Home Ten year analysis of the clinic profile of the tertiary paediatric endocrine service in Western Australia
Article
Licensed
Unlicensed Requires Authentication

Ten year analysis of the clinic profile of the tertiary paediatric endocrine service in Western Australia

  • Nadya Birdus , Maree Grant , Paul G. Stevenson , Catherine S. Y. Choong and Aris Siafarikas EMAIL logo
Published/Copyright: May 5, 2022
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 35 Issue 6

Abstract

Objectives

There is a paucity of information regarding the profile of entire paediatric endocrine clinics and how they are changing. This study aimed to analyse the clinic profile of the Western Australian tertiary paediatric endocrine outpatient service over 10 years and compare to national and international data.

Methods

Retrospective analysis of the Western Australian Paediatric Endocrine Database (WAPED) between 2007 and 2017 looking at the frequency, proportion and longitudinal change of diagnosis categories, specific diagnoses, and gender breakdown.

Results

In total, 2,791 endocrine diagnoses were recorded for 2,312 patients. The most frequent reason for referral (22.1% of patients), was for evaluation of abnormalities in thyroid function. The most common diagnosis being hypothyroidism (76.7%). Evaluation of short stature was the reason for referral in 19.2% of patients, 14.6% of whom were diagnosed with growth hormone deficiency. Evaluation of puberty disorders, syndromes with endocrine features and disorders of calcium and phosphate metabolism were other common reasons for clinic referral, seen in 11.3, 9.8 and 8.2% of patients respectively. Between 2007 and 2017, the odds ratio of a thyroid diagnosis increased by 1.07 per year (95% CI: 1.02–1.12), whilst the odds ratio of a short stature diagnosis decreased by 0.91 per year (95% CI: 0.87–0.95).

Conclusions

The profile of the WAPED is similar to previously published national and international data. The analysis of the profile of diagnoses and its longitudinal change over a ten-year period offer a unique opportunity to guide clinic planning, resource allocation and future research.

Keywords: clinic; paediatric endocrinology; profile
Corresponding author: Aris Siafarikas, A/Professor, Department of Endocrinology and Diabetes, Perth Children’s Hospital, 15 Hospital Avenue, Nedlands, WA, 6009, Australia, Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia, Medical School, The University of Western Australia, Nedlands, WA, Australia; and Institute for Health Research, The University of Notre Dame, Fremantle, WA, Australia, Phone: +61 08 6456 5035, E-mail:

Acknowledgments

Department of Endocrinology and Diabetes, Perth Children’s Hospital and Dr Aveni Haynes, PhD, Telethon Kids Institute, for her advice on epidemiological analyses.

  1. Research funding: None declared.

  2. Author contributions: CSYC, AS and MG created the database. MG was responsible for the entering and maintaining of data in the database. AS conceived this study and AS and NB were involved in planning of this study. NB cleaned the database, classified entries using the ICPED system, completed the descriptive statistics and drafted the manuscript. PGS completed the statistical analysis. All authors critically discussed and reviewed the manuscript.

  3. Competing interests: The authors have no conflict of interest to declare.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: Ethics approval was granted from the Perth Child and Adolescent Health Service Human Research Ethics Committee, Approval # RGS 2356. Signed informed consent was obtained from parents/legal guardians of children whose data was entered into the data base.

  6. Data availability statement: All data generated or analysed during this study are included in this article [and/or] its supplementary material files. Further enquiries can be directed to the corresponding author.

References

1. Fisher, DA. A short history of pediatric endocrinology in North America. Pediatr Res 2004;55:716–26.10.1203/01.PDR.0000113824.18487.9BSearch in Google Scholar PubMed

2. Grimberg, A, Kutikov, JK, Cucchiara, AJ. Sex differences in patients referred for evaluation of poor growth. J Pediatr 2005;146:212–6.10.1016/j.jpeds.2004.09.009Search in Google Scholar PubMed PubMed Central

3. Stalman, S, Pons, A, Wit, J, Kamp, G, Plötz, F. Diagnostic work-up and follow-up in children with tall stature: a simplified algorithm for clinical practice. J Clin Res Pediatr Endocrinol 2015;7:260–7.10.4274/jcrpe.2220Search in Google Scholar PubMed PubMed Central

4. Ganie, Y, Aldous, C, Balakrishna, Y, Wiersma, R. Disorders of sex development in children in KwaZulu-Natal Durban South Africa: 20-year experience in a tertiary centre. J Pediatr Endocrinol Metab 2017;30:11–8.10.1515/jpem-2016-0152Search in Google Scholar PubMed

5. Sedlmeyer, IL, Palmert, MR. Delayed puberty: analysis of a large case series from an academic center. J Pediatr Endocrinol Metab 2002;87:1613–20.10.1210/jcem.87.4.8395Search in Google Scholar PubMed

6. New, MI, Obeid, J, Wilson, RC, Cabrera, MS, Goseco, A, Macapagal, MC, et al.. Profile of the pediatric endocrine clinic at New York–Presbyterian Hospital, New York Weill Cornell Center. J Clin Endocrinol Metab 1999;84:4444–9.10.1210/jc.84.12.4444Search in Google Scholar

7. Thomsett, MJ. The spectrum of clinical paediatric endocrinology: 28 years of referrals to an individual consultant. J Paediatr Child Health 2010;46:304–9.10.1111/j.1440-1754.2010.01713.xSearch in Google Scholar PubMed

8. Al jurayyan, N. Spectrum of endocrine disorders at the paediatric endocrine clinic, King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia. J Taibah Univ Med Sci 2012;7:99–103.10.1016/j.jtumed.2012.10.002Search in Google Scholar

9. Witt, JM. International classification of pediatric endocrine diagnoses. Horm Res Paediatr 2016;86:212–4.10.1159/000448893Search in Google Scholar PubMed PubMed Central

10. R Core Team. R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2018. Available from: https://www.R-project.org/.Search in Google Scholar

11. Harris, KB, Pass, KA. Increase in congenital hypothyroidism in New York State and in the United States. Mol Genet Metabol 2007;91:268–7.10.1016/j.ymgme.2007.03.012Search in Google Scholar PubMed

12. McGrath, N, Hawkes, CP, McDonnell, CM, Cody, D, O’Connell, SM, Mayne, PD, et al.. Incidence of congenital hypothyroidism over 37 years in Ireland. Pediatr 2018;142:e20181199.10.1542/peds.2018-1199Search in Google Scholar

13. Lazar, L, Frumkin, RB-D, Battat, E, Lebenthal, Y, Phillip, M, Meyerovitch, J. Natural history of thyroid function tests over 5 years in a large pediatric cohort. J Clin Endocrinol Metab 2009;94:1678–82.10.1210/jc.2008-2615Search in Google Scholar

14. Hunter, IG, Stephen, A, MacDonald, TM, Morris, AD. Prevalence and aetiology of hypothyroidism in the young. Arch Dis Child 2000;83:207.10.1136/adc.83.3.207Search in Google Scholar

15. Medda, E, Olivieri, A, Stazi, MA, Grandolfo, ME, Fazzini, C, Baserga, M, et al.. Risk factors for congenital hypothyroidism: results of a population case-control study (1997–2003). Eur J Endocrinol 2005;153:765–73.10.1530/eje.1.02048Search in Google Scholar

16. Lorey, FW, Cunningham, GC. Birth prevalence of primary congenital hypothyroidism by sex and ethnicity. Hum Biol 1992;64:531–8.Search in Google Scholar

17. Lerner, A, Jeremias, P, Matthias, T. The world incidence and prevalence of autoimmune diseases is increasing. Int J Celiac Dis 2015;3:151–5.10.12691/ijcd-3-4-8Search in Google Scholar

18. Cooper, GS, Stroehla, BC. The epidemiology of autoimmune diseases. Autoimmun Rev 2003;2:119–25.10.1016/S1568-9972(03)00006-5Search in Google Scholar

19. McLeod, D, Cooper, DS. The incidence and prevalence of thyroid autoimmunity. Endocrine 2012;42:252–65.10.1007/s12020-012-9703-2Search in Google Scholar PubMed

20. Rodanaki, M, Lodefalk, M, Forssell, K, Arvidsson, C-G, Forssberg, M, Åman, J. The incidence of childhood thyrotoxicosis is increasing in both girls and boys in Sweden. Horm Res Paediatr 2019;91:195–202.10.1159/000500265Search in Google Scholar PubMed PubMed Central

21. Ranke, MB, Lindberg, A, Tanaka, T, Camacho-Hübner, C, Dunger, DB, Geffner, ME. Baseline characteristics and gender differences in prepubertal children treated with growth hormone in Europe, USA, and Japan: 25 years’ KIGS® experience (1987-2012) and review. Horm Res Paediatr 2017;87:30–41.10.1159/000452887Search in Google Scholar PubMed

22. Yardeni, D, Loewenthal, N, Limony, Y, Hershkovitz, E. Ethnic and gender inequities in the evaluation of referred short children. Horm Res Paediatr 2011;76:50–5.10.1159/000325705Search in Google Scholar PubMed

23. Grimberg, A, Feemster, KA, Pati, S, Ramos, M, Grundmeier, R, Cucchiara, AJ, et al.. Medically underserved girls receive less evaluation for short stature. Pediatrics 2011;127:696–702.10.1542/peds.2010-1563Search in Google Scholar

24. Hughes, IP, Choong, CS, Cotterill, A, Harris, M, Davies, PSW. Gender bias in children receiving growth hormone treatment. J Clin Endocrinol Metab 2010;95:1191–8.10.1210/jc.2009-1563Search in Google Scholar

25. Papadimitriou, A, Douros, K, Papadimitriou, DT, Kleanthous, K, Karapanou, O, Fretzayas, A. Characteristics of the short children referred to an academic paediatric endocrine clinic in Greece. J Pediatr Child Health 2012;48:236–67.10.1111/j.1440-1754.2011.02256.xSearch in Google Scholar

26. Hussein, A, Farghaly, H, Askar, E, Metwalley, K, Saad, K, Zahran, A, et al.. Etiological factors of short stature in children and adolescents: experience at a tertiary care hospital in Egypt. Ther Adv Endocrinol Metab 2018;8:75–80.10.1177/2042018817707464Search in Google Scholar

27. Loesch, DZ, Stokes, K, Huggins, RM. Secular trend in body height and weight of Australian children and adolescents. Am J Phys Anthropol 2000;111:545–56.10.1002/(SICI)1096-8644(200004)111:4<545::AID-AJPA9>3.0.CO;2-XSearch in Google Scholar

28. Hughes, IP, Choong, CS, Cotterill, A, Harris, M, Davies, PS. The influence of secular trend for height on ascertainment and eligibility for growth hormone treatment. Clin Endocrinol 2010;73:760–8.10.1111/j.1365-2265.2010.03874.xSearch in Google Scholar

29. Hughes, I, Harris, M, Cotterill, A, Garnett, S, Bannink, E, Pennell, C, et al.. Comparison of centers for disease control and prevention and World Health Organization references/standards for height in contemporary Australian children: analyses of the raine study and Australian National Children’s Nutrition and Physical Activity cohorts. J Paediatr Child Health 2014;50:895–901.10.1111/jpc.12672Search in Google Scholar

30. Kaplowitz, P. Clinical characteristics of 104 children referred for evaluation of precocious puberty. J Clin Endocrinol Metab 2004;89:3644–50.10.1210/jc.2003-031532Search in Google Scholar

31. Sedlmeyer, IL, Palmert, MR. Delayed puberty: analysis of a large case series from an academic center. J Clin Endocrinol Metab 2002;87:1613–20.10.1210/jcem.87.4.8395Search in Google Scholar

32. Prentice, A. Nutritional rickets around the world. J Steroid Biochem Mol Biol 2013;136:201–6.10.1016/j.jsbmb.2012.11.018Search in Google Scholar

33. El-Mouzan, M, Al-Salloum, A, Al-Herbish, A, Qurachi, M, Al-Omar, A. Regional variations in the prevalence of consanguinity in Saudi Arabia. Saudi Med J 2007;28:1881–4.10.4103/0256-4947.51726Search in Google Scholar

34. Thygesen, LC, Ersboll, AK. When the entire population is the sample, strengths and limitations in register-based epidemiology. Eur J Epidemiol 2014;29:551–8.10.1007/s10654-013-9873-0Search in Google Scholar PubMed

Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/jpem-2022-0055).

Received: 2022-01-30
Accepted: 2022-04-05
Published Online: 2022-05-05
Published in Print: 2022-06-27

© 2022 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Review Articles
  3. The genetic elucidation of monogenic obesity in the Arab world: a systematic review
  4. Global perspective on pediatric growth hormone registries: a systematic review
  5. Mini Review
  6. Considering metformin as a second-line treatment for children and adolescents with prediabetes
  7. Original Articles
  8. Central adrenal insufficiency screening with morning plasma cortisol and ACTH levels in Prader–Willi syndrome
  9. Clinical characteristics and genetics analysis for the ITD of congenital hypothyroidism
  10. Genomic landscape of sporadic pediatric differentiated thyroid cancers: a systematic review and meta-analysis
  11. The role of circulating miRNAs in leptin resistance in obese children
  12. Relationship between height age, bone age and chronological age in normal children in the context of nutritional and pubertal status
  13. Clinical, biochemical, and biomolecular aspects of congenital adrenal hyperplasia in a group of Cameroonian children and adolescents
  14. Ten year analysis of the clinic profile of the tertiary paediatric endocrine service in Western Australia
  15. Postoperative intensive care management and residual endocrinopathy of pediatric supratentorial brain tumors: a retrospective cohort study
  16. Successful telehealth transformation of a pediatric outpatient obesity teaching program due to the COVID-19 pandemic – the “Video KiCK” program
  17. Glycemic control among children with type 1 diabetes mellitus and its determinants in a resource-limited setting
  18. Letter to the Editor
  19. Anxiety, pediatric type 1 diabetes and COVID-19 lockdown
  20. Short Communication
  21. Ethnic diversity and burden of polycystic ovary syndrome among US adolescent females
  22. Case Reports
  23. Feminizing adrenocortical oncocytoma presenting as precocious puberty: a case report and literature review
  24. Novel OTX2 loss of function variant associated with congenital hypopituitarism without eye abnormalities
  25. Bilateral Wilms’ tumor in a child with Denys-Drash syndrome: novel frameshift variant disrupts the WT1 nuclear location signaling region
  26. A very rare cause of arthrogryposis multiplex congenita: a novel mutation in TOR1A
https://doi.org/10.1515/jpem-2022-0055
Keywords for this article
clinic; paediatric endocrinology; profile

Articles in the same Issue

  1. Frontmatter
  2. Review Articles
  3. The genetic elucidation of monogenic obesity in the Arab world: a systematic review
  4. Global perspective on pediatric growth hormone registries: a systematic review
  5. Mini Review
  6. Considering metformin as a second-line treatment for children and adolescents with prediabetes
  7. Original Articles
  8. Central adrenal insufficiency screening with morning plasma cortisol and ACTH levels in Prader–Willi syndrome
  9. Clinical characteristics and genetics analysis for the ITD of congenital hypothyroidism
  10. Genomic landscape of sporadic pediatric differentiated thyroid cancers: a systematic review and meta-analysis
  11. The role of circulating miRNAs in leptin resistance in obese children
  12. Relationship between height age, bone age and chronological age in normal children in the context of nutritional and pubertal status
  13. Clinical, biochemical, and biomolecular aspects of congenital adrenal hyperplasia in a group of Cameroonian children and adolescents
  14. Ten year analysis of the clinic profile of the tertiary paediatric endocrine service in Western Australia
  15. Postoperative intensive care management and residual endocrinopathy of pediatric supratentorial brain tumors: a retrospective cohort study
  16. Successful telehealth transformation of a pediatric outpatient obesity teaching program due to the COVID-19 pandemic – the “Video KiCK” program
  17. Glycemic control among children with type 1 diabetes mellitus and its determinants in a resource-limited setting
  18. Letter to the Editor
  19. Anxiety, pediatric type 1 diabetes and COVID-19 lockdown
  20. Short Communication
  21. Ethnic diversity and burden of polycystic ovary syndrome among US adolescent females
  22. Case Reports
  23. Feminizing adrenocortical oncocytoma presenting as precocious puberty: a case report and literature review
  24. Novel OTX2 loss of function variant associated with congenital hypopituitarism without eye abnormalities
  25. Bilateral Wilms’ tumor in a child with Denys-Drash syndrome: novel frameshift variant disrupts the WT1 nuclear location signaling region
  26. A very rare cause of arthrogryposis multiplex congenita: a novel mutation in TOR1A
Sign up now to receive a 20% welcome discount
Institutional Access
How does access work?
Have an idea on how to improve our website?
Please write us.
© 2025 De Gruyter Brill
Downloaded on 11.9.2025 from https://www.degruyterbrill.com/document/doi/10.1515/jpem-2022-0055/html
Scroll to top button