IAP Textbook on PEDIATRIC ENDOCRINOLOGY
IAP Textbook on PEDIATRIC ENDOCRINOLOGY
Editor-in-Chief
Vaman Khadilkar MD MRCP (UK) DCH (London)
Senior Pediatric Endocrinologist Jehangir Hospital, Pune and Bombay Hospital, Mumbai Department of Health Sciences Savitribai Phule Pune University
Pune, Maharashtra, India
Associate Editors
Anurag Bajpai MD FRACP SCE
Senior Consultant Regency Center for Diabetes Endocrinology and Research Kanpur, Uttar Pradesh, India Fortis Memorial Research Institute
Gurugram, Haryana, India
Hemchand K Prasad MD (Ped) PDCC (Ped Endo) Fellow (Ped Endo, UK) Fellow (Ped Diabetes, USA)
Consultant Department of Pediatric Endocrinology and Diabetes Mehta Hospital
Chennai, Tamil Nadu, India
Foreword
Santosh T Soans
Digant D Shastri
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IAP Textbook on Pediatric Endocrinology
First Edition: 2019
9789352709052
Printed at
- Aashima Dabas MD
- Assistant Professor
- Department of Pediatrics
- Maulana Azad Medical College
- Lok Nayak Hospital
- New Delhi, India
- Abhishek Kulkarni MD PDCC Visiting Fellowship RCPCH (London)
- Head
- Department of Pediatric and Adolescent Endocrinology
- T2T Hormone Clinics India
- Department Coordiantor
- SRCC Children's Hospital
- Honorary Consultant
- Apollo and PD Hinduja and Jaslok Hospitals
- Mumbai, Maharashtra, India
- Ahila Ayyavoo DCH DNB PhD
- Consultant, Department of Pediatric Endocrinology and Diabetes
- GKNM Hospital, Coimbatore
- Aditi Hospital, Trichy
- Tamil Nadu, India
- Akanksha Parikh MD DNB
- Fellow
- Department of Pediatric Endocrinology
- Indira Gandhi Institute of Child Health
- Bengaluru, Karnataka, India
- Alok Sardesai DNB (Ped)
- Clinical Assistant
- Department of Pediatric and Adolescent Endocrinology
- T2T Hormone Clinics India
- Clinical Fellow
- Department of Pediatric and Adolescent Endocrinology
- SRCC Children's Hospital
- Mumbai, Maharashtra, India
- Amarnath Kulkarni MBBS DCH DNB (Ped)
- Fellowship in Pediatric and Adolescent Endocrinology (RGUHS)
- Senior Consultant
- DNB Academic Coordinator
- Lotus Hospital
- Hyderabad, Telangana, India
- Anjana Hulse MRCPCH (UK) MSc Clin (Ped Sc-Endo, UK)
- Consultant Pediatric Endocrinologist
- Apollo Hospitals
- Bengaluru, Karnataka, India
- Anju Seth MD (Ped)
- Director and Professor
- Department of Pediatrics
- Lady Hardinge Medical College
- Kalawati Saran Children's Hospital
- New Delhi, India
- Anju Virmani MD (Ped) DNB (Endo)
- Senior Consultant
- Pediatric Endocrinology
- Pentamed and Rainbow Hospitals
- Associate Director
- Pediatric Endocrinology
- Max Hospitals (Saket, Gurugram)
- New Delhi, India
- Ankita Maheshwari MBBS MD (Ped) PDCF (Ped Endo)
- ESPE Fellow
- Southampton, London, United Kingdom
- Anna Simon MBBS DCH MD FRCP (Edin)
- Consultant
- Department of Pediatric Endocrinology and Metabolism
- Professor and Head
- Division of Child Health
- Christian Medical College
- Vellore, Tamil Nadu, India
- Anupama Sankaran MD (Ped)
- Registrar, Department of Pediatrics
- Mehta Multispeciality Hospitals
- Chennai, Tamil Nadu, India
- Anuradha V Khadilkar MBBS MD DCH
- Deputy Director
- Hirabai Cowasji Jehangir Medical Research Institute
- Jehangir Hospital
- Pune, Maharashtra, India
- Anurag Bajpai MD FRACP SCE
- Senior Consultant
- Regency Center for Diabetes Endocrinology and Research
- Kanpur, Uttar Pradesh, India
- Fortis Memorial Research Institute
- Gurugram, Haryana, India
- Archana Dayal Arya DNB (Ped)
- Post Doctoral Fellowship in Pediatric Endocrinology (USA)
- Senior Consultant, Sir Ganga Ram Hospital
- New Delhi, India
- Ashwin Dalal MD (Ped) DM (Medical Genetics)
- Head, Diagnostics Division
- Centre for DNA Fingerprinting and Diagnostics
- Hyderabad, Telangana, India
- Aspi J Irani MD DCH
- Pediatrician
- Nanavati Super Speciality Hospital
- Trustee and In-Charge
- Juvenile Diabetes Foundation (Maharashtra Chapter)
- Mumbai, Maharashtra, India
- Benjamin B Albert MB ChB PhD FRACP
- Research Fellow
- Liggins Institute
- University of Auckland
- Auckland, New Zealand
- Chetankumar Dave MBBS DCh
- Fellow Pediatric and Adolescent Endocrinology
- Regency Center of Diabetes, Endocrinology and Research
- Kanpur, Uttar Pradesh, India
- Dhanya Lakshmi Narayanan MD (Ped) DCH DNB (Ped) DM (Medical Genetics)
- Assistant Professor
- Department of Medical Genetics
- Nizam's Institute of Medical Sciences
- Hyderabad, Telangana, India
- Hari Mangtani MBBS DCH DNB (Ped) PDCC (Ped Endo)
- Consultant Pediatric Endocrinologist
- Pearl Endocrine Clinic
- Nagpur, Maharashtra, India
- Visiting Consultant
- Shri Shishu Bhavan
- Bilaspur, Chhattisgarh
- Bal Gopal Hospital
- Raipur, Chhattisgarh, India
- Hemchand K Prasad MD (Ped) PDCC (Ped Endo) Fellow (Ped Endo, UK) Fellow (Ped Diabetes, USA)
- Consultant
- Department of Pediatric Endocrinology and Diabetes
- Mehta Hospital
- Chennai, Tamil Nadu, India
- IPS Kochar MD (Ped) MAMS (Vienna) MRCPCH (London)
- Fellow Pediatric and Adolescent Endocrinology (GOSH London)
- Senior Consultant
- Pediatric and Adolescent Endocrinologist
- Indraprastha Apollo Hospital
- New Delhi, India
- KG Ravikumar MD FRCPCH (UK)
- Consultant Pediatric Endocrinologist
- Kanchi Kamakoti Childs Trust Hospital
- Chennai, Tamil Nadu, India
- Kumar Angadi MBBS MD (Ped) Fellow (Pediatric and Adolescent Endocrinology)
- Assistant Professor, Department of Pediatrics
- MR Medical College
- Consultant Pediatric and Adolescent Endocrinologist
- Basaveshwar Teaching and General Hospital
- Kalaburagi, Karnataka, India
- Leena Priyambada MD PDCC (Ped End)
- Rainbow Children's Hospital
- Hyderabad, Telangana, India
- Leenatha Reddy Jakkidi MRCPCH CCT (UK)
- Consultant Pediatric Endocrinologist
- Rainbow Children's and Apollo Hospitals
- Hyderabad, Telangana, India
- M Vijayakumar MD DCH DNB
- Professor and Head
- Department of Pediatrics
- Government Medical College
- Manjeri, Kerala, India
- Madhura K Joshi MBBS DNB (Ped)
- Fellowship in Pediatric Endocrinology
- Consultant Pediatric Endocrinologist
- Jupiter Hospital
- Surya Mother and Child Care
- Visiting Consultant
- Jehangir Speciality Hospital
- Pune, Maharashtra, India
- Hanumant Hospital
- Mahuva, Gujarat, India
- Mamta Muranjan MD (Ped) DCH
- Additional Professor
- Department of Pediatrics
- In-Charge
- Genetic Clinic, Seth GS Medical College and KEM Hospital, Parel, Mumbai
- Consultant in Clinical Genetics
- PD Hinduja National Hospital and Medical Research Center Mahim, Mumbai
- SRCC Hospital
- Mumbai, Maharashtra, India
- Medha Mittal MD
- Associate Professor
- Department of Pediatrics
- Chacha Nehru Bal Chikitsalaya
- Delhi, India
- Nalini Samir Shah MD (Ped) DM (Endo)
- Professor Emeritus
- Seth GS Medical College and KEM Hospital
- Mumbai, Maharashtra, India
- Neha Agarwal MD
- Department of Pediatric Endocrinology
- Regency Center for Diabetes Endocrinology and Research
- Kanpur, Uttar Pradesh, India
- Neha Bhise DNB (Ped) FIAP (Ped Endo)
- Pediatric Endocrinologist
- Kaushalya Hospital
- Currae Hospital
- Sushrusha Hospital
- KJ Somaiya Hospital
- ACE Hospital, Dombivli
- Yashonandan Hospital, Kalyan
- Mumbai, Maharashtra, India
- Nikhil Lohiya DNB
- Fellow Pediatric Endocrinology
- HCJMRI and Jehangir Hospital
- Pune, Maharashtra, India
- Palany Raghupathy MD DCH FRCP
- Professor
- Department of Pediatric Endocrinology
- Indira Gandhi Institute of Child Health
- Bengaluru, Karnataka, India
- Parvathy L MBBS DCH MD (Ped)
- Fellowship in Pediatric and Adolescent Endocrinology
- Consultant
- Department of Pediatric Endocrinology
- Aster Medcity
- Kochi, Kerala, India
- Poovazhagi Varadarajan MD DCH PhD
- Professor
- Department of Pediatrics
- Government Stanley Medical College
- Chennai, Tamil Nadu, India
- Prachi Bansal MD (Ped) DM (Endo)
- Senior Resident
- Department of Endocrinology
- Seth GS Medical College and KEM Hospital
- Mumbai, Maharashtra, India
- Prashant P Patil MD PDCC (Ped Endo) ESPE Fellowship (Liverpool, UK)
- Consultant Pediatric Endocrinologist
- SRCC NH Children's Hospital, Haji Ali
- Jaslok Hospital
- Mumbai, Maharashtra, India
- Preeti Singh MD (Ped)
- Assistant Professor
- Department of Pediatrics
- Lady Hardinge Medical College
- Kalawati Saran Children's Hospital
- New Delhi, India
- (Lt Col) Priscilla Joshi MD (Radiodiagnosis)
- Professor and Head
- Department of Radiodiagnosis
- Vice-Principal (PG Academics)
- Bharati Vidyapeeth (Deemed to be University)
- Medical College and Hospital
- Pune, Maharashtra, India
- Purna Kurkure
- Chairman
- Clinical Collegium for Oncology Services, Narayana Health Group
- Head, Division of Pediatric Hemato-Oncology and BMT
- SRCC Children's Hospital, Managed by Narayana Health
- Mumbai, Maharashtra, India
- Rahul Jahagirdar MD PDCC (Ped Endo) ESPE Fellowship (Liverpool, UK)
- Professor and Pediatric Endocrinologist
- Bharati Vidyapeeth University Medical College
- Pune, Maharashtra, India
- Raja Padidela MD (Ped) DNB (Ped) MRCPCH MD (Research)
- Consultant Pediatric Endocrinologist and Metabolic Bone Diseases
- Department of Pediatric Endocrinology
- Royal Manchester Children's Hospital
- Manchester University NHS Foundation Trust
- Manchester, England, United Kingdom
- Rajesh Khadgawat MD DM DNB MNAMS
- Professor
- Department of Endocrinology and Metabolism
- All India Institute of Medical Sciences
- New Delhi, India
- Rakesh Kumar MD Fellowship (Ped Endo)
- Professor, Pediatric Endocrinology and Diabetes Unit
- Department of Pediatrics
- Advanced Pediatrics Centre
- Post Graduate Institute of Medical Education and Research (PGIMER)
- Chandigarh, Punjab, India
- Riaz I MBBS DCH DNB (Ped)
- Fellowship in Pediatric and Adolescent Endocrinology
- Associate Professor
- Department of Pediatrics
- In-Charge, Pediatric Endocrine Clinic and Diabetes Clinic
- SAT Hospital
- Government Medical College
- Thiruvananthapuram, Kerala, India
- Riddhi Patel MD (Ped)
- Fellow in Pediatric and Adolescent Endocrinology
- Center for Diabetes and Endocrinology Research
- Regency Healthcare
- Kanpur, Uttar Pradesh, India
- Ruchi Nadar DNB (Ped) MRCPCH Fellowship in Pediatric Endocrinology (Pune)
- Clinical Fellow in Pediatric Endocrinology
- Birmingham Children's Hospital
- Birmingham, England, United Kindom
- Ruchi Parikh MBBS DNB (Ped) Fellowship (Ped Endo)
- Consultant Pediatric Endocrinologist
- Division of Pediatric Endocrinology
- Bai Jerbai Wadia Hospital for Children, Mumbai
- Comprehensive Thalassemia Care
- Pediatric Hematology-Oncology and Bone Marrow Transplantation Centre
- SRCC Children's Hospital
- Surya Children Hospital
- Mumbai, Maharashtra, India
- Ruchira Misra MBBS DCh DNB (Ped) FRAH
- Consultant
- Division of Pediatric Hematology–Oncology and BMT
- SRCC Children's Hospital, Managed by Narayana Health
- Mumbai, Maharashtra, India
- Ruma Deshpande MD (Ped) PDCC
- Assistant Professor and Pediatric Endocrinologist
- Bharati Vidyapeeth Medical College
- Pune, Maharashtra, India
- Sandhya Kondpalle DNB (Ped) PDCF (Ped Endo)
- Pediatric Endocrinologist
- Manik Hospital
- Aurangabad, Maharashtra, India
- Sangeeta Yadav MD FIAP
- Director Professor
- Department of Pediatrics
- In-Charge
- Pediatric and Adolescent Endocrinology
- Maulana Azad Medical College
- University of Delhi
- New Delhi, India
- Sanjana Dey MBBS
- Honorary Clinical Fellow
- Department of Pediatrics
- Apollo Gleneagles Hospital
- Kolkata, West Bengal, India
- Santhosh Olety MBBS DCH MRCPCH CCST ([UK)
- SCE in Endocrinology and Diabetes (FRCP, ABCD and the Society for Endocrinology, UK)
- Consultant Pediatric and Adolescent Endocrinologist
- Karnataka Institute of Endocrinology and Research
- White Lotus Healthcare
- Cloudnine Kids Hospital
- Fortis Hospital
- Bengaluru, Karnataka, India
- Sarah Mathai DCH DNBE (Ped) PhD
- Professor, Department of Pediatrics
- Christian Medical College
- Vellore, Tamil Nadu, India
- Saurabh Uppal MD (Ped) MRCPCH (UK)
- Fellowship in Pediatric Endocrinology
- Manipal Advanced Children Centre, Bengaluru, Karnataka, India
- ESPE Fellowship in Pediatric Endocrinology
- Alder Hey Children's Hospital, Liverpool, UK
- Consultant Pediatric Endocrinologist
- Endo-Kidz Centre for Growth, Diabetes and Hormones for Children
- Jalandhar, Punjab, India
- Senthil Senniappan MD MRCPCH FRCPCH MSc (Diab) PhD
- Consultant Pediatric Endocrinologist and
- Honorary Senior Lecturer
- Alder Hey Children's Hospital
- Liverpool, England, United Kingdom
- Shaila S Bhattacharyya MD DCH DM MRCP
- Professor
- Department of Pediatrics and Pediatric Endocrinology
- Shivajoyti, Indiranagar
- Manipal Hospital
- Bengaluru, Karnataka, India
- Shalmi Mehta MD (Ped, Gold Medalist)
- Department of Pediatric Endocrinology
- Hospital for Sick Children, Toronto
- Consultant Pediatric Endocrinologist
- Endokids Clinic
- Ahmedabad, Gujarat, India
- Sirisha Kusuma Boddu MBBS MD
- Fellow in Pediatric Endocrinology
- Consultant Pediatric Endocrinologist
- Rainbow Children's Hospital
- Hyderabad, Telangana, India
- Smita Koppikar MBBS DNB (Ped) MRCPCH CCT (UK)
- Consultant Pediatric Endocrinologist
- Department of Pediatrics
- Sir HN Reliance Foundation Hospital
- Mumbai, Maharashtra, India
- Smita Ramachandran MD (Ped)
- Fellow
- Pediatric and Adolescent Endocrinology
- Indraprastha Apollo Hospital
- New Delhi, India
- Subrata Dey MD DCH DNB MRCP (UK)
- Fellowship in Pediatric Endocrinology (USA)
- Academic Head and Director, DNB Pediatrics Program
- Department of Pediatrics
- Senior Pediatric Endocrinologist
- Apollo Gleneagles Hospital
- Kolkata, West Bengal, India
- Sudha Rao MD
- Professor and Chief
- Division of Pediatric Endocrinology
- Bai Jerbai Wadia Hospital for Children
- Jupiter Hospital
- Tata Memorial Hospital
- Mumbai, Maharashtra, India
- Supriya Gupte MD Fellowship (Ped Endo) ESPE Fellow (UK)
- Consultant, Deenanath Mangeshkar Hospital
- Honorary Consultant, DY Patil Medical College
- Pune, Maharashtra, India
- Thakur Vikrant Anand Singh MD (Ped)
- Fellowship in Pediatric and Adolescent Endocrinology (RGUHS)
- Assistant Professor and Consultant
- Pediatric and Adolescent Endocrinologist
- Muzzaffarnagar Medical College
- Muzzaffarnagar, Uttar Pradesh, India
- Tushar Godbole MBBS DCH DNB (Ped) PDCC
- Fellow in Pediatric Endocrinology
- Director, Harmony Health Hub
- Assistant Professor, Dr Vasantrao Pawar Medical College
- Nashik, Maharashtra, India
- V Shobi Anandi MD (Ped)
- Fellowship in Pediatric Endocrinology
- Consultant Pediatric Endocrinologist
- Sri Ramakrishna Multi Speciality Hospital
- Coimbatore, Tamil Nadu, India
- Vaman Khadilkar MD MRCP (UK) DCH (London)
- Senior Pediatric Endocrinologist
- Jehangir Hospital, Pune and Bombay Hospital, Mumbai
- Department of Health Sciences
- Savitribai Phule Pune University
- Pune, Maharashtra, India
- Vandana Jain MD
- Professor and In-Charge, Pediatric Endocrinology Division
- Department of Pediatrics
- All India Institute of Medical Sciences
- New Delhi, India
- Vasundhara Chugh MD Fellowship in Pediatric Endocrinology
- Fellow
- Sir Ganga Ram Hospital
- New Delhi, India
- Veena H Ekbote MSc PhD
- Research Officer
- Hirabai Cowasji Jehangir Medical Research Institute
- Jehangir Hospital
- Pune, Maharashtra, India
- Veena V Nair MD DCH PDCC (Ped Endo)
- Consultant Pediatric and Adolescent Endocrinologist
- Ananthapuri Hospitals and Research Institute
- Thiruvananthapuram, Kerala, India
- Vijaya Sarathi HA MD (Ped) DM (Endo)
- Associate Professor
- Department of Endocrinology
- Narayana Medical College
- Nellore, Andhra Pradesh, India
- Wayne Cutfield MB ChB MD FRACP
- Professor, Pediatric Endocrinology
- Liggins Institute
- University of Auckland
- Auckland, New Zealand
- Yeshwant Krishna Amdekar MD DCH FIAP
- Medical Director
- BJ Wadia Hospital for Children
- Mumbai, Maharashtra, India
- Yuthika Sharma MD
- Fellowship in Pediatric and Adolescent Gynecology (RCH, Melbourne Australia)
- Consultant and Head, Department of Reproductive Medicine and IVF
- Regency Healthcare, Kanpur, Uttar Pradesh, India
Endocrine system plays a critical role in physical and mental development, especially during the delicate antenatal and postnatal period as well as during adolescence. During these periods, the body undergoes major transformations in its journey from fetus to adult. Where any problem is detected, timely treatment is essential to gain better control over its progression. Hence, the practising pediatrician should be well equipped with knowledge regarding the endocrinal issues that normally affect children. This textbook of pediatric endocrinology introduces the students of pediatrics, be it undergraduate, postgraduate or DM to this vast subject with depth and clarity. This is the first textbook in the field of endocrinology to be specially commissioned by the Indian Academy of Pediatrics (IAP) and it reflects the growing importance of this field in general practice.
First and foremost, I wish to congratulate Dr Vaman Khadilkar who took on this project almost single handed and has been able to bring out the book within the time limit which is highly appreciable. I also thank Dr Anurag Bajpai and Dr Hemchand K Prasad for taking up the onerous task of compiling this book and enthusiastically pursuing this project to fruition. They have envisioned a comprehensive coverage of endocrinology in this book with Indian focus and perspective in mind. I am also glad to see that a large number of experts in this field have contributed chapters and made this into a genuine team effort.
An organization can thrive only when it is focused on its core purpose. I have spent the better part of my presidential tenure to renew IAP's focus on academics. The IAP has a long-standing track record of outstanding academic activity. The IAP Endocrinology Chapter has been at the forefront in bringing out various guidelines and growth charts which are known throughout the globe. The IAP can be reinvigorated only when we continue to produce academic output of excellent quality. This textbook is a step forward in that direction. I wish to convey the academy's gratitude to all those who have been involved in this effort, chiefly the editors and contributors for giving life to IAP's vision for emerging as a professional organization of repute.
I wish the reader a fruitful reading experience.
Santosh T Soans
President
Indian Academy of Pediatrics
Foreword
It gives me sense of honor and pleasure to write the Foreword for the IAP Textbook on Pediatric Endocrinology.
In earlier time in India, there was a handful of institutions where children with endocrine problems were managed and probably for getting trained in this subspecialty, one had to go out of country. But, in the last few years, pediatric endocrinology has emerged as an important subspecialty with many institutions not only offering treatment to children with endocrine problems but also train students in this subspecialty. In view of country-specific medical problems and difficulties associated with its management within the available resources, it will be imperative to have a textbook written by local experts who not only know the problems but also have developed alternative indigenous management system.
Keeping this in mind, the Indian Academy of Pediatrics (IAP) decided to come out with the first ever edition of IAP Textbook on Pediatric Endocrinology, which will be useful to pediatric endocrine trainees as well as to practicing pediatricians. The text will surely prove to be useful to DM endocrine students who have special interest in pediatric endocrinology.
The book covers almost all aspects of pediatric endocrinology, growth disorders and diabetes in children. This book is enriched with flowcharts, diagrams, photographs and guidelines.
My sincere compliments and congratulations to all the authors, who as a part of their sincere efforts to disseminate the knowledge have contributed chapters for this prestigious publication. I congratulate the entire editorial board lead by Dr Vaman Khadilkar, Dr Anurag Bajpai and Dr Hemchand K Prasad, for their untiring efforts to bring out this book.
I am sure that this book will be popular amongst the postgraduate students, teaching faculties as well as practicing pediatricians. I wish this landmark publication great success.
Digant D Shastri
President
Indian Academy of Pediatrics, 2019
Preface
Pediatric endocrinology has taken major strides in the last few years in our country and many institutions have started fellowship training courses in pediatric endocrinology in the last decade. Keeping this in mind, the Indian Academy of Pediatrics (IAP) decided to have a Textbook on Pediatric Endocrinology for the first time this year which will be of use to pediatric endocrine trainees as well as to practicing pediatricians. The text will also be useful to DM endocrine students who have special interest in pediatric endocrinology. Postgraduates in pediatric training will also benefit from the basics written at the beginning of each chapter. Although there are many books written in the recent times on pediatric endocrinology in India, this text is specifically written with the perspective of pediatric endocrinology practice in India and the chapters include many protocols in pediatric endocrinology published by the Indian Academy of Pediatrics. This textbook also includes dynamic endocrine stimulation tests and synopsis of commonly used drugs in pediatric endocrinology. At the end of each chapter, there is a comprehensive bibliography to expand readers’ knowledge beyond this book.
The book covers almost all aspects of pediatric endocrinology, growth disorders and diabetes in children. This book is enriched with flowcharts, diagrams, photographs and guidelines.
Vaman Khadilkar
Anurag Bajpai
Hemchand K Prasad
Acknowledgments
The journey of writing this book has given us great opportunity to learn, interact with colleagues and friends from India and abroad and we are very grateful to all the contributors who have tended the midnight wick to complete their responsibilities despite very tight timelines. Finally, we would like to thank Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Mr MS Mani (Group President), and the staff of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, who have worked endlessly to take this work to completion in a very able and professional manner.