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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Pediatrics".

Deadline for manuscript submissions: 25 May 2026 | Viewed by 2504

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Dr. Marco Fiore

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Institute of Biochemistry and Cell Biology (IBBC-CNR), Department of Sensory Organs, Sapienza University of Rome, 00185 Rome, Italy
Interests: endocrinology; neurotrophins; oxidative stress; cancer; toxicology; addiction; antioxidants; polyphenols; alcohol use disorders
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Dear Colleagues,

Pediatric endocrinology is a quickly evolving field, with incessant advances in our comprehension of endocrine disorders that influence growth, metabolism, and development in children. This Special Issue of the Journal of Clinical Medicine—"New Insights in Paediatric Endocrinology"—is aimed to highlighting the latest findings and clinical developments that are influencing the future of diagnosis, treatment, and long-term management of pediatric endocrine disorders.

From innovative genetic discoveries to cutting-edge therapeutic advances, this compendium of articles will include an extensive spectrum of topics, covering growth disorders, obesity, diabetes, adrenal and pituitary abnormalities, thyroid dysfunctions, and puberty-related diseases. With the mounting application of precision medicine, innovative pharmacological strategies, and artificial intelligence, pediatric endocrinology is actually undergoing a crucial revolution that enriches both clinical outcomes and the affected children’s quality of life.

By bringing together leading experts in this field, this Special Issue could provide key viewpoints for debating developing trends, sharing innovative research, and promoting interdisciplinary collaborations. We do hope that these contributions might not only potentiate scientific knowledge but also increase the clinical practice for benefiting young patients.

We look forward to attracting discussions and contributions that could better arrange the forthcoming pediatric endocrinology.

Dr. Marco Fiore
Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

endocrinology
pediatrics
hormones
therapy and treatment
adolescents
newborns

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Published Papers (3 papers)

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Research

16 pages, 979 KB

Open AccessArticle

Growth Outcomes and Relapse Risk in Pediatric Medulloblastoma Survivors with and Without Growth Hormone Therapy: A 23-Year Single-Center Cohort Study

by Gerdi Tuli, Jessica Munarin, Paola Ragazzi, Eleonora Biasin, Francesco Felicetti, Anna Mussano, Stefano Gabriele Vallero, Daniele Bertin, Paola Peretta, Giovanni Morana, Franca Fagioli and Luisa De Sanctis

J. Clin. Med. 2026, 15(9), 3472; https://doi.org/10.3390/jcm15093472 - 1 May 2026

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Abstract

Background: Growth hormone deficiency (GHD) is one of the most common endocrine sequelae in survivors of pediatric medulloblastoma, largely resulting from hypothalamic–pituitary irradiation. Concerns regarding the oncologic safety of growth hormone (GH) replacement have historically limited its use. This study aimed to evaluate growth response to GH therapy and its potential association with tumor relapse in medulloblastoma survivors treated between 2000 and 2023. Methods: We conducted a retrospective single-center cohort study including 74 patients diagnosed with medulloblastoma before 18 years of age. GHD was confirmed by stimulation testing according to standard criteria. Auxological, endocrine, and oncologic data were collected longitudinally. Growth outcomes were compared among patients without GHD (n = 38), patients with untreated GHD (n = 13), and patients with GHD receiving GH treatment (n = 23). Relapse rates were assessed following GH initiation and compared with those of untreated patients. Results: GHD was diagnosed in 48.7% of patients. Baseline height SDS did not differ among groups. Patients with untreated GHD experienced a significant decline in height SDS (−1.93 ± 0.78), whereas GH-treated patients showed a significant increase (+0.39 ± 0.06; p < 0.0001). Final height SDS was significantly lower in untreated GHD patients (−2.45 ± 0.36) compared with GH-treated patients (−1.71 ± 0.68) and patients without GHD (−0.68 ± 0.24; p < 0.0001). No evidence of an increased risk of tumor relapse was observed in association with GH therapy during follow-up. Conclusions: GH replacement significantly improves growth outcomes in medulloblastoma survivors with confirmed GHD without apparent increase in relapse risk when initiated after stable remission. The early identification and multidisciplinary management of GHD are essential components of long-term survivorship care. Full article

(This article belongs to the Special Issue New Insights in Paediatric Endocrinology)

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16 pages, 1107 KB

Open AccessArticle

Spectrum of Osteoporosis Etiologies with Associated Vertebral Compression Fractures in Children: Analysis of 11 Cases

by Sara Aszkiełowicz, Anna Łupińska, Izabela Michałus, Arkadiusz Zygmunt and Renata Stawerska

J. Clin. Med. 2026, 15(1), 123; https://doi.org/10.3390/jcm15010123 - 24 Dec 2025

Viewed by 952

Abstract

Background/Objectives: Pediatric osteoporosis is a multifactorial condition characterized by impaired bone mineralization and increased fracture risk, particularly vertebral compression fractures. This study aims to evaluate the diverse etiology, diagnostic challenges, and treatment options for pediatric osteoporosis in a cohort of affected children. Methods: We reviewed eleven pediatric patients (aged 5–16 years) diagnosed with vertebral fractures and osteoporosis, who were hospitalized between 2020 and 2024 at the Department of Endocrinology and Metabolic Diseases at PMMH-RI in Lodz. Clinical evaluation included medical history, physical examination, biochemical markers of bone metabolism, and imaging techniques such as dual-energy X-ray absorptiometry (DXA) to determine underlying causes of bone fragility. Results: The cohort presented a broad etiological spectrum, including seven patients with genetic disorders (e.g., mutations in COL1A1, LRP5, SGMS2, and ALPL genes) and secondary osteoporosis due to chronic diseases requiring prolonged glucocorticoid therapy (two patients with Duchenne muscular dystrophy (DMD), one patient with Crohn’s disease) or endocrinological disorders (one patient with Cushing disease). Vertebral fractures were confirmed in all patients, with back pain as the predominant symptom. Low bone mass (BMD Z-score < −2.0) was observed in eight individuals; in others, clinical signs of skeletal fragility were present despite Z-scores above this threshold. Mild biochemical abnormalities included hypercalciuria (3/11 cases) and vitamin D deficiency (6/11 cases). Height adjustment improved BMD interpretation in short-stature patients. Most children received bisphosphonate therapy, supplemented with calcium and vitamin D. In two patients, bisphosphonates were not used due to lack of parental consent or underlying conditions in which such treatment is not recommended. Conclusions: Pediatric osteoporosis requires a multidisciplinary diagnostic and therapeutic approach, integrating clinical, biochemical, and genetic factors. It is a heterogeneous and often underrecognized condition, with vertebral fractures frequently serving as its earliest sign—even in the absence of overt symptoms or low bone mass. This underscores the need for clinical vigilance, as significant skeletal fragility may occur despite normal BMD values. Importantly, pediatric osteoporosis may also impact the attainment of peak bone mass and ultimately affect final adult height. Early diagnosis through thorough assessment, including height-adjusted DXA, and a multidisciplinary approach are essential to ensure timely management and prevent long-term complications. Full article

(This article belongs to the Special Issue New Insights in Paediatric Endocrinology)

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17 pages, 555 KB

Open AccessArticle

Adipokine Profile Signature in Adolescent Girls with Menstrual Disorders and Hyperandrogenism Differs from That of Regularly Menstruating Girls

by Elżbieta Foryś, Agnieszka Drosdzol-Cop, Ewa Małecka-Tendera, Aneta Monika Gawlik-Starzyk, Karolina Skrzyńska, Magdalena Olszanecka-Glinianowicz and Agnieszka Zachurzok

J. Clin. Med. 2025, 14(22), 7987; https://doi.org/10.3390/jcm14227987 - 11 Nov 2025

Cited by 1 | Viewed by 659

Abstract

Introduction: Polycystic ovary syndrome (PCOS) is associated with obesity, numerous metabolic complications, and an increased risk of cardiovascular disease. Adipokines, secreted by adipose tissue, may contribute to the development of these cardiometabolic disturbances. The aim of this study was to investigate the adipokine levels and their relationship with metabolic status in adolescent girls with PCOS. Patients and Methods: This cross-sectional study included 66 adolescent girls with PCOS (mean age: 16.5 ± 1.08 years; study group, SG) and 30 regularly menstruating girls (mean age: 16.2 ± 1.37 years; control group, CG) recruited between 2012 and 2017. All participants underwent physical examination, body composition assessment, liver ultrasonography, and biochemical and hormonal evaluations. Fasting venous blood samples were collected to determine the adipokine profile, and the leptin-to-adiponectin ratio (L/A) was calculated. Results: Compared with the control group, the PCOS group demonstrated significantly lower adiponectin (p = 0.019) and vaspin (p = 0.037) concentrations, and higher RBP-4 levels (p = 0.048). Positive correlations were observed between adiponectin, apelin, and omentin, while negative correlations were found between leptin and L/A and HDL cholesterol levels in the SG. Omentin showed a negative association, and leptin and L/A a positive association, with triglyceride concentration. In the SG, resistin and visfatin levels were negatively correlated with total cholesterol, and resistin also showed a negative correlation with LDL cholesterol. In patients with PCOS, adverse associations were observed between carbohydrate metabolism parameters and insulin resistance indices, while insulin sensitivity indices correlated positively with adiponectin and omentin concentrations. Visfatin levels in the SG correlated negatively with QUICKI. Conclusions: The adipokine profile of adolescent girls with PCOS differs from that of regularly menstruating peers, particularly in adiponectin, RBP-4, and vaspin concentrations. However, the absence of significant correlations between RBP-4 and vaspin and lipid or carbohydrate metabolism parameters suggests that these adipokines are not reliable markers of metabolic disturbances in adolescent girls with PCOS. Full article

(This article belongs to the Special Issue New Insights in Paediatric Endocrinology)

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