Endocrinology. Pediatric endocrinology Prices for the services of a pediatric endocrinologist

Hormones regulate metabolism, respiration, growth, and other essential processes in the organs of the human body. Hormonal imbalance is the main cause of a wide range of diseases.

What an endocrinologist does is closely related to the study of the action of hormones and the work of the glands and tissues that produce these hormones. The human body produces more than 50 different hormones. They can exist in very small amounts, yet have a significant impact on bodily functions and development.

Main functions

If the general practitioner suspects that the underlying cause of the disease is related to the production of hormones, he may refer the patient to an endocrinologist, a doctor who specializes in the endocrine glands.

Unlike a general practitioner, an endocrinologist examines only hormones and hormonal diseases. Most general practitioners have the skills needed to diagnose and treat underlying hormonal conditions, but sometimes specialist help is needed.

However, endocrinologists also have their own specializations.. For example, a doctor who specializes in diseases of the thyroid gland is called a thyroidologist. And there are endocrinologists-gynecologists, genetic endocrinologists, pediatric and adolescent endocrinologists and other branches of endocrinology.

The question of what an endocrinologist does is often heard by doctors. The endocrinologist helps to choose a treatment aimed at restoring the hormonal balance in the body systems (Tyrogen is often prescribed). This doctor also considers physiological disorders such as poor metabolism, digestion, or circulation, as hormonal imbalances can result from organs outside the endocrine system (such as the brain, heart, and kidneys). He will also suggest the best ways to prevent endocrine diseases.

Endocrinologists usually treat the following conditions:

menopausal disorders;
premenstrual syndrome;
cancer of the endocrine glands;
male menopause (andropause);
metabolic disorders;
thyroid disease;
adrenal disorders such as Cushing's disease or Addison's disease;
pituitary disorders such as growth hormone deficiency;
infertility.

Most endocrine diseases are chronic and require lifelong treatment.

What organs are treated

Here is what an endocrinologist does when it comes to diagnosing and treating specific organs of the human body:

adrenal glands, which are found on top of the kidneys and help control things like blood pressure, metabolism, stress, and sex hormones.
Hypothalamus The part of the brain that controls body temperature, hunger and thirst.
Pancreas, which produces insulin and other substances for digestion.
parathyroid glands are small glands in the neck that control the amount of calcium in the blood.
Pituitary The gland is about the size of a pea and is located at the base of the brain and controls the balance of hormones.
sex glands (gonads) are the ovaries in women and the testicles in men.
Thyroid a butterfly-shaped gland in the neck that controls energy metabolism and growth and brain development.

What symptoms lead to the endocrinologist's office

Typically, people who see an endocrinologist are suffering from: unreasonable irritability, excessive sweating, menstrual irregularities, unexplained weight fluctuations, rapid heartbeat, chronic fatigue, infertility, and problems concentrating.

Symptoms of Diabetes

Diabetes is often called the silent killer because of its symptoms, which are easy to attribute to many other diseases and often go unnoticed. Diabetes is what an endocrinologist deals with in most cases of patient visits, since the prevalence of this disease in different countries of the world is very high.

The best way to know if you have diabetes or not is to measure your blood sugar levels.

But if you have these symptoms, make an appointment with an endocrinologist:

Frequent urination, excessive thirst.
Weight loss.
Constant feeling of hunger.
Skin itching.
Slow wound healing.
Yeast infections. Diabetes leads to increased susceptibility to various infections, although yeast (Candida) and other fungal infections are the most common. Fungi and bacteria thrive in a sugar-rich environment. Vaginal candida infections are very common in diabetic women.
Chronic fatigue and irritability.
Blurred vision. Distorted vision or random flashes of light are a direct result of high blood sugar levels. The good news is that this symptom is reversible once blood sugar levels return to normal.
Tingling or numbness in the arms and legs, as well as burning pain or swelling. These are signs that the nerves have been damaged due to diabetes.

What can be seen in the endocrinologist's office

Almost every endocrinologist's office, both in the clinic and in the paid medical center, has a set of medical devices necessary for physical diagnosis.

These devices include:

scales;
a device for measuring pressure;
glucometer;
neurological hammer;
tape measure;
stadiometer;
monofilament to determine violations of tactile sensitivity;
medical tuning fork according to Rüdel-Seiffer for the detection of diabetic neuropathy.

Appointment with an endocrinologist: what symptoms to treat adults and children

Children are less likely than adults to be in the office of an endocrinologist. This is partly due to the fact that parents do not pay attention to the child's health problems in a timely manner, believing that hormonal changes during puberty are to blame for everything and "this will soon pass." Also, children do not always tell their parents about their poor health.

However, attentive parents can notice signs in time that an endocrinologist is needed. These include: impaired growth and physical and emotional development, rapid weight gain or loss, persistent infectious diseases, which is a signal of a decrease in the protective functions of the body, delayed or accelerated puberty, impaired mental development.

What kind of problems do people go to the endocrinologist's office?

If a person under 45 does not have disturbing symptoms, then there is no need to visit an endocrinologist. However, couples planning to conceive a child, women with complaints of insomnia, irritability and other problems due to menopause, as well as people over 45 years of age, need to see an endocrinologist at least once a year.

How is a scheduled inspection

During the first appointment, the endocrinologist will ask the patient a series of questions to clarify the diagnosis. These questions help the doctor gather information about the patient's current medications, vitamins, and supplements; family medical history and other medical conditions, including allergies to food habits.

The endocrinologist may ask about symptoms that do not seem to be related to the underlying disease and that may seem minor to the patient. However, such information is also important because hormone levels affect many different systems in the body. Therefore, small changes in one gland can affect a part of the body that is far from the diseased gland.

The doctor will also check the patient's blood pressure and heart rate, look at the condition of the patient's skin, hair, teeth, and oral cavity, and feel the thyroid gland to see if it is enlarged.

After visual diagnostics, the specialist will refer the patient for additional tests, and, taking them into account, will draw up a treatment plan.

What examinations and tests can be ordered

An endocrinologist uses diagnostic tests for several reasons, including:

To measure the level of various hormones in the patient's body.
In order to find out if the endocrine glands are working properly.
In order to determine the cause of the endocrinological problem.
In order to confirm the diagnosis made earlier.

Most likely, after the first appointment, the endocrinologist will refer the patient to the analysis of blood glucose, urine and cholesterol.

In the case of infertility treatment, an endocrinologist may order a semen analysis for a male patient. This is a test that checks semen for sperm count, sperm motility, and white blood cell count, which may indicate an infection.

For the diagnosis of hyperthyroidism, and the study of nodules in the thyroid gland, a thyroid scan is prescribed. It is an image of the thyroid gland after the patient swallowed a pill (or was given an injection) with a small amount of radioactive iodine.

Because the thyroid gland uses iodine to produce some of its hormones, it will absorb the radioactive material. This substance radiates energy and allows you to get an image of the gland. The entire scan is painless and takes about half an hour.

A faster, albeit less informative, procedure is an ultrasound of the thyroid gland.

Doctor endocrinologist, Ph.D. Toshchevikova Alina Konstantinovna

What does a pediatric endocrinologist do?

A pediatric endocrinologist is a doctor who deals with the pathology of the endocrine glands. The organs of the endocrine system are the thyroid, parathyroid, pancreas, testicles and ovaries, hypothalamus and pituitary gland, as well as the adrenal glands.

Most often, endocrine diseases are manifested by a violation of the physical and sexual development of children. Therefore, the pediatric endocrinologist will first of all assess whether the child has an acceleration or retardation of growth, whether he is gaining weight correctly. He will ask you about the child's appetite, drinking regimen. Also, the doctor will look at whether the formation of the skeleton is proportional. Secondly, the doctor will examine the genitals of the child, assess the harmony of sexual development.

This will allow early detection of diseases such as diabetes mellitus, thyroid diseases, hypo- and hyperthyroidism, thyroid nodules, hypertrophy of the thyroid gland, obesity, dysplasia (both delayed and accelerated growth), impaired sexual development in boys and girls (both delayed puberty and premature puberty), adrenal disease, osteoporosis.

When should you contact a pediatric endocrinologist?

If the next of kin have endocrine diseases.
If the child began to drink more, urinate more often, especially if he gets up at night to drink water.
If your baby was born with a weight of more than 4 kg, or is rapidly gaining weight, fuller than his peers;
If you have a child with low body weight (hypotrophy). If the child loses weight for unknown reasons.
If your child is significantly taller or shorter than their peers, if in a year the increase in height was less than 4 cm.
If a child has a fracture with a slight traumatic effect, or repeated fractures occur.
In violation of sexual development: premature sexual development is characterized by the early appearance (up to 8 years in girls and up to 9 years in boys) of secondary sexual characteristics (hair growth of intimate areas, armpits; in girls - breast enlargement, menstruation, in boys - penis enlargement, testicles, the appearance of hair on the chin, above the upper lip).
With a delay in sexual development, when at 13 years old in girls and at 14 years old in boys there are no secondary sexual characteristics.
If you suspect a thyroid disease. The main signs of which are: an increase in the thyroid gland, weakness, fatigue, or vice versa, increased nervous excitability, palpitations and sweating, dry skin, constipation, hair loss, brittle nails, in girls, menstrual irregularities.
Also, together with a urologist and a neurologist, an endocrinologist can participate in the treatment of urinary incontinence.

If you notice one of the above symptoms, then you should not delay a visit to a pediatric endocrinologist!

Scheduled examinations of the child by a pediatric endocrinologist

There are some situations in medical practice when it is recommended to regularly bring a child for examination to a pediatric endocrinologist.

A visit to such a doctor is necessary if:

The weight of the child at birth was less than 2.8 kilograms, or more than 4.
The baby has congenital or acquired diseases of the thyroid gland.
Diseases of the adrenal glands were found.
A diagnosis was made of a violation of sexual development (gynecomastia, delayed sexual development, accelerated sexual development, impaired sexual differentiation).
The child is diagnosed with obesity.
Children with diabetes and diabetes insipidus.
Children with an already established diagnosis, requiring regular monitoring by an endocrinologist and laboratory control.

In these cases, a timely visit to a pediatric endocrinologist will help your child lead a normal life. Moreover, constant consultation with a specialist will help prevent serious complications.

Mandatory is a preventive examination by an endocrinologist at the age of 7, 10, 14.15 and 17 years.

What additional examinations can a pediatric endocrinologist prescribe?

If necessary, ultrasound of the thyroid gland, kidneys and adrenal glands, as well as abdominal organs, is performed, if necessary, consultations of other specialists. In addition, the doctor may prescribe hormonal tests and tests to clarify the diagnosis. With pathology of growth, bone age is necessarily determined by radiographs of the hands.

According to the results of the examination, treatment is prescribed.

Our task is to raise a child without excess weight.

In today's world, more and more people are overweight and obese. The task of children's doctors and in particular endocrinologists is to make sure that as many children as possible have a normal weight by adulthood.
The increase in the number of overweight children these days is mainly due to malnutrition and a sedentary lifestyle. However, obesity can be the result of diseases of the endocrine system, brain tumors and other serious diseases. In this regard, it is important for parents to pay attention to the state of health of the child in time, find out the cause of obesity and start treatment on time.

In childhood, obesity can lead to the development of serious complications. In particular, overweight children have an increased risk of developing diabetes mellitus, arterial hypertension, liver diseases, gallbladder ... As adults, people who have been obese since childhood are prone to the early development of coronary heart disease, myocardial infarction, infertility, joint diseases and veins. Moreover, all these diseases, characteristic of old age, occur early, at the very peak of a person's creative and personal activity.

It is necessary to visit an endocrinologist regularly, at least 2 times a year, to monitor the disease and to detect its complications in a timely manner.

increase the percentage of fruits and vegetables in the diet, as well as legumes, whole grains - instead of easily digestible carbohydrates.
it is important to eat regularly, 4-5 times a day, but in the intervals between these meals it is also important NOT to eat;
reduce total caloric intake.
limit energy intake from all types of fats and switch from saturated fats to unsaturated fats;
limit your intake of free sugars;
spend at least a day 60 minutes moderate to vigorous intensity physical activity that is developmentally appropriate and encompasses a variety of activities. More intense physical activity may be required to control weight.

Treatment of an obese and overweight child requires concerted and systematic efforts of all family members.

The doctor will help to more specifically plan the nutrition and physical activity of the child, if necessary, prescribe medication.

What determines the growth of a child?

In fact, a person's height is registered in his genome and determined at the stage of intrauterine development. It depends on gender, heredity received from parents, race - the totality of those signs that cannot be changed. But in the course of life, the final height may change. Ecology, nutrition, past illnesses, hormonal disorders, physical exercises, mental state, functioning of the pituitary gland affect the growth mechanism.

If your child is lower or taller than other children in the age group, it is necessary to visit an endocrinologist. It is also necessary to pay attention to the annual increase in growth in children. After 3 years, it should be at least 4 cm per year. Measure your kids! A decrease in growth rates may be the first sign of an endocrine or somatic disease. Growth processes are significantly influenced by adrenal and thyroid hormones. With a disease of these organs of the endocrine system, growth can slow down or accelerate.
Basically, human growth is provided by somatotropic hormone. The maximum amount of this hormone is produced during adolescence, so it is considered one of the most important in the formation of the human body. If at this stage the body lacks any substances, or the lifestyle disrupts the production of the hormone, then growth may slow down.

Smoking and insufficient consumption of protein foods (meat, fish, dairy products) are especially bad for growth.

Girls grow most intensively from 10 to 14 years old, boys - from 13 to 18. It is very important during this period to prevent adverse factors from affecting growth.

No wonder preventive examinations by an endocrinologist are mandatory at this age.

The state of health of the child is determined by the correct development and harmonious functioning of all organism generally.

The endocrine system is considered the most important system of the child's body, since it is she who coordinates most of the processes.

To see if it's working properly endocrine system child, parents should know what are the symptoms of diseases associated with this system, and in which cases it is necessary to consult a doctor.

What does an endocrinologist treat?

Endocrinologist - doctor, which carries out diagnostics, and also prescribes effective treatment in case of violations in the endocrine system.

The endocrine system is endocrine glands, which produce and release into the blood hormones that coordinate the main processes of the body. These include the pituitary gland, pancreas, hypothalamus, thyroid gland, testicles and ovaries, and so on.

The endocrine system is a rather sensitive mechanism that is able to respond to the negative effects of various factors. This system of the child's body is more susceptible to such factors than the same system of the adult body.

Many diseases This system begins its development in childhood, for this reason it is important to periodically visit the endocrinologist, especially if you notice that the child has signs of diseases of this system. Timely diagnosis and treatment will avoid serious complications.

Symptoms that indicate the presence of an endocrine disease in a child.

1. Stopping sexual development or early development.

If girls who have reached the age of fifteen do not menstruate and do not develop mammary glands, and boys at this age do not have pubic and armpit hair, and testicles are not enlarged, this indicates a delay development of the reproductive system.

It happens that this delay is not due to a malfunction of the endocrine system, but is genetic. Despite this, it is still necessary to visit endocrinologist which will confirm or refute the presence of diseases of this system.

Premature development The reproductive system implies the presence of menstruation and enlarged mammary glands in girls under the age of nine, and in boys under ten years of age - the presence of armpit and pubic hair, as well as large testicles.

Almost all cases of early sexual development are explained by disorders in the endocrine system.

2. Signs of diabetes.

In case of malfunctions in the functioning of the endocrine system, the baby may experience signs diabetes: the child drinks a lot of liquids, runs to the toilet very often, consumes sweets in large quantities, there is a decrease in body weight for no particular reason, he complains of weakness, does not want to play, jump or run.

In this case, you should immediately seek help from a doctor.

3. Too low or too high.

Pay attention to your baby's peers and compare them growth with your child's growth. If your baby is too small compared to others, he may be experiencing growth retardation. If he is much taller than other children of the same age, this indicates excessive growth.

Such violations can be caused not only by diseases associated with the endocrine system, but also by hereditary disorders of the osteoarticular system. In this case, visit a doctor who will prescribe an examination of the hands and joints of the child using x-rays.

4. Small and overweight.

Be sure to check the rules weight a child at a particular age at the doctor. If the weight of your baby does not correspond to them, it is necessary to be examined by an endocrinologist.

5. Enlargement of the thyroid gland.

It is quite difficult to notice an increase in this gland. However, the child may complain of feeling discomfort when swallowing, feeling a coma in the larynx, there may also be minor pain.

In this case, it is necessary to pass tests in order to doctor was able to diagnose the disease, identify the cause of its occurrence and prescribe the correct treatment.

It is also necessary to consult a specialist if your child's birth weight was more than 4 kg, and there are also relatives relatives who had endocrine diseases.

Hormonal disorders are quite common in both adults and children. The pediatric endocrinologist is engaged in the diagnosis and treatment of these pathologies in young patients. Many parents are frightened when a pediatrician writes out a referral for a consultation with this specialist. However, in most cases, such fears are unfounded. Consider what pediatric endocrinology is and when a pediatric endocrinologist is needed.

What is Pediatric Endocrinology?

Endocrinology is a medical science that studies the structure and function of the endocrine glands, as well as diseases that are caused by a violation of their functioning. Pediatric endocrinology, as a separate specialty, has appeared quite recently. Its occurrence is associated with some features of the development of endocrine diseases in children and adolescents. Experts note that, for example, diabetes mellitus in children often resembles influenza, childhood infections and acute abdomen syndrome with symptoms.

The human endocrine system is represented by endocrine glands responsible for the production and release of hormones into the blood. With the help of hormones, the work of the body is regulated, they directly affect the growth and development of the child. The organs of the endocrine system include: the hypothalamic-pituitary system, the thyroid gland, pancreas, adrenal glands and sex glands (gonads).

Separately, it is worth mentioning the pediatric gynecologist-endocrinologist. A doctor of this specialty is engaged in the treatment and prevention of diseases of the genital organs in girls that are associated with endocrine disorders.

What does an endocrinologist treat?

According to reviews, a pediatrician usually sends a child to a pediatric endocrinologist. The specialist determines the disease and, if present, selects the most appropriate treatment regimen and ways to prevent complications.

What diseases are diagnosed and treated by a pediatric endocrinologist? These pathologies include:

Thyroid diseases: hypo- and hyperthyroidism, nodular goiter, diffuse toxic goiter, thyroiditis, iodine deficiency pathologies;
Diabetes;
Dysfunctions of the hypothalamic-pituitary system: diencephalic syndrome, acromegaly, Itsenko-Cushing's disease;
Adrenal dysfunction;
Puberty disorders.

The specialization of a pediatric gynecologist-endocrinologist includes the diagnosis and treatment of the following diseases in girls:

Congenital malformations of the organs of the reproductive system;
Violations of sexual development.

At the appointment, the doctor collects a medical history (anamnesis), examines the child, gets acquainted with complaints, if any. A good pediatric endocrinologist will prescribe additional examinations for a small patient. Most often these are: ultrasound, CT or MRI, a biochemical blood test, a blood test for sugar and hormones.

If the child does not have any pathology, but there are prerequisites for its development, the doctor may prescribe preventive therapy for him.

Usually, parents take the child for a consultation with a doctor in the direction of a pediatrician. However, there are some symptoms that may indicate the development of endocrine diseases. Having noticed the following manifestations in a child, it is necessary to show it to a good pediatric endocrinologist:

Drowsiness, lethargy, fatigue, irritability, mild excitability;
Heart palpitations;
Overweight, stretch marks on the skin;
Sudden weight loss;
Constant thirst and frequent urination;
Increased blood pressure for a long time;
Lagging behind peers or a sharp advance in their growth;
Sleepiness during the day and insomnia at night;
Swelling and dry skin;
Discomfort or pain in the front of the neck;
If symptoms of puberty (breast enlargement, growth of pubic and underarm hair) appear before age 8 or are absent after age 13.

Parents should know that the earlier a child is diagnosed with an endocrine disease, the more effective treatment will be. Therefore, if suspicious symptoms appear, the baby should be shown to a pediatric endocrinologist. To do this, you must contact the children's clinic at the place of residence or a private medical center.

All processes in the body occur under the close control of two regulatory systems: nervous and endocrine. The latter consists of glands that produce special bioactive substances - hormones that can have a very pronounced effect in extremely low concentrations. The prefix "endo-" means that these substances are produced exclusively in the internal environment of the body (blood). They easily penetrate into other fluids (cerebrospinal, intercellular), which determines another name for this regulatory system - humoral.

Endocrine organs have their own hierarchy. The whole process is controlled by a special structure of the brain - the hypothalamic-epiphyseal-pituitary complex, in which the main role belongs to the adenohypophysis. It releases, in addition to its own active substances, also tropic hormones, the concentration of which depends on other endocrine glands. In turn, the "subordinate" endocrine organs, releasing a large amount of hormones, lower the tropic activity of the pituitary gland. Those glands that are not subordinate to it are controlled by the pineal gland and hypothalamus.

The laying of the endocrine system occurs already at the 4th week of intrauterine development. Its formation proceeds throughout pregnancy, during which, the activity of different glands, periodically, increases and decreases. The final development of the internal secretion system ends with puberty.

Indications for consultation

Preventive endocrinological examinations of infants and young children are not provided. In the maternity hospital (on the 3-5th day of a newborn's life), mandatory screening is carried out for 5 hereditary diseases, 2 of which are related to internal secretion: adrenogenital syndrome and hypothyroidism. Identified violations prescribe the observation of infants by a specialist at the place of residence or hospitalization in a specialized hospital.

Pre-teenage children (at 10 years old) and during puberty (from 14 years old - annually) are subject to obligatory medical examination. Additionally, an examination by a pediatric endocrinologist can be recommended by doctors of any specialty. But more often, a referral for a consultation is issued by a pediatrician, pediatric gastroenterologist, surgeon and gynecologist.

Particular attention is paid to young patients whose parents (close relatives) have identified endocrine diseases.

Self-referral of parents to a specialist in endocrine glands can cause various changes in the status of the child. This can be expressed in:

Morbidity structure by age

Endocrine disruption can occur at any age. Even in the process of intrauterine development, the fetus may experience disturbances in the laying and formation of the organs of internal secretion and, in the future, their function. The cause may be external factors, hereditary diseases, congenital pathologies. Endocrine disease can develop in early childhood, during school years, and in adolescents. The most significant in this regard are the periods of active growth of the child: infancy and infancy (1.), the first (2.) and second (3.) traction.

Newborns and children up to 3 years. During this period, dysfunctions of the thyroid gland (congenital hypothyroidism), adrenal cortex (adrenogenital syndrome), insulin-producing cells of the pancreas (congenital type I diabetes mellitus - insulin dependent) can be detected. Changes in anthropometric indicators (disharmonious physical development, its acceleration or deceleration).
In preschoolers and primary school students, the possibility of a failure in insulin production remains relevant. A change (more often, an increase) in body weight and height (more often, a slowdown) is also typical for this age.
Adolescents are prone, first of all, to violations in puberty. Early development or its slowdown, as well as type changes in the manifestation of secondary sexual characteristics, require immediate consultation with a pediatric endocrinologist.

In addition to the main age-related problems in the system of internal secretion, there is the possibility of the appearance of any diseases of a different morphological and functional nature, but affecting the hormonal functions of the affected organ. Among them, for example, the absence of a testicle (one or both), hormone-producing tumors and a number of others.

General and special examination methods

A consultation with a pediatric endocrinologist begins with identifying the problems that brought you to the doctor's office. Close attention is paid to heredity, in particular, the presence of endocrine pathology in the family. The specialist will be interested in the course of pregnancy and childbirth, the development of the child, the diseases he has suffered.

Conducting a physical examination, a pediatric endocrinologist will assess the condition of the skin and its appendages (hair, nails). By palpation (palpation), the doctor will determine the structure and approximate linear values of the thyroid gland, examine the organs. An important diagnostic value is data on the height and weight of the child and their ratio, head circumference and limb length. Absolutely in all children (even babies) sexual development is assessed according to a special system of determination.

The laboratory can carry out a blood test for the content of all known hormones, hormone-like substrates, enzymes and other biologically active substances. Since most of them have daily fluctuations or other physiological changes, blood sampling for the test is carried out taking into account these conditions. Serological studies are used (the state of the immune system), for example, for antibodies to the tissues of one's own glands.

The analysis of peripheral blood is of interest to the endocrinologist from the standpoint of determining the level of sugar, its daily fluctuations and the glucose tolerance test. During the diagnosis (treatment) of diabetes, a study of the sugar content in the urine may be prescribed.

Ultrasound scanning of the endocrine glands has been widely used. It is also used to assess the structure of "target organs" that respond to changes in the content of the studied hormones. Due to its safety, relative ease of implementation and low cost, ultrasound can be performed repeatedly. Including, to assess the dynamic responses to the therapy being taken.

MRI and CT are performed as needed, taking into account all the indications and contraindications of these studies. Relatively, the state of the pituitary gland can be judged by radiography of the anatomical bone formation, called the Turkish saddle. A specialized radioisotope study (scintigraphy) is rarely used in pediatric practice.

The endocrine system of a child is a complex, mutually regulated combination of endocrine glands, hormone-producing cell clusters in other organs (insulinocytes of the islets of Langerhans of the pancreas) and individual elements with the function of producing bioactive substances. Independent intervention in these processes (be it the use of 0.5% hydrocortisone ointment or oral contraception), as well as untimely correction of violations, can lead to very serious consequences.