Endocrinology - For patients and families
The Endocrinology Department provides specialist care and clinics for the following conditions / disorders:
General Endocrinology
General Endocrinology clinics provide care to children with a variety of endocrine problems.
These include pubertal development (both premature and delayed) and other hormone imbalances not requiring acute intervention or specialist care.
Thyroid
Endocrinology Services at PCH offer speciality thyroid clinics which are devoted to the care and treatment of children with thyroid disease.
Thyroid clinics offer clinical evaluation, treatment and follow up for infants, children, and adolescents with all types of thyroid disease, including hypothyroidism, hyperthyroidism, and thyroid nodules.
The is a multidisciplinary clinic comprising an endocrinologist, specialist nurses, dietitians, and social workers.
Children in the thyroid clinic are assigned to age grouped clinics:
- Thyroid clinic 1 (TH1) < 4 years
- Thyroid clinic 2 (TH2) ≥ 4 years
- Nurse-led clinics
In some cases, according to criteria, a mixed service delivery model can be offered that includes:
- Face to face to appointments
- Virtual appointments
- Telephone Consultation
Download the Thyroid Service information sheet
Growth
The clinic provides evaluation and treatment for children with short or tall stature, due to hormonal issues.
This clinic comprises specialist endocrine medical care complemented by multidisciplinary care as required.
The service encompasses a research program evaluating the genetics of growth disorders and newer therapeutics for growth hormone deficiency.
Download the Growth Service information sheet
Bone
Bone-related clinics are specialist clinics for primary (Osteogenesis Imperfecta, OI) and secondary osteoporosis, different forms of rickets and all aspects of calcium and bone metabolism.
This is a multidisciplinary clinic that includes an adult endocrinologist, a geneticist, coordinating social worker, physiotherapist, and orthopaedic surgeon.
Members of the clinic team attend specialised neuromuscular clinics at PCH for endocrine advice.
The bone and mineral service is linked to the Day Treatment Unit for therapeutic and diagnostic interventions.
The team participates in several active research programs covering aspects of bone health.
These include:
- diagnostics
- new forms of medical therapy
- targeted exercise modalities
- ways to prevent osteoporosis in youth to decrease the burden of osteoporosis later in life
Endocrine Emergencies (Fast Track and Acute Care)
Acute Endocrinology Services are designed to promote the timely and efficient review of priority cases and to streamline patient flow in the endocrine service.
Two service models are offered:
1. Acute Care
For patients who require a follow-up after an initial endocrine review either following an inpatient admission or as an urgent initial outpatient review.
Due to clinical need one further follow-up may be offered in the Acute Care clinic but for the majority of patient’s, allocation to the suitable sub speciality Endocrine clinic is recommended and preferred.
2. Fast Track
For patients identified on intake as priority 1 (< 30 days) or 2 (30-60 days).
Patients are seen at least initially for a detailed medical assessment of an urgent endocrine issue and where indicated a maximum of 1 medical follow up before discharge, on-referral or allocation to a regular Endocrinology sub speciality clinic.
One slot in these clinics will be kept open for emergencies until the last working day before the next clinic date.
Persistent Hyperinsulinaemia Hypoglycaemia in Infancy (PHHI)
This speciality clinic is for children with hyperinsulinism and is a multidisciplinary clinic comprising an endocrinologist, an endocrine liaison nurse and a dietitian and social worker to provide individualised care to review growth and development, monitor hypoglycaemia (using glucometers or sensors) and adjust therapy as required.
Adrenal
These clinics see patients with adrenal issues, potentially resulting in the need for cortisol supplementation.
This can result from congenital adrenal hyperplasia, adrenal tumours, pituitary abnormalities, auto-immune processes, and long-term steroid therapy.
Download the Steroid Cover Emergency Plan
Prader Willi, Turner and Klinefelter Syndromes
These clinics are for children and adolescents with specific genetic disorders that result in endocrine conditions.
The clinics deliver specialised and individualised care through careful planning in pre- and post-clinic meetings with involvement from colleagues and allied health professionals from other specialities.
There are specific clinics for:
- Girls with Turner Syndrome: comprising specialist endocrine nurses as well as endocrinologists with expertise in Turner Syndrome, growth and growth hormone and pubertal hormonal replacement. A social worker is on call if needed and patients can be referred for dietetic advice.
- Prader Willi Syndrome
- Klinefelter Syndrome
- Patients with chromosome 22q11 deletions and trisomy 21 located in the department of General Paediatrics
DSD (Differentiation of Sexual Development)
This clinic provides initial assessment and ongoing management of infants, children and adolescents born with differences of sex development.
A multidisciplinary approach is offered with discussion at quarterly meetings of the Western Australian DSD team which includes endocrinologists, an endocrine nurse, a geneticist, gynaecologist, psychiatrist, histopathologist and chemical pathologist. A social worker is on call if necessary.
Initial workup of infants is usually performed by members of the DSD team as an inpatient with follow-up at the DSD clinic.
Oncology
Endocrine and metabolic complications of childhood cancer therapy occur in many survivors.
These clinics provide surveillance and management of endocrine late effects in childhood cancer survivors and endocrine management of acute side effects during cancer treatment. The program comprises two clinical models:
One clinic is conducted within the endocrine service and comprises specialist endocrine nurses and endocrinologists that commonly provide management for hypothalamic- pituitary dysfunction, thyroid dysfunction, metabolic disorders and sex hormone deficits in survivors.
Endocrinology also provides an in reach multidisciplinary clinic jointly with an oncologist within the oncology service.
The aim is to provide acute endocrine advice and management of patients during cancer therapy. The multispecialty nature facilitates active transfer of information between specialties and timely management of acute endocrine effects of cancer treatment and planning of endocrine surveillance of cancer patients for late effects during the first 5 years following end of cancer therapy. In addition, the clinic undertakes multispecialty review and management of thyroid nodules and thyroid malignancy, and planning of endocrine surveillance for late effects during the first 5 years following end of cancer therapy.
Endocrine Testing and Intervention
Endocrine testing is an essential component of the Endocrine Service and mainly occurs in:
1. PCH Day Treatment Unit (DTU)
Medical staff of the Endocrine Service provide and oversee all aspects of endocrine function testing and day therapy.
As a part of this service Endocrinologists provide education to DTU nursing staff.
2. Overnight Growth Hormone Tests
To complement growth hormone stimulation tests in DTU, overnight admissions for the assessment of spontaneous growth hormone secretion are facilitated by medical staff of the Endocrine Service.
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