Pediatric endocrinology consultation |
/1–3 years without GH |
/1 year without GH |
/6 months |
/6 months on rhGH |
/6 months on rhGH |
Clinical examination |
1x/year |
/6 months on rhGH (1x/year without rhGH) |
/6 months on rhGH (1x/year without rhGH) |
Measurement of BP |
1x/year |
1x/year |
1x/year |
Screening for kyphosis, scoliosis (starting at 8–10 yrs++) |
1x/year |
1x/year |
1x/year |
Every 6 months on GH |
Every 6 months on rhGH |
Every 6 months on rhGH |
Standard and Turner growth curves |
1x/year |
At each visit |
At each visit |
Serum IGF-I determination |
Start of GH treatment |
Start of GH treatment |
/12 months on rhGH treatment |
/12 months on rhGH treatment |
Serum estradiol, FSH, LH, AMH determinations |
|
|
Check before inducing puberty or 1x/year if puberty is spontaneous |
Anti-TPO Ab |
From the age of 4 years |
1x/year |
TSH, ± FT4 |
From the age of 4 years |
If treating hypo- or hyperthyroidism: TSH, FT4: every 3–12 months |
HbA1c |
|
> 10 years: 1x/year HbA1C/3 months if diabetic |
± blood glucose levels |
± fasting insulinemia |
± OGTT |
Before rhGH treatment if glycemia or HbA1c levels moderately high |
OGTT before rhGH treatment if risk factors and if glycemia or HbA1c levels moderately high |
AST, ALT, gamma-GT |
|
> 6 years: |
6–10 years 1 × every 2 years |
> 10 years: 1x/year |
IgA antitransglutaminases, total IgA |
> 2 years: 1 × every 2 years |
1 × every 2 years |
1 × every 2 years |
Total cholesterol/HDLc/LDLc/Triglycerides |
|
> 10 years: 1 × every 3–4 years |
1 × every 3–4 years |
Creatininemia, Microalbumin/creatinine in urine |
If renal malformation or HBP |
25(OH)D |
/2–3 years |
/2–3 years |
/2–3 years |
Consultation with (pediatric) cardiologist, with cardiac ultrasound |
Depending on heart disease/condition |
1x/year if cardiopathy or HBP |
1 × every 5 years: systematically if no risk factors |
Systematically before transition to adult care |
Aortic and cardiac MRI |
As advised by the cardiologist |
As advised by the cardiologist |
Thyroid ultrasound |
If there is dysthyroidism, palpable nodule, and/or goiter |
ENT consultation and hearing evaluation |
1x/year if recurrent bouts of otitis |
As advised by ENT, with consultation at least once every 5 years provided there are no risk factors |
Ophthalmologic consultation |
Systematic screening between 12 and 15 months and between 3 and 4 years (as in the general population) |
Consultation only if necessary: suspicious signs, sensory or motor abnormality, follow-up for strabismus, follow-up of refractive abnormalities, follow-up for organic abnormality |
Dermatological consultation |
As a function of symptoms |
Bone age |
1 × every 2 to 3 years in case of rhGH treatment |
Bone densitometry |
|
Check-up at end of the growth period or puberty |
Pelvic ultrasound |
|
Check-up at end of the growth period or puberty |
Dental consultation |
Annually, with adjustment according to clinical profile |
Annually, with adjustment according to clinical profile |
Consultation with a dietitian |
If overweight, carbohydrate intolerance, diabetes, dyslipidemia |
Supplementation with calcium and vitamin D, if necessary |
Screening for behavioral problems |
Every year, during the clinical evaluation |
Psychological consultation |
Around the age of 4–5 years (before, if there are suspicious signs) |
Every 5 years, with re-evaluation as a function of symptoms |
± Psychometric tests |
Therapeutic education |
Every 1–2 years and as required |
Gynecology consultation |
|
During puberty induction, then every 2–3 years |