ESPE Global Care Pediatrics Endocrinology Conference. This meeting is truly an international meeting. The primary organizers are the Lawson Wilkens Pediatric Endocrine Society (LWPES) and the European Society for Paediatric Endocrinology (ESPE), in cooperation with pediatric endocrine societies serving Australia, Asia Pacific, Japan and Latin America. This year’s exhibit was held September 9-12, 2009 in New York City. The booth was coordinated by Meg Keil, (Director of Pediatric Programs for the CSRF), and staffed by Laura, Karen, and Jessi. Thanks to all!

For this exhibit, the CSRF used a new booth that highlighted the symptoms of Cushing’s in children and adolescents, with children’s pictures on one side of the booth and adolescent photos on the other. The booth also included a two growth charts to emphasize that careful attention to weight gain and growth deceleration can be key indicators of Cushing’s in children. We are very thankful to Meg Keil for directing us on the booth content, encouraging us to exhibit, and for guidance on booth handouts.

This exhibit was attended by approximately 3000 involved in Pediatric Endocrinology from around the world. Booth traffic was very good and the CSRF had the opportunity to hand out a great deal of information. Of primary interest to those visiting our booth, was testing for Cushing’s in children. This was very definitely a worthwhile event!

In the technical program, one “Meet the Expert” session was presented on “Challenges in Decision Making in Cushing Disease” by Dr. Nalini Shah of Seth GS Medical College, Mumbai, India. Cushing’s was also discussed in a number of poster sessions, and included several case reports. In contrast to adult endocrinology conferences, there seemed to be a higher number of reports on Carney Complex, McCune Albright, and the bilateral adrenal hyperplasias that can be hereditary and can become apparent in childhood.

Yes, Cushing’s appears to be under-diagnosed in children. Researchers from St. Petersburg, Russia (Zulfiya, R, et al) studied 62 obese and non-obese patients ages 15-20 and found 5 patients (12.5%) with sub-clinical Cushing’s Syndrome based on unsuppressed 24hr UFC after a 2mg dex test.

Another interesting poster (Leblicq, C, et al, Univ of Montreal) titled “Are Guidelines For Glucocorticoid Coverage Being Followed In Patients With Adrenal Insufficiency During Periods Of Stress?” indicated between 1997 and 2007, of children with adrenal insufficiency urgently hospitalized, only 53% had been given stress doses of steroids prior to an urgent admission. Infection was the most common cause of admission. In general, the author suggests the risk of hospitalization might be minimized by more “conscientious application” of stress glucocorticoids by parents.