of our department know how to find a common language with children of all ages and have extensive experience interacting with them. Doctor will make sure that child is not afraid or in pain during procedures and examinations. Specialist will devote as much time to little patient as necessary.

Modern treatment methods in pediatric endocrinology

In Pediatric Endocrinology Department of TAMC successfully copes with diabetes mellitus, regardless of its type, cause and course. For this purpose, doctors use the entire spectrum of traditional and innovative treatment methods of this serious disease.

Insulin pumps are medical devices that are designed to deliver insulin into patient’s body with diabetes. Insulin pump therapy is also known as continuous subcutaneous insulin therapy. The device includes: the pump itself (with a control console, information processing module and batteries), a replaceable reservoir for insulin (inside the pump), a replaceable infusion set, including a cannula for subcutaneous injection and a tubing system for connecting the reservoir to cannula.

An insulin pump is an alternative to multiple daily insulin injections with an insulin syringe or insulin pen and allows for intensive insulin therapy in combination with glucose monitoring and dietary carbohydrate counting.

A professional continuous glucose monitoring system (CGM) is a modern technology that is available to patients in Pediatric Endocrinology Department of TAMC. Using a high-tech device, glucose levels are measured every five minutes not in blood, but in intercellular fluid and recorded in device’s memory.

After training, a specialist or patient himself installs a special sensor, which is located on the surface of the body and has an electrode under skin and connects it to monitor. Device is usually attached to patient in the back of shoulder, which does not interfere with the activity of a child with diabetes. Special software is installed on a mobile device (smartphone, tablet), which analyzes all measurements, systematizes and stores the data. Based on such monitoring results, doctor adjusts the treatment plan or develops up an individual insulin therapy regimen.

The main advantages of continuous blood glucose monitoring compared to conventional glucose meters:

24-hour measurement and recording of blood glucose levels;
detection of a sharp decrease (hypoglycemia) or increase in glucose levels;
alarm signal for sudden changes in indicators that go beyond acceptable limits;
absence of pain and stress from constant burning of fingers;
possibility of more accurate and effective correction of insulin therapy.

Artificial pancreas. With the advent of insulin pumps, life of patients with diabetes has become much easier, since they do not need to give themselves insulin injections several times a day – the pump will do this. But correct pump operation directly depends on patient himself: he must regularly enter data on blood sugar levels and set the required dose of short- and long-term insulin.

The artificial pancreas is an innovative device that combines an insulin pump and a continuous glucose monitoring device. Thus, artificial pancreas independently monitors blood glucose levels and administers the required dose of drug regardless of patient.

Studies have shown that this modern device provides better blood glycemic control and reduces the risk of developing chronic and acute diabetes complications. This device turned out to be especially convenient for children who do not need to measure their sugar 5 times a day and inject insulin on their own.

If sexual differentiation is impaired in a child, the issue of gender selection is resolved only at a special consultation. After this, child is prescribed medicinal hormonal therapy to develop secondary sexual characteristics, and question of when and to what extent surgical gender reassignment will be performed is also decided.

According to specialists group conclusions, if necessary, feminizing operations can be performed, for example, removal of gonads by laparoscopy in case of impaired sexual differentiation with a 46XY karyotype (male karyotype). This is necessary to prevent their malignant degeneration when located in abdominal cavity. Also, in some cases, plastic surgery of xternal genitalia may be indicated for virillization according to Prader III-V (plasty of urogenital sinus with delimitation of urinary tract and vagina, plastic surgery of clitoris with preservation of head on neurovascular crus) and other reconstructive interventions.

Obesity treatment in children. A clinic for childhood and teenagers obesity treatment operates on basis of Pediatric Endocrinology Department at TAMC. Endocrinologists collaborate with the Pediatric Psychiatry and Psychosomatic Department, which specialize in treatment of eating disorders, and they can also provide, if necessary, a base for hospitalization of children with such disorders.

Our department operates various thematic programs that are designed for overweight children:

Dietetics and healthy eating.
Physical culture and sport.
Dramatic arts for obese children.
Summer holiday camp.
Helpline.

In especially severe cases (grade 3 obesity, morbid obesity), drug weight correction techniques (a new class of drugs – analogues of glucagon-like peptide-1 (GLP-1)) or surgical interventions (bariatric surgery) can additionally be used. This is very individual, since such methods of weight correction are not recommended in childhood, but in cases where the benefit significantly outweighs the risk, they can be used both in combination and alone.

If your child is diagnosed with any type of endocrine disease, do not wait until the disease causes severe complications. Contact pediatric endocrinologists who work at TAMC for a consultation.