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Pediatric Endocrinology.
  1. FERGUS CAMERON, Visiting registrar in endocrinology
    1. RICHARD STANHOPE, Consultant paediatric endocrinologist

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      Pediatric Endocrinology. Edited by Mark A Sperling. (Pp 614; £68 hardback.) W B Saunders, 1996. ISBN 0-7216-5522-X.

      The practice of paediatric endocrinology is the struggle to maintain physiology and constancy of physical development, sexual maturation, metabolic rate, plasma electrolytes, serum calcium, and glucose concentrations. To some, the objectives may seem mundane, but their attainment can at times be extraordinarily difficult. Contemporary paediatric endocrinologists need to know the link between clinical syndromes and the underlying pathology in transcriptional, ligand/receptor or secondary, intracellular mechanisms. Thus, a textbook of paediatric endocrinology must address this and the aim of the editor is to do so. The opening chapters relating to endocrine physiology and molecular endocrinology are clear and provide an overview of many research techniques. After reading this section, the clinical endocrinologist should have little difficulty digesting complex molecular biology, which is now prominent in endocrine research. The text has a symmetry with the last two chapters dealing with the methodology of clinical investigative techniques, again expressed both concisely and clearly. The pre-eminence of health economics in all developed countries has encouraged a direct and rational approach to investigative aspects of clinical practice and the chapter on medical imaging is refreshingly pragmatic. The intervening chapters are a mixture of system orientated and clinical problem orientated reviews. Regardless of orientation, each chapter covers the pertinent physiology, pathophysiology, clinical consequences, and treatment strategies well. The chapters on disorders of growth hormone and insulin-like growth factors and Turner’s syndrome are particularly good.

      There are two limitations to this text. Firstly, the authorship is entirely North American and their clinical dogma not universally practised. While this is not a problem for the reader in North America, it may be limiting elsewhere. The second problem is inherent to all textbooks—that of currency. Notwithstanding this, it is a little disappointing for a text published in 1996 not to include any mention of a topical endocrine issue such as the role of leptin in childhood obesity. However, this should be seen as a minor criticism. In summary,Pediatric Endocrinology is a comprehensive, readable text with an eminent authorship. It has achieved the editor’s stated aim of bridging the gap between biomedical science and the clinical practice of paediatric endocrinology.

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