As we march into 2023, we are focusing on all the efforts from the Committees and Special Interest Groups (SIGs). Most exciting is the planning for the May 5-8 Annual Meeting in San Diego. Registration will open tomorrow, Wednesday, February 1, 2023! You can register for the meeting at Early Bird pricing, as well as secure the discounted hotel room rates. The Board Review will take place just prior to the Annual Meeting.
Apart from planning for the Annual Meeting, we continue our work on re-shaping the goals and vision of the Pediatric Endocrine Society, all stemming from the survey that many of you completed last year. Speaking of vision, I present two cases with prominent endocrine and ophthalmologic features.
1) Vision loss on a child with new onset diabetes
A 14-year-old girl presented with new onset diabetes in DKA. Over the next two days, her electrolyte and pH disturbances all resolved and there was never a concern of cerebral edema. On day 3, she complained of headaches and trouble seeing out of both eyes. What was the cause of this problem?
Imaging was concerning for diffuse mucormycosis (fungal infection). She was treated for months with anti-fungal therapy as well as hyperbaric oxygen. She would survive but unfortunately lost all vision. She also presented with severe primary hypothyroidism at the time of diagnosis of diabetes.
Mucormycosis is seen in both new onset diabetes mellitus, as in this case seen in my fellowship, as well as in chronic Diabetes mellitus and those immunocompromised. The rhino-cerebral form of mucormycosis is most commonly seen in patients with diabetes mellitus, whereas pulmonary mucormycosis in patients with hematological malignancy and transplant recipients.
2) Respecting your visual history
An 11-year-old girl was having a routine reading evaluation at school and the teacher noted the child was holding the book up unusually close to her face. She denied any previous history of visual complaints but agreed that she had to hold the book up close to read. She was moved to the front of the class and a formal vision test was going to be arranged. However, she was having daily headaches which brought her to the ER where a CT revealed a suprasellar mass. (She also had poly’s, sodium 171, fatigue, and 15 lbs. weight loss over 6 months). The diagnosis was a germinoma, but for this case, I am focusing on lessons learned from her visual assessments.
At the time of initial presentation, her vision was assessed at 20/150 in the right eye and NLP (no light perception) in the left. She was unaware that she was essentially blind on her left eye. Fast forward to age 14 years when she would be assessed as having significant, though partial, recovery of her vision. She was 20/70 in the right eye, and 20/150 in the left eye which previously had no light perception. (One typically needs 20/40 in one eye for unrestricted driving, but this was amazing life-changing recovery). Having 20/70 vision may allow one to drive during the day.
The optic nerve compression from a suprasellar mass, once relieved, sometimes can result in recovery of vision, though the degree is unpredictable. It can take a couple of years.
This case, which has countless teaching points, highlights that in taking a visual history, a child/family may not be aware of the extent of visual changes. In this case, she was completely unaware of essential blindness in one eye. This case also offers solace that sometimes there can be some recovery of vision when we treat our pituitary/hypothalamic tumors.
Craig A. Alter, MD
2023 Annual Meeting Registration & Housing Opens February 1
Check here for up to the minute session content and meeting details!
EDI Spotlight: February is Black History Month & American Heart Month
An Invitation from the 11th Internatinal Meeting of Pediatric Endocrinology (IMPE) Planning Committee & Fellow Scholarships for Virtual Access!
The 11th International Meeting of Pediatric Endocrinology (IMPE) is quickly approaching March 4-7, 2023, in Buenos Aires, Argentina. The theme is “Equal opportunities in pediatric endocrine care around the world”. The meeting will be held in person and online. The program is outstanding and includes state of the art lectures from experts around the globe. If you are unable to attend due to the high cost of airfare, we strongly encourage you to register for the virtual meeting. All meeting content will be filmed and available. A discounted registration for the online program will be $540 for regular members and $320 for allied health and fellows for the next few weeks.
The PES board of directors has approved the support 15 Fellows for virtual participation in the international meeting. Please apply here if you are interested. The first 15 fellows to apply (from different institutions) will be contacted with a coupon code to register for the virtual access. Do not delay! Apply today. https://www.surveymonkey.co.uk/r/7LRLZZ2
Please take a moment to look at the program in the meeting link below. The success of this meeting and prospects for future international pediatric endocrine meetings depend on robust support from larger countries such as the US. The highly successful 2017 international meeting hosted by PES benefited greatly from enthusiastic support from all the world’s pediatric endocrine societies. We encourage you to register for and join this unique international gathering of our pediatric endocrine colleagues from around the world. https://www.impe2023.org/
Dorothy Shulman – International Program Organizing Committee
Jack Fuqua – International Program Organizing Committee
David Allen – International Program Organizing committee, and President, 2017 International Meeting of Pediatric Endocrinology
Upcoming Webinar on Congenital Hypothyroidism for Medical Students
Student Endocrinology Exposure Development (SEED) Program
SEED is a novel interactive session series that aims to enhance clinical learning for medical students and increase their exposure to pediatric endocrinology.
Congenital Hypothyroidism presented by Doris Fadoju, MD, Assistant Professor, Pediatric Endocrinology, Emory University School of Medicine, Children’s Healthcare of Atlanta
Session Description: Discuss thyroid hormone synthesis and common causes of congenital hypothyroidism and its presentation, findings, implications and treatment.
Students Only Register here
In Memorium: Barbara Migeon
News from the NIH: Behavioral Codes of Conduct for NIH Award Recipients
By Mike Lauer
We are pleased to announce that the NIH Grants Policy Statement was recently updated, replacing the December 2021 version as standard terms and conditions of award. Consistent with longstanding federal regulations, institutions receiving NIH support will now be required to have internal controls to assure compliance with terms and conditions of award. These internal controls include behavioral codes of conduct to assure safe and healthful working conditions for their employees and foster work environments conducive to high-quality research.
2022: A Year in Review
By Mike Lauer
Just like in previous years, Dr. Michael Lauer, Deputy Director for Extramural Research at NIH, virtually sat down with Dr. David Kosub, from our communications group, to reflect on 2022 and what is in store for 2023. Please join us for this brief conversation and share your thoughts.
APP Spotlight: Stephanie Tarlow
Fellow Spotlight: Yesenia Sanchez-Kleinberg
Historical Tidbit: Alfred F. Hess, MD (9 October 1875 to 5 December 1933) and the Prevention of Rickets
Submitted by Alan D. Rogol, MD, PhD