Pediatric Endocrinology, Fourth Edition

by Lifshitz; Fima

• ISBN13: 9780824708160
• ISBN10: 0824708164
• Edition: 4th
• Format: Hardcover
• Copyright: 2003-01-31
• Publisher: CRC Press

Summary

The fourth edition of this text presents breakthroughs in the diagnosis, treatment, and control of children with endocrine and endocrine-related disorders. It addresses every condition and situation encountered in day-to-day clinical practice - from growth abnormalities and thyroid disease to diabetes, obesity and hypertension.

Table of Contents

About the Series	iv
Foreword	v
Robert M. Blizzard
Foreword	v
Maria I. New
Preface	vii
Contributors	xxi
Online References Cited in Text	xxv
I. GROWTH AND GROWTH DISORDERS
Worrisome Growth	1	(46)
Fima Lifshitz
Diego Botero
The General Problem	1	(1)
The Medical Problem	2	(1)
Diagnosis of Short Stature	3	(1)
Growth Patterns	4	(6)
Constitutional Growth Delay	10	(3)
Familial Short Stature	13	(1)
Pathological Short Stature	14	(1)
Intrauterine Growth Retardation	15	(5)
Failure to Thrive	20	(5)
Nutritional Growth Retardation	25	(9)
Laboratory Aids in Differentiating Short Stature	34	(1)
Final Considerations	35	(12)
References	35	(12)
Hypopituitarism and Other Disorders of the Growth Hormone and Insulin-Like Growth Factor Axis	47	(40)
Arlan L. Rosenbloom
Ellen Lancon Connor
Introduction	47	(1)
Pituitary Gland, Growth Hormone, and IGF-I	47	(7)
Classification of Disorders Involving the GH/IGF-I Axis	54	(1)
Congenital GH Deficiency	54	(4)
Acquired GH Deficiency	58	(6)
Congenital GH Insensitivity	64	(3)
Acquired GH Insensitivity	67	(1)
Primary IGF-I Deficiency and IGF-I Resistance	67	(1)
Diagnostic Evaluation	68	(6)
Treatment	74	(13)
References	78	(9)
Growth Hormone Treatment	87	(26)
David B. Allen
Introduction	87	(1)
Growth Hormone Physiology	88	(1)
Growth Hormone Effects	89	(1)
Growth Hormone Deficiency	90	(5)
Idiopathic Short Stature and Constitutional Growth Delay	95	(2)
Turner Syndrome and Noonan Syndrome	97	(1)
Intrauterine Growth Retardation	98	(1)
Chronic Renal Failure and Hypophosphatemic Rickets	99	(1)
Skeletal Dysplasias	99	(1)
Glucocorticoid-Treated Children	100	(1)
Prader-Willi Syndrome	101	(1)
Other Syndromes and Defects Associated with Short Stature	102	(1)
Adults with GH Deficiency and the Elderly	102	(1)
Catabolic States	103	(1)
Adverse Effects of GH Treatment	103	(2)
Ethical Issues in GH Treatment	105	(8)
References	106	(7)
Skeletal Dysplasias	113	(20)
Mordechai Shohat
David L. Rimoin
Introduction	113	(1)
Differentiation	113	(1)
International Classification and Nomenclature	114	(1)
Diagnosis and Assessment	114	(15)
Prenatal Diagnosis	129	(1)
Management	129	(1)
Extended Limb Lengthening	129	(1)
Growth Hormone Therapy in Achondroplasia	130	(1)
Collection of Skeletal Tissues	130	(3)
References	131	(2)
Tall Stature and Excessive Growth Syndromes	133	(14)
S. Douglas Frasier
Definition and Classification of Overgrowth Syndromes	133	(1)
Growth Hormone Excess	133	(2)
Cerebral Gigantism (Sotos Syndrome)	135	(2)
Klinefelter Syndrome	137	(1)
XYY Syndrome	138	(1)
Marfan Syndrome	138	(1)
Homocystinuria	139	(1)
Beckwith-Wiedemann Syndrome	140	(1)
Hemihypertrophy	141	(1)
Constitutional Tall Stature	141	(6)
References	143	(4)
II. ADRENAL DISORDERS AND SEXUAL DEVELOPMENT ABNORMALITIES
Adrenal Cortex: Hypo- and Hyperfunction	147	(28)
Claude J. Migeon
Roberto L. Lanes
Introduction	147	(1)
Physiology	147	(7)
Hypoadrenocorticism	154	(1)
Hypoadrenocorticism: Primary Adrenocortical Insufficiency	154	(5)
Addison's Disease (Chronic Hypoadrenocorticism)	159	(1)
Hypoadrenocorticism Secondary to Deficient CRH and/or ACTH Secretion	160	(2)
Hypoadrenocorticism Secondary to End-Organ Unresponsiveness	162	(1)
Treatment of Hypoadrenocorticism	163	(1)
Hyperadrenocorticism	163	(1)
Hypercortisolism	164	(2)
Adrenogenital Syndrome	166	(1)
Feminizing Adrenal Tumors	167	(1)
Hyperaldosteronism	168	(7)
References	170	(5)
Congenital Adrenal Hyperplasia	175	(18)
Maria I. New
Lucia Ghizzoni
Introduction	175	(1)
Pathophysiology	175	(3)
Clinical Features	178	(1)
Clinical Forms of Adrenal Hyperplasia Caused by 21-Hydroxylase Deficiency	178	(3)
Pubertal Maturation in Classical Congenital Adrenal Hyperplasia	181	(2)
Genetics	183	(1)
Epidemiology	183	(1)
Diagnosis	183	(4)
Treatment	187	(1)
Conclusion	187	(6)
References	187	(6)
Disorders of the Adrenal Medulla: Catecholamine-Producing Tumors in Childhood	193	(18)
Karel Pacak
Martina Weise
Graeme Eisenhofer
Frederieke M. Brouwers
Christian A. Koch
The Catecholamines	193	(1)
Pheochromocytoma	194	(3)
Multiple Endocrine Neoplasia Syndromes	197	(2)
Neuroblastoma	199	(4)
Ganglioneuroma	203	(1)
Neural Tumors and Chronic Diarrhea	203	(8)
References	203	(8)
Puberty and Its Disorders	211	(28)
Peter A. Lee
Normal Puberty	211	(3)
Precocious Puberty	214	(9)
Therapy	223	(2)
Partial Pubertal Development: Variants of Normal	225	(1)
Inappropriate Sex-Steroid-Stimulated Changes for Sex	226	(1)
Delayed Puberty and Hypogonadism Presenting During Adolescence	227	(12)
References	235	(4)
Turner Syndrome	239	(18)
E. Kirk Neely
Ron G. Rosenfeld
Introduction	239	(1)
Features of Turner Syndrome	239	(8)
The Genetic Basis of TS	247	(2)
Medical Therapies	249	(8)
References	252	(5)
Nonendocrine Vaginal Bleeding	257	(20)
Albert Altchek
Introduction	257	(1)
Causes of Local Nonendocrine Bleeding	258	(1)
Severe Vaginal Infections as a Cause of Local Nonendocrine Bleeding	259	(1)
Trauma as a Cause of Local Nonendocrine Bleeding	260	(1)
Foreign Bodies in the Vagina as a Cause of Local Nonendocrine Bleeding	261	(1)
Vulvar Lesions as a Cause of Local Nonendocrine Bleeding	261	(4)
Prolapse of the Urethra as a Cause of Local Nonendocrine Bleeding	265	(1)
Anal Lesions as a Cause of Local Nonendocrine Bleeding	265	(1)
Polyps of the Hymen as a Cause of Local Nonendocrine Bleeding	266	(1)
Malignant and Benign Tumors of the Vagina, Uterus, and Ovaries	266	(2)
Coagulation Defects as a Cause of Local Nonhormonal Bleeding	268	(2)
Evaluation	270	(2)
Conclusion	272	(5)
References	273	(4)
Hirsutism, Polycystic Ovary Syndrome, and Menstrual Disorders	277	(42)
Songya Pang
Introduction	277	(1)
Physiology of Androgen Metabolism	277	(5)
Physiology of Hair Growth, Proposed Intradermal Immunoregulation, and Skin Androgen Metabolism	282	(2)
Pathophysiology and Causes of Hirsutism and Polycystic Ovary Syndrome	284	(10)
Diagnostic Approach and Differential Diagnosis	294	(4)
Treatment of Hirsutism and Polycystic Ovary Syndrome	298	(3)
Menstrual Disorders in Adolescents	301	(18)
References	309	(10)
Disorders of Sexual Differentiation	319	(28)
Adriana A. Carrillo
Marco Danon
Gary D. Berkovitz
Gonadal Differentiation	319	(1)
Anatomical Sex Differentiation of the Reproductive Tract	320	(3)
Hormonal Control of Sex Differentiation	323	(2)
Ambiguous Genitalia	325	(9)
Diagnostic Evaluation for Ambiguous Genitalia	334	(2)
Management of Intersex	336	(3)
Micropenis	339	(1)
Hypospadias	339	(1)
Cryptorchidism	340	(7)
References	342	(5)
III. THYROID DISORDERS
Thyroid Disorders in Infancy	347	(12)
Guy Van Vliet
Introduction	347	(1)
Changes in Thyroid Hormone Economy from Conception to 3 Years of Age	347	(1)
Congenital Hypothyroidism	348	(5)
Hypothyroxinemia of the Newborn	353	(1)
Congenital Hyperthyroidism	354	(1)
Acquired Hypo- and Hyperthyroidism in Infancy	355	(1)
Structural Thyroid Problems	355	(1)
Conclusion	356	(3)
References	356	(3)
Hypothyroidism	359	(12)
John S. Dallas
Thomas P. Foley, Jr.
Historical Background	359	(1)
Classification and Causes	360	(2)
Pathophysiology	362	(1)
Clinical Presentation	362	(2)
Diagnostic Evaluation	364	(2)
Clinical Course and Management	366	(5)
References	368	(3)
Hyperthyroidism	371	(22)
John S. Dallas
Thomas P. Foley, Jr.
Pathogenesis and Etiology	371	(1)
Graves' Disease	371	(4)
Autonomous Thyroid Nodule	375	(1)
Familial Nonautoimmune Hyperthyroidism	376	(1)
TSH-Induced Hyperthyroidism	377	(1)
Subacute and Hashimoto's Thyroiditis	378	(1)
Exogenous Thyroid Hormone	378	(1)
Euthyroid Hyperthyroxinemia	379	(2)
T3 and T4 Toxicosis	381	(1)
Graves' Ophthalmopathy	382	(1)
Laboratory Evaluation	383	(1)
Prognosis and Treatment	384	(9)
References	388	(5)
Thyromegaly	393	(14)
John S. Dallas
Thomas P. Foley, Jr.
Introduction	393	(1)
Pathogenesis	393	(1)
Autoimmune Thyroid Disease: Thyroiditis	394	(5)
Acute and Subacute Thyroiditis	399	(1)
Iodine Deficiency	400	(1)
Goitrogens	400	(1)
Familial Thyroid Dyshormonogenesis	400	(1)
Idiopathic Goiter	401	(1)
Nodular Thyromegaly	402	(1)
Evaluation of Patients with Thyromegaly	403	(4)
References	404	(3)
Thyroid Tumors in Children	407	(14)
Donald Zimmerman
Epidemiology	407	(1)
Pathology	408	(3)
Pathogenesis	411	(3)
Diagnosis	414	(1)
Treatment	414	(7)
References	417	(4)
IV. DISORDERS OF CALCIUM AND PHOSPHORUS METABOLISM
Hypoparathyroidism and Mineral Homeostasis	421	(60)
Jaakko Perheentupa
Introduction	421	(1)
Physiological Background: The Parathyroid Glands and Hormones	421	(2)
Calcitriol (1,25-Dihydroxycalciferol)	423	(2)
The Kidneys	425	(3)
The Skeleton	428	(1)
The Intestine	429	(1)
Calcium, Phosphate, and Magnesium in Plasma	429	(1)
Manifestations of Deficient Parathyroid Hormone Action	430	(2)
Causes of Hypoparathyroidism	432	(1)
Familial Isolated Hypoparathyroidism	432	(1)
Autoimmune Polyendocrinopathy-Candidiasis--Ectodermal Dystrophy (APECED) (MIM 240300)	433	(4)
Hypoparathyroidism of Dysmorphic Syndromes	437	(5)
Transient Hyperparathyroidism	442	(2)
Other Acquired Hypoparathyroidism	444	(1)
Pseudohypoparathyroidism	444	(5)
Diagnosis	449	(4)
Therapy	453	(16)
References	457	(12)
Hyperparathyroidism in Children
Scott A. Rivkees
Thomas O. Carpenter
Introduction	469	(1)
The Parathyroid Glands	469	(1)
Parathyroid Hormone and Regulation of Its Secretion	470	(1)
Assays for Parathyroid Hormone	470	(1)
PTH/PtHrP Receptors	470	(1)
Mechanism of Parathyroid Hormone Action	471	(1)
Pathogenesis of Hyperparathyroidism	471	(1)
Differential Diagnosis	472	(1)
Recognition and Diagnosis	472	(1)
Primary Hyperparathyroidism	473	(1)
Secondary and Tertiary Hyperparathyroidism	473	(1)
Complications of Hyperparathyroidism and Hypercalcemia	474	(1)
Treatment of Hyperparathyroidism and Hypercalcemia	474	(1)
Management After Parathyroidectomy	475	(1)
Summary	475	(6)
References	476	(5)
Neonatal Calcium and Phosphorus Disorders	481	(36)
Winston W. K. Koo
Introduction	481	(1)
Maintenance of Calcium and Phosphorus Homeostasis	481	(2)
Hormonal Control of Calcium and P Homeostasis via PTH, CT, and 1,25(OH)2D	483	(7)
Nonclassic Control of Calcium and P Homeostasis	490	(1)
Hypocalcemia	491	(6)
Hypercalcemia	497	(3)
Hypophosphatemia	500	(2)
Hyperphosphatemia	502	(1)
Skeletal Manifestations of Disturbed Mineral Homeostasis	503	(14)
References	505	(12)
Metabolic Bone Disease	517	(24)
Joseph M. Gertner
Introduction	517	(1)
Rickets	517	(3)
Disorders of Vitamin D Metabolism	520	(1)
Disorders of Phosphate Homeostasis	521	(4)
Ricketslike Conditions	525	(1)
Metabolic and Genetic Disorders Intrinsic to the Skeleton	526	(5)
Skeletal Dysplasia	531	(3)
Treatment of Skeletal Disorders	534	(7)
References	536	(5)
V. HYPOGLYCEMIA AND DIABETES MELLITUS
Hypoglycemia in the Newborn, Including the Infant of a Diabetic Mother	541	(34)
Hussien M. Farrag
Richard M. Cowett
Introduction	541	(1)
Neonatal Euglycemia and Hypoglycemia	541	(6)
Glucose Metabolism	547	(6)
Clinical Assessment	553	(2)
Preterm Appropriate for Gestational Age Neonates	555	(1)
Small for Gestational Age Infants	555	(2)
Congenital Heart Disease/Congestive Heart Failure	557	(1)
Perinatal Stress/Hypoxia	557	(1)
Cold Injury and Sepsis	557	(1)
Hyperinsulinism: The Infant of the Diabetic Mother	558	(2)
Rh Incompatability and Hypoglycemia	560	(1)
Exchange Transfusion and Umbilical Catheter	560	(1)
Persistent Hyperinsulinemic Hypoglycemia	561	(1)
Hypoglycemia Following Maternal Ethanol Consumption and Miscellaneous Causes	562	(1)
Beckwith-Wiedemann Syndrome	563	(1)
Defective Gluconeogenesis/Glycogenolysis	563	(1)
Evaluation	563	(1)
Treatment	564	(11)
References	568	(7)
Hypoglycemia in Children	575	(36)
Joseph I. Wolfsdorf
David A. Weinstein
Introduction	575	(1)
Definition of Hypoglycemia	575	(1)
Overview of Fuel Metabolism	576	(3)
Regulation of Insulin Secretion	579	(1)
Clinical Manifestations of Hypoglycemia	580	(1)
Causes of Hypoglycemia in Infants and Children	581	(2)
Hyperinsulinism	583	(2)
Hormone Deficiency	585	(1)
Disorders of Glycogen Synthesis and Glycogen Degradation	586	(3)
Disorders of Gluconeogenesis	589	(1)
Disorders of Amino Acid Metabolism	590	(1)
Miscellaneous Causes of Hypoglycemia	591	(1)
Disorders of Carnitine Metabolism, Fatty Acid β-Oxidation, and Ketone Synthesis	592	(4)
Determining the Cause of Hypoglycemia	596	(2)
Treatment	598	(1)
Hypoglycemia and Diabetes Mellitus	598	(13)
References	603	(8)
Diabetes in the Child and Adolescent	611	(42)
Arlan L. Rosenbloom
Janet H. Silverstein
Introduction	611	(1)
Diagnosis and Classification	611	(3)
Type 1 Diabetes	614	(13)
Type 2 Diabetes	627	(12)
Other Types of Diabetes	639	(14)
References	641	(12)
Management of the Child with Diabetes	653	(16)
Oscar Escobar
Dorothy J. Becker
Allan L. Drash
Introduction	653	(1)
Metabolic Disturbances as a Consequence of Insulin Deficiency	653	(1)
Management	654	(1)
Insulin Therapy	654	(2)
Intensive Diabetes Therapy	656	(1)
Somogyi Effect and Dawn Phenomenon	657	(1)
Dietary Management	658	(1)
Exercise as a Therapeutic Modality	659	(1)
Education and Emotional Support	659	(1)
The Therapeutic Team	660	(1)
Therapeutic Objectives and Monitoring Requirements	661	(3)
Consultations and Referrals	664	(1)
Clinical Assessment and Therapeutic Decision-Making	665	(4)
References	666	(3)
Diabetic Ketoacidosis	669	(14)
Dorothy J. Becker
Allan L. Drash
Oscar Escobar
Introduction	669	(1)
Presentation and Clinical Features	669	(1)
Pathogenesis	670	(3)
Causes of Diabetic Ketoacidosis	673	(1)
Differential Diagnosis	674	(1)
Clinical Assessment	674	(1)
Therapy	675	(4)
Complications of DKA	679	(1)
Preventive Therapy	680	(3)
References	680	(3)
VI. MISCELLANEOUS DISORDERS
Autoimmune Endocrinopathies	683	(38)
William E. Winter
Autoimmunity and Autoimmune Diseases	683	(6)
Classification and Recognition of Autoimmune Diseases	689	(2)
Autoimmunity to the Pancreatic Islets, Insulin Receptors, and Insulin	691	(6)
Autoimmune Thyroid Disease	697	(5)
Autoimmune Addison's Disease	702	(1)
Acquired Primary Gonadal Failure	703	(1)
Idiopathic Hypoparathyroidism	703	(1)
Hypophysitis and Autoimmune Disease of the Pituitary	704	(1)
Autoimmune Diabetes Insipidus	704	(1)
Associated Nonendocrine Autoimmune Diseases	704	(1)
Autoimmune Disease Associations	705	(2)
Clinical Approach to the Autoimmune Endocrinopathies and Related Diseases	707	(1)
Summary	708	(13)
References	708	(13)
Multiple Endocrine Neoplasia Syndromes	721	(14)
Giulia Costi
Noel K. Maclaren
Introduction	721	(1)
MEN-1	721	(2)
MEN-2	723	(1)
Adrenal Adenoma	724	(2)
Thyroid Adenomas	726	(1)
Pituitary Adenomas	727	(3)
Pancreatic Adenomas	730	(5)
References	730	(5)
Endocrine Tumors in Children	735	(14)
Muhammad A. Jabbar
Introduction	735	(1)
Adrenal Tumors	735	(2)
Gonadal Tumors	737	(3)
Tumors of Endocrine Pancreas	740	(9)
References	745	(4)
Nontraditional Inheritance of Endocrine Disorders	749	(6)
Judith G. Hall
Introduction	749	(1)
Uniparental Disomy	749	(1)
Mosaicism	750	(1)
Germline Mosaicism	751	(1)
Genomic Imprinting	751	(1)
Cytoplasmic Inheritance	752	(1)
Summary	752	(3)
References	752	(3)
Disorders of Water Homeostasis	755	(32)
Joseph A. Majzoub
Louis J. Muglia
Introduction	755	(1)
Regulation of Thirst and Fluid Balance	755	(6)
Central Diabetes Insipidus	761	(6)
Nephrogenic Diabetes Insipidus	767	(2)
Hyponatremia and the Syndrome of Inappropriate Secretion of Vasopressin	769	(6)
Concluding Remarks	775	(12)
References	776	(11)
Emergencies of Inborn Metabolic Diseases	787	(36)
Jose E. Abdenur
Introduction	787	(1)
Urea Cycle Defects	787	(5)
Organic Acidemias	792	(6)
Fatty Acid Oxidation Defects	798	(7)
Primary Lactic Acidemias	805	(6)
Maple Syrup Urine Disease	811	(12)
References	812	(11)
Obesity in Children	823	(36)
Ramin Alemzadeh
Russell Rising
Maribel Cedillo
Fima Lifshitz
Prevalence	823	(1)
Morbidity	824	(2)
Social Obesity	826	(1)
Growth Assessment	827	(4)
Who Is at Risk?	831	(1)
Genetics	832	(4)
Energy Balance	836	(1)
Physical Activity	836	(1)
Hyperinsulinism	837	(1)
Hormonal Alterations	838	(2)
Hypothalamus	840	(1)
Treatment Modalities	840	(1)
Diets	841	(3)
Exercise	844	(1)
Family Involvement	844	(1)
Other Therapies	845	(2)
Yo-Yo Weight Cycling	847	(1)
Prevention	847	(1)
Final Considerations	848	(11)
References	848	(11)
Hyperlipoproteinemias in Children and Adolescents	859	(6)
Kurt Widhalm
Introduction	859	(1)
Lipoprotein Background and Basics	859	(1)
Definition of Hyperlipoproteinemia/Dyslipoproteinemia	860	(1)
Familial Hypercholesterolemia	861	(1)
Treatment	861	(2)
Familial Combined Hyperlipidemia	863	(1)
Hypertriglyceridemia/Chylomicronemia Syndrome	863	(2)
References	863	(2)
Endocrine Disorders After Cancer Therapy	865	(10)
Raphael Rappaport
Elisabeth Thibaud
Introduction	865	(1)
Growth	865	(2)
Puberty	867	(1)
Growth Hormone Secretion	867	(1)
Thyroid	868	(1)
Gonadal and Reproductive Function	868	(2)
Other Endocrine Complications	870	(1)
Follow-Up and Management	870	(5)
References	871	(4)
Endocrine Alterations in Human Immunodeficiency Virus Infections	875	(20)
Robert Rapaport
Daphne Sack-Rivers
Introduction	875	(1)
Growth	876	(4)
Adrenal Function	880	(2)
Thyroid	882	(1)
Gonads	883	(1)
Pancreas	884	(1)
Parathyroid	885	(1)
Prolactin	885	(1)
Hypothalamus and Pituitary	885	(1)
Endocrine Alterations Secondary to Treatment	886	(1)
Future Hormonal Therapy in HIV Infections	886	(1)
Conclusion	887	(8)
References	887	(8)
Hypertension in Children: Endocrine Considerations	895	(22)
Julie R. Ingelfinger
Introduction	895	(1)
Normal Blood Pressure and Its Definition	895	(1)
Causes of Hypertension	895	(1)
Complications of Hypertension: Patterns and Diagnosis	895	(7)
Steroidogenic Enzyme Defects	902	(1)
Primary Aldosteronism: Aldosterone-Producing Adenoma and Bilateral Adrenal Hyperplasia	903	(2)
Glucocorticoid-Responsive Aldosteronism: Dexamethasone-Suppressible Hyperaldosteronism (OMIM 103900)	905	(1)
Apparent Mineralocorticoid Excess (OMIM 218030)	906	(1)
Mutations in Renal Transporters Causing Low-Renin Hypertension	906	(1)
Cushing Syndrome and Hypertension	907	(1)
Hypertension in Pheochromocytoma and Neural Crest Tumors	907	(1)
Hypertension in Thyroid Disease	908	(1)
Hyperparathyroidism and Hypertension	909	(1)
Prevention of Hypertension and Endocrine Systems	909	(1)
Primary Hypertension: How Often Endocrine?	909	(1)
Treatment	909	(8)
References	912	(5)
VII. ADDITIONAL INFORMATION AND RESOURCES
Dietary Supplements to Enhance Athletic Performance	917	(6)
Alan D. Rogol
Introduction	917	(1)
Dietary Supplements: Herbal Products	917	(1)
Ephedra	918	(1)
Ginseng	918	(1)
Creatine	918	(1)
Anabolic Steroids	919	(1)
Dehydroepiandrosterone	920	(1)
Androstenedione	920	(1)
Growth Hormone and Insulin-Like Growth Factor 1	921	(1)
Conclusions	921	(2)
References	921	(2)
Using the Web to Obtain Information on Genetic and Hormone Disorders	923	(12)
John A. Phillips III
Introduction	923	(1)
Using the Web to Obtain Information for Dysmorphic Patients	924	(1)
How to Generate a Differential Diagnosis for a Family Having Unusual Endocrine Problems	925	(4)
How to Obtain Information on a Case of Endocrine Neoplasia	929	(2)
Selected Web Sites on Growth and Hormone Disorders	931	(2)
Conclusions	933	(2)
References	933	(2)
Hormone Measurements and Dynamic Tests in Pediatric Endocrinology	935	(24)
Adriana A. Carrillo
Fred Chasalow
Introduction	935	(1)
Role of the Laboratory	935	(2)
Practical Considerations	937	(1)
Practical Protocols for Dynamic Testing in Children	938	(21)
References	955	(4)
Reimbursement Issues in Endocrinology: A Coding Supplement	959	(10)
Bridget F. Recker
Reimbursement	959	(1)
CPT Coding	959	(1)
ICD-9 (ICD-10 Coming)	960	(1)
Linking CPT and ICD Coding	960	(1)
Collections	961	(1)
Denial and Appeal	961	(1)
Contracting	962	(1)
Chart Reviews	962	(1)
Stimulation Testing	962	(1)
Diabetic Education	963	(1)
Clinical Trials	963	(3)
What Is Needed?	966	(1)
Frequently Used Diagnosed Codes for the Pediatric Endocrine Practice	967	(2)
References	967	(2)
Reference Charts Used Frequently by Endocrinologists in Assessing the Growth and Development of Youth	969	(72)
Adriana A. Carillo
Bridget F. Recker
Standards of Growth and Development	971	(27)
Miscellaneous Standards	998	(13)
Standard Growth Charts for Children with Genetic or Pathological Conditions	1011	(30)
Index	1041