2020
DOI: 10.3389/fped.2020.580588
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Pattern and Features of Pediatric Endocrinology Referrals: A Retrospective Study in a Single Tertiary Center in Italy

Abstract: Introduction: The knowledge of the pattern and the features of pediatric endocrinology referrals is crucial to optimize resources and guide public health interventions. We explored the numbers and the reasons for referral to a pediatric endocrinology outpatient clinic and investigated their features in terms of assignment of priority ranks, sex, age differences, the prevalence of pathological findings among referred cases, and the agreement among referrals, final diagnosis, treatment, and follow-up.… Show more

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Cited by 17 publications
(17 citation statements)
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“…Regarding the tests investigating GH secretion, we detected a striking reduction (− 35%) in tests performed in 2020, compared to 2019. This was sharply in contrast with a steady increase in referrals for growth issues that we reported from 2014 to 2018 in a previous study [ 1 ], even though the criteria – according to the Italian Medicines Agency (AIFA) – to perform stimulation tests were the same (i.e., height ≤ − 3 SD; or height ≤ − 2 SD + growth velocity per year ≤ − 1 DS for age and sex evaluated for at least 6 months or a reduction of height of 0.5 SD per year in children > 2 years of age; or height ≤ − 1.5 SD compared to target height and growth velocity per year ≤ − 2 SD or ≤ − 1.5 SD for two consecutive years; or growth velocity per year ≤ − 2 SD or ≤ − 1.5 SD after two consecutive years, even without short stature and after exclusion of other causes of failure to thrive; or malformations/lesions of hypothalamus/pituitary demonstrated at brain MRI) [ 13 ]. Although this is the first study reporting a decrease of referrals for suspected GHD during 2020 lockdowns, our results align with previous reports addressing a delay of hospital care admissions and a reduction of 30–40% in visits during the COVID-19 pandemic [ 9 , 10 ].…”
Section: Discussioncontrasting
confidence: 84%
See 1 more Smart Citation
“…Regarding the tests investigating GH secretion, we detected a striking reduction (− 35%) in tests performed in 2020, compared to 2019. This was sharply in contrast with a steady increase in referrals for growth issues that we reported from 2014 to 2018 in a previous study [ 1 ], even though the criteria – according to the Italian Medicines Agency (AIFA) – to perform stimulation tests were the same (i.e., height ≤ − 3 SD; or height ≤ − 2 SD + growth velocity per year ≤ − 1 DS for age and sex evaluated for at least 6 months or a reduction of height of 0.5 SD per year in children > 2 years of age; or height ≤ − 1.5 SD compared to target height and growth velocity per year ≤ − 2 SD or ≤ − 1.5 SD for two consecutive years; or growth velocity per year ≤ − 2 SD or ≤ − 1.5 SD after two consecutive years, even without short stature and after exclusion of other causes of failure to thrive; or malformations/lesions of hypothalamus/pituitary demonstrated at brain MRI) [ 13 ]. Although this is the first study reporting a decrease of referrals for suspected GHD during 2020 lockdowns, our results align with previous reports addressing a delay of hospital care admissions and a reduction of 30–40% in visits during the COVID-19 pandemic [ 9 , 10 ].…”
Section: Discussioncontrasting
confidence: 84%
“…The two most frequent referral reasons in pediatric endocrinology are issues regarding growth and puberty, which constitutes almost half of the referrals for pediatric endocrinologists [ 1 ]. To detect growth hormone deficiency (GHD) or central precocious puberty (CPP), among other endocrine diseases, the determination of basal hormones is of limited diagnostic value, and stimulation tests – which require hospital admission – are needed.…”
Section: Introductionmentioning
confidence: 99%
“…Children and young people referred to pediatric endocrinology services present with a wide range of illnesses and disorders varying from minor to life-threatening conditions ( 1 ). Diagnosis rely greatly on laboratory testing: while for some disorders a single blood sample is sufficient (e.g.…”
Section: Introductionmentioning
confidence: 99%
“…Short stature (SS) – defined as a height ≤ − 2 standard deviation score (SDS) – is the most common referral reason in pediatric endocrinology [ 1 ].…”
Section: Introductionmentioning
confidence: 99%