The endocrine system is a group of glands which release and produce hormones and help to control many important body functions and allow body's ability to change calories into energy that powers cells and organs. The endocrine system influences heart to beats and bones and tissues to grow and even enable ability to make a baby. Endocrine system plays a very important role in whether or not to develop diabetes, growth disorders, thyroid disease, sexual dysfunction, and a host of other hormone-related disorders.

Causes of Endocrine Disorders

Endocrine disorders are typically grouped into two categories:

• Endocrine disease which results when a gland produces excess or too little of an endocrine hormone is known as a hormone imbalance.
• Endocrine disease due to the development of nodules or tumors in the endocrine system can affect hormone levels.

The endocrine's system helps to control the balance of hormones in the bloodstream. If the patient has too much or too little of a various hormone by which the endocrine feedback system signals the glands to correct the problem. A hormone imbalance can occur if the feedback system has any problem/trouble keeping the right level of hormones in the bloodstream, or if the body doesn't clear them out of the bloodstream properly.

Increased or low levels of endocrine hormone may cause due to:

• A problem with the endocrine feedback system
• Disease
• Failure of a gland to stimulate the gland to release hormone
• A genetic disorder like multiple endocrine neoplasia or congenital hypothyroidism
• Infection
• Injury to an endocrine gland
• Tumor of an endocrine gland

Most endocrine tumors and nodules (lumps) are noncancerous. These tumors or nodules usually do not spread to any other parts of the body. However, the tumor/nodule on the gland may or may not interfere with the production of the gland's hormone.

Types of Endocrine Disorders

There are many different types of endocrine disorders.

Other endocrine disorders include:

• Adrenal insufficiency. The adrenal gland releases little amount of the hormone like cortisol and aldosterone. There symptoms include stomach upset, fatigue, dehydration, and skin changes. Addison's disease is a type of adrenal insufficiency.
• Cushing's disease. Overproduction of a pituitary gland hormone can result in overactive adrenal gland. A similar condition of pituitary gland is known as Cushing's syndrome and may occur in people, basically in the children and the person who take high doses of corticosteroid medications.
• Gigantism (acromegaly) and other growth hormone problems. If the pituitary gland produces large amount of growth hormone, then it results into abnormal bone growth in children and body parts may grow abnormally fast. If the level of growth hormone is too low, then the child even can stop growing in height.
• Hyperthyroidism. The thyroid gland releases large amount of the thyroid hormone which can lead to weight loss, sweating, fast heart rate, and nervousness. The most common causes of overactive thyroid is an autoimmune disorder which is also called Grave's disease.
• Hypothyroidism. In this pituitary gland does not produce enough thyroid hormone and lead to fatigue, dry skin, constipation, and depression. The underactive gland can also lead to slowed development in children and some types of hypothyroidism are present at birth of the child.
• Hypopituitarism. The pituitary gland releases very less hormones. This may be caused due to a number of different diseases. In women with this type of the conditions may stop getting their periods.
• Multiple endocrine neoplasia I and II. These are the rare genetic conditions which passed through families. And they can cause tumors of the parathyroid, thyroid glands, adrenal, and leading to overproduction of hormones.
• Polycystic ovary syndrome (PCOS). In this there is an Overproduction of androgens which interfere with the eggs development and release from the female ovaries. PCOS is a leading cause of infertility.
• Precocious puberty. In this there is Abnormal and early puberty which occurs when glands tell the body to release sex hormones too soon in life.

Common Endocrine Disorders

• Type 1 Diabetes.
• Type 2 Diabetes.
• Osteoporosis.
• Thyroid Cancer.
• Addison's Disease.
• Cushing's Syndrome.
• Graves' Disease.
• Hashimoto's Thyroiditis.

Testing for Endocrine Disorders

• The symptoms of an endocrine disorder may vary widely on the specific gland.
• Blood and urine tests for checking the hormone levels.
• Imaging tests to locate or pinpoint a nodule or tumor..

Congenital heart defects:

• Aortic Stenosis
• Atrial Septal Defect
• Atrioventricular Canal Defect
• Coarctation of the Aorta
• Ebstein’s Anomaly
• Hypoplastic Left Heart Syndrome
• Interrupted Aortic Arch
• Patent Ductus Arteriosus
• Pulmonary Stenosis
• Pulmonary Atresia
• Single Ventricle (Functionally Univentricular Heart)
• Tetralogy of Fallot
• Transposition of the Great Arteries
• Truncus Arteriosus
• Ventricular Septal Defects

Procedures and interventions includes

• Electrocardiogram (ECG)
• Advanced imaging – CT/MRI
• Diagnostic and therapeutic catheterisation
• Exercise testing
• Cardiac event recording
• Chest x-ray
• Balloon atrial septostomy – In this there is a small hole is created in the upper two chambers of the heart to increase oxygen saturation
• Paediatric cardiac transplantation
• Ultrasound scans of the heart

Associated sub-specialties

• Adult congenital heart disease
• Fetal cardiology
• Advanced imaging (CT/MRI)
• Diagnostic and therapeutic catheterization
• Invasive electrophysiology and pacing in children and adults with congenial heart disease
• Pulmonary hypotension
• Heart failure and cardiac transplantation
• Advanced echocardiography

PEDIATRIC SURGERY

Pediatric surgery is a subspecialty of surgery involving the surgery of fetuses, infants, children, adolescents, and young adults. Pediatric surgery includes: Neonatal surgery and Fetal surgery. Other area of pediatric specialties:

• Pediatric cardiothoracic (surgery on the child's heart and/or lungs, heart and lung transplantation)
• Pediatric nephrological surgery (surgery of kidneys and ureters, and also include renal, or kidney, transplantation)
• Pediatric neurosurgery (surgery on the child's brain, central nervous system, medulla spinalis, and peripheral nerves)
• Pediatric urological surgery (surgery on the child's bladder and other structures below the kidney necessary for ejaculation)
• Pediatric emergency surgery, surgery involving fetuses or embryos (overlapping with obstetrical surgery, maternal-fetal medicine and neonatology), surgery involving adolescents or young adults
• Pediatric hepatological which involve liver and gastrointestinal which involve stomach and intestines surgery (and also includes liver and intestinal transplantation in children)
• Pediatric orthopedic surgery (this involve both muscle and bone surgery in children)
• Pediatric plastic and plastic surgery (such as for burns, or for congenital defects like birth defect not involving the major organs)
• Pediatric oncological (childhood cancer) surgery

Common pediatric diseases which will require pediatric surgery include

• Congenital malformations: harelip and palate, NEC, lymphangioma, meconium plugs, esophageal atresia and tracheoesophageal fistula, hypertrophic stenosis, intestinal atresia, Hirschsprung's disease, anus, undescended testes, intestinal malrotation
• Abdominal wall defects: omphalocele, gastroschisis, hernias
• Chest wall deformities: pectus excavatumn
• Childhood tumors: like neuroblastoma, Wilms' tumor, rhabdomyosarcoma, ATRT, liver tumors, teratomas, kidney tumors
• Separation of conjoined twins

Pediatric Nephrology

Pediatric nephrology is the branch of medicine which deals with the physiology and diseases/disorders of the kidneys.

Pediatric nephrological disorders:

• Acute kidney failure – the sudden loss of the kidney’s ability to remove waste from the body
• Acute nephritic syndrome – this is group of kidney disorders that can lead to inflammation and swelling of internal parts of the kidney
• Analgesic nephropathy – In this damage can cause in one or both kidneys due to mixture of medications which is commonly seen when there is an overexposure to over-the-counter pain medications
• Congenital nephrotic syndrome – This is a genetically inherited disorder in which a baby develops protein in the urine that causes swelling in the body
• Chronic renal failure – In this there is gradual loss of the kidney's ability to remove body waste
• Goodpasture syndrome – This is a very rare disease which causes kidney failure and lung disease
• Hypertension - high blood pressure
• Interstitial nephritis – a disorder in which the areas between the kidney tubes become inflamed, which can affect the kidney’s ability to manage the body’s waste
• Kidney removal – surgery performed to remove all or part of a person’s kidney
• Kidney stone – This is a group of tiny crystals that are very difficult to come out through the body
• Kidney transplant – the placement of a healthy kidney in a patient with kidney failure
• Lithotripsy – the use of shock waves to break up stones that have formed in the kidney, bladder or the tubes that drain urine from the kidneys to the bladder
• Lupus nephritis – a kidney disorder, caused by the autoimmune disease, systemic lupus erythematosus
• Membranoproliferative glomerulonephritis – a kidney disorder that leads to inflammation of the kidney, as well as tiny changes to the kidney’s cells that lead to disruption of the kidney’s normal processes
• Membranous nephropathy – a kidney disorder that causes inflammation and structural changes inside the kidney, leading to problems with the kidney’s normal processes
• Nephrocalcinosis – This is a kidney disorder in which there is an excess/incresed amount of calcium is left in the kidneys
• Polycystic kidney disease – a genetically-passed kidney disorder in which multiple cysts form on the kidneys, causing them to enlarge
• Post-streptococcal GN – a kidney disorder caused by infection with particular strains of the Streptococcus (strep) bacteria
• Posterior urethral valve - the presence of valves within the urethra that block the urine flowing out of the bladder
• Vesicoureteral reflux - The back-up of urine toward the kidney
• Reflux nephropathy – Kidney damage due to vesicoureteral reflux
• Renal papillary necrosis – a condition in which all or part of the openings of the kidney’s collecting ducts die
• Renal artery or vein thrombosis – a blood clot in the artery or vein in which blood passes from the kidney
• Renal tubular acidosis – in this body acid build up and cause kidneys fail to excrete body acids
• Fanconi syndrome (when certain substances normally absorbed into the bloodstream by the kidneys are released into the urine instead)
• Glomerulonephritis (inflammation of the glomeruli, the structures inside the kidney that help to filter the blood)
• Hematuria (blood in the urine)
• High blood pressure (hypertension)
• Hydronephrosis (swollen kidney)
• Kidney stones (small, solid masses that can form in the urinary tract)
• Multicystic kidney disease (In this when a baby doesn’t develop appropriately in the womb during pregnancy and multiple cysts and follicles form where a kidney should be)
• Nephrotic syndrome (This a group of symptoms which happens together and results into swelling, protein in the urine, low blood protein levels and high blood cholesterol)
• Obstructive uropathy (when urine can’t drain through a ureter — the tube that carries urine from the kidneys to the bladder — backing urine up into the kidney and causing it to become swollen)
• Polycystic kidney disease (a hereditary disorder when cysts form over time in both kidneys)
• Proteinuria (protein in the urine)
• Renal agenesis
• Renal tubular acidosis (when acid builds up in the body because the kidneys don’t filter urine properly)
• Systemic lupus erythematosus (This is an autoimmune disease — this happen when the body’s immune system reacts against itself — that can cause kidney and other problems)
• Urinary tract infections
• Vesicoureteral reflux (when urine flows backward from the bladder into the kidneys and ureters — the thin tubes that carry the urine from the kidneys to the bladder)
• Voiding dysfunction (when the bladder doesn’t empty normally, causing kids to urinate too often, daytime accidents and/or nighttime bedwetting)