https://www.gosh.nhs.uk/wards-and-departments/departments/clinical-specialties/endocrinology-information/information-for-patients-and-families/conditions-we-treat/

Conditions treated by the Endocrinology department

Staff on Kingfisher Ward preparing canulas

The Endocrinology Department at Great Ormond Street Hospital (GOSH) treat a wide range of conditions.

We provide a NHS England-commissioned Highly Specialised Service at GOSH, caring for national and international patients with congenital hyperinsulinism. Approximately 19-23 new cases per annum are referred.

Our multidisciplinary team works closely with radiology, chemical pathology, gastroenterology, surgery, histopathology and nuclear medicine services.

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We have expertise in the management of patients with congenital and acquired hypopituitarism, working within a dedicated and committed multi-disciplinary team at Great Ormond Street Hospital in order to provide the best care possible to a cohort of approximately 500 highly complex patients. Members of the multi-disciplinary team include an endocrine consultant, endocrine clinical nurse specialists, ward staff, psychologists, social workers, the developmental vision team, ophthalmology and neurology as required. There is also a close relationship with the sleep clinic at Guys and St Thomas’ Hospital, and the neuropsychiatry service at the Maudsley Hospital.

The congenital hypopituitarism regional service has developed over more than 15 years and is a joint venture with ophthalmology and neurodevelopmental paediatrics. It works on a shared care basis linked with local services for these highly complex patients. In particular, we care for a large cohort of children with septo-optic dysplasia (SOD), a rare condition affecting around 1 in every 10,000 births. 

Similarly, the acquired hypopituitarism service cares mainly for children and young people with brain tumours, working closely with the neuro-oncology and neurosurgery departments as part of the largest paediatric/ oncology centre in Europe and one of six Tessa Jowell Centres of Excellence for Children with brain tumours in the UK. We also host the national Hypothalamo-Pituitary Axis Tumour (HPAT) Advisory Group and have expertise in the management of children with pituitary adenomas.

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We manage a large cohort of children with a range of diseases causing cortisol deficiency including congenital adrenal hyperplasia. Additionally, we also have expertise in the management of cortisol excess (Cushing syndrome), working closely with the surgical and neurosurgical teams in the management of adrenal and pituitary tumours. Our neurosurgical department also works closely with the adult pituitary surgeons at the National Hospital for Neurology and Neurosurgery.

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We provide a follow-on service for the North Thames screening programme for congenital hypothyroidism. Current diagnostic rates average 87 new cases per annum and an integrated service is provided between chemical pathology, nuclear medicine, audiology and endocrinology for the initial assessment of these individuals. Patterns of care are then established with either local paediatricians with a special interest in endocrinology or further care is provided at GOSH. Patients are reviewed in a dedicated thyroid clinic with same day turn around of thyroid function tests.

Our team also provide specialist input for children and young people with other thyroid disorders including Graves' disease. This is usually managed in conjunction with local paediatric services. We work alongside thyroid surgeons to manage younger patients who require thyroid surgery (thyroidectomy). Adolescent thyroid surgery usually takes place at University College London Hospital (UCLH). We also have close links with the UCLH nuclear medicine department fo referral of patients over the age of 10 years who wish to have radioactive iodine treatment.

For more information about thyroid disorders please go to the British Thyroid Foundation.

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Specialist diagnostic and clinic services are provided for children and young people with DSD and related conditions. Decisions are made jointly in a monthly multidisciplinary meeting held with the urology, psychology, chemical pathology, gynaecology/adolescent urology, and clinical genetics teams.

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Specialist clinics for patients with metabolic bone and calcium disorders are held twice monthly and are supported by a dedicated Clinical Nurse Specialist. Additionally, there are dedicated clinics for patients with skeletal dysplasia and osteogenesis Imperfecta (the latter held jointly with the neurodisability service).

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The main type 1 diabetes service is based at University College London Hospital. The GOSH diabetes team provide support and care for children and young people with complex diabetes, including those with cystic fibrosis, genetic forms of diabetes, and those where diabetes complicates or develops during their treatment at GOSH for other conditions. We also provide support to any patient with type 1 diabetes who comes to GOSH for other reasons such as surgery.

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The provision for the endocrine long-term follow-up of children who received oncology therapy is divided into two sections. Patients with brain tumours are managed by our acquired hypopituitarism/ neuroendocrine service, whilst long-term follow-up of other cancers, particularly for patients with haematological malignancies and/ or who are post-bone marrow transplant, occurs in joint multidisciplinary clinics with the haematology/ oncology team. A similar service exists for patients with Langerhans cell histiocytosis.