An explanation for the presenting symptom(s) is required and need for further investigations. Further discussions depend on results of these investigations. Long-term hormone replacement therapy, management of intercurrent infections (see above) and importance of glucose monitoring needs to be discussed. Child minders need to be informed about the risk of adrenal insufficiency during an intercurrent illness. Babies with anomalies of the optic nerve may have reduced visual acuity or be blind. Implications of associated anomalies, particularly the brain will require discussion.
Hypoglycaemia: Chapter 2. Micropenis: Chapter 6.
Normal ranges: Appendix 3. Dynamic tests: Chapter 2. Hyponatraemia: Chapter 15. Hypernatraemia: Chapter 17. Formulary: Appendix 5.
The pituitary Foundation: www.pituitary.org.uk
Serono booklet: Emergency Information Pack for Children with Cortisol and GH Deficiencies and those Experiencing Recurrent Hypoglycaemia: www.bsped.org. uk/patients/serono/05_EmergencyInformationPack.pdf
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