Kinderarzt-Praxis 23558 Lübeck - Dr. Esther M. Nitsche - Kinderendokrinologie
Endocrinology
We are specialized in Pediatric Endocrinology, this field comprises
- inborn and accquired disorders of the thyroid
- growth disorders - small stature, tall stature, failure to grow / growth arrest
- delayed and precoccious (too early) puberty
- disorders of the adrenals
- disorders of female and male sexual differentiation and maturation
- bone and calcium metabolism disturbances
- enuresis during the night ("bed wetting") persisting after the 5th birthday
- gross overweight due to hormonal disturbances
- pediatric and adolescent gynaekological problems
- various other, rare disorders caused by or accompanied by hormonal disturbances
The endocrinology consultation
Examinations für suspected / proven hormone disorders we also perform on request by other pediatricians. In this case, your family pediatrician will receive regular reports on course, treatment and results.
First visit to the endocrinologist
Usually you present to our office, because you or your pediatrician suspect a hormonal disorder in your child / in you. Endocrinological exams are performed by appointment only, as the problems usually are rather complex and require sufficient time for history taking and exam.
When you call to get an appointment, the staff will ask you several questions in order to offer you the right type of appointment.
In childhood and adolescens, growth and bone maturation provide important information. Therefore we often ask to come in to take the child's / your body masses and note the previous growth and weight data from the yellow medical record book prior to the actual appointment. Also the determination of the bone maturation status (coll. ‘bone age') can be very helpfull ahead of time. In other disturbances an ultrasonography or detailed protocols help make the first visit to the doctor very efficient - in these cases, you will receive referrals and/or protocol sheets at your first visit to the office.
When you meet the doctor for the first time, taking your / your child's history as well as your family history will be the first thing we do, followed by a physical exam. Depending on history and findings on exam, we might draw some blood for hormone measurements.
Stimulation Tests, Functional Tests
Not all hormonal disorders can be diagnosed satisfyingly by a basic hormonal status. Occasionally function tests are required. We do perform a number of tests in our office (glucose tolerance test, gonadal stimulation tests, adrenal stimulation tests, thyroid stimulation test). As theses tests require to be done in the morning and the patients has to be fasting, stimulation tests always require a separate appointment.
We do not perform all possible tests in our office. For tests, we do not offer, we closely collaborate with other pediatric endocrinologists.
Useful links
http://www.dgkj.de/690.html German Society for Pediatrics, Endocrinology
www.willi-will-wachsen.de Body mass Index (BMI), growth charts
http://www.forumwachsen.de Information for parents of children with growth disorders www.bkmf.de national assocoation of people with short stature http://www.kindergynaekologie.de/ Work group for pediatric and adolescent gynaecology
http://www.sd-bv.de/home.php Self help group for parents of children with thyroid disorders
https://www.ags-initiative.de Self help group for patients and parents with congenital adrenal hyperplasia (CAH)
http://www.turner-syndrom.de/ Self help group for patients w Ullrich Turner's Syndrom (UTS)
www.a-g-a.de Workgroup for obesity in childhood and adolescence
http://www.diabetes-kids.de/files/Kigainfo150.pdf Diabetes - Information for Kindergardens
http://www.diabetes-kids.de/files/Kigainfo150.pdf Diabetes - Information for school teachers