As we are in the Holiday filled month of December, I wish everyone a moment to pause and reflect on how life has changed for each of us in the past 12 months.   

As a Board, we have had many meetings, but all of them since 2020 have been virtual…..until this month when 21 PES members (8 from the Board) met to review and update the society’s strategic plan.  

Many thanks to the 289 of you that completed the survey along with 17 phone interview participants. The consultant that worked with us on the review and revision of the plan analyzed all the data, and she made a point of saying that the comments numbered over 100 pages in total! That depth and breadth of feedback allows us, the Board, to make sure that we’re being responsive to your issues and needs and remain relevant. There were some insights that came from the data, both in terms of positive trends and areas of opportunity. The planning group are charged with getting this to next steps and we cannot do it alone. We will be sharing more detail of the reoccurring themes expressed as priorities and will be reaching out to our many volunteers on committees and SIGs to help flesh out the tactics/action items to help us realize the strategies identified in the goal areas that rose to the top.

You will hear more of the results of the Strategic Planning meeting in the coming months. 

December is named the “tenth month” (Latin word, “decem,” means ten), because it was originally the 10^th month of the year until January and February were granted entry to the Calendar Union.   

December is unique as we have the shortest days, culminating with the Winter Solstice occurring on December 21.  However, this is just for the Northern Hemisphere.  In the Southern Hemisphere, such as in South America, it is on June 21, 2023.  Speaking of South America, when the 11^th International Meeting of Pediatric Endocrinology (IMPE) will take place in Buenos Aires (March 4-7, 2023), it will be the transition from Summer to Autumn.  

In my next message, I will share some teasers of the PES Annual conference of May 5-8, 2023! Save the date and plan to join us.    

I leave you with two cases, each where a specific observation led to a faster diagnosis. 

Case A (from the 1990’s archive) 

A 3-month-old girl was admitted with a fever and was having a sepsis work-up.  When the physician obtained urine by catheterization, they noted an enlarged clitoris.  The weekend endocrine fellow (JO) suggested to the ER staff, by telephone, to obtain a 17-hydroxy-progesterone, electrolytes, and while the results are pending, to administer stress dose steroids.  No one in the family had CAH.  The next day, the next fellow performed a consultation.  He initially felt the chances of the girl having CAH to be low, until he asked the parents one particular question. What was that question?  (Answer after the second case) 

Case B 

A 12-year-old boy was admitted for a water deprivation study.  Apart from several months of marked polyuria and polydipsia, he was healthy.  The referring endocrinologist felt DI was possible but not probable.  On inpatient rounds, while examining this boy at the start of the water deprivation study, something was observed, and the diagnosis of DI went from possible to highly probable.  What was that physical examination finding?  

Answers: 

In Case A, the parents were asked if there was consanguinity.  Parents were first cousins.  This significantly raised the chance of a recessive condition.  The 17-OH progesterone returned approximately 20,000 ng/dL (630 nmol/L).  This case pre-dated the Newborn Screen for CAH.   

In Case B, the boy had a rash on his wrists and his groin.  Dermatology was consulted and asked specifically if this was a rash suggestive of Langerhans Cell Histiocytosis (LCH).  Dermatology was convinced it was indeed a rash of LCH and a biopsy provided confirmation.  The water deprivation proved central DI, and the MRI showed an absent bright spot, and a thickened infundibulum but no bony lesions.