Pattern of Paediatric Endocrine Disorders According to ICD-10 Classification in a Tertiary Centre in Southern Nigeria

Abstract

Aim: To describe the spectrum of various endocrine disorders seen in children and adolescents in Port Harcourt over the period 2013-2017 using modified European Society of Paediatric endocrinology ICD -10 classification. Study Design: Descriptive, Cross sectional study. Place and Duration: Paediatric endocrinology Unit, Department of Paediatrics, University of Port Harcourt Teaching Hospital.  Study was done with data from January 2013 to August 2017. Methods: A retrospective review of 178 patients with various endocrine diseases was reported. Data on biodata, clinical presentations and investigations with diagnosis   were retrieved from the clinic and ward records and endocrine unit registers. Results: A total of 178 patients were seen with various endocrine disorders over the study period accounting for 4.5% of Paediatric specialist clinic consultations. There were 89(50.0%) females and 80(44.9%) males. Nine (5.1%) had genital ambiguity.  The ages of patients ranged from 12days to 17years with a mean age of 6.9 ± 5.1years. The commonest endocrine disorders were pubertal disorders, diabetes mellitus, thyroid disorders and  calcium phosphate metabolism and bone disorders  in 34(17%), 27(14%)  23(12%), 22(11%) and 22(11%) respectively.  Twenty two (11%) of the patients had obesity and 10(5%) had syndromes with endocrine features.  Other disorders seen were sex development and gender disorders, testicular/male reproductive tract disorders, growth disorders (short stature) ovarian/female reproductive tract disorders, pituitary/ hypothalamic disorders and adrenal disorders in 17(9%), 17(9%) 10(5%),7(4%), 5(2.5%) and 3(1.5%) respectively. Type 1 DM remained the commonest type of DM. Most of the patients were of the middle social class (social class III). Challenges to management included high cost of investigations and drugs, high rate of loss to follow up. Conclusion: Pubertal disorders, type 1 Diabetes mellitus, thyroid disorders, calcium and phosphate metabolism and bone disorders and obesity were the commonest cases in our review. Most investigations were available in private laboratories with high cost of investigation leading to loss to follow up and continuation of care.