310293?1274743373
Deanna L Aftab Guy, MD  
Female
Nashville, TN

Specialties: Short Stature, Thyroid, Puberty concerns


Vanderbilt Children’s Hospital
2200 Children's Way
Nashville, TN
My Posts
Delaying epiphyseal closure
Jan 26, 2009 in the Pediatric Endocrinology Expert Forum
A bone age is a radiological evaluation of growth plates taken for the left hand and wrist, it is compared to standards in an atlas, most commonly used is the Gruehlich and Pyle Atlas, it is very very subjective in regards to one person's interpretation versus another's. We usually never get repeat bone ages any sooner than 6 months apart, the bones just don'...
advanced bone age
Jan 26, 2009 in the Pediatric Endocrinology Expert Forum
Lisa, a stimulation test (stim test) is an endocrine term for a test to assess a hormone response to a stimulus. It helps us assess for deficiencies or overproduction of hormones. In regards to puberty the test to see if the brain is maturely signalling is called a leuprolide stim test, a medication called leuprolide is given and levels of the pituitary puber...
A 3rd follow-up on Newborn with Low Normal T4 and High TSH
Jan 05, 2009 in the Pediatric Endocrinology Expert Forum
given this unusual history of iodine exposure it is more than likely the cause-iodine is needed in the production of thyroid hormone, it is also used as a topical wound cleanser and antibiotic like substance(preoperatively as well) but chronic use on a daily basis is very rare and not expected. The iodine use can lead to goiter and rise in tsh. I would monit...
Premature adrenarche
Jan 05, 2009 in the Pediatric Endocrinology Expert Forum
This is premature adrenarche, the early production of the male hormones from the adrenal glands, when they are produced early or in excess it is important to rule out abnormal reasons. One important cause that is rare and often screened for at birth is congenital adrenal hyperplasia, this is a block in the enzymes that the adrenal glands make and there is a b...
Growth Hormone Deficiency
Jan 05, 2009 in the Pediatric Endocrinology Expert Forum
She is definitely short and body weight is too high for her height, glad to see you saw an endo. She is gh deficient and this is a very good reason for central obesity(more weight around the tummy) and short stature!!! Do not feel overwhelmed, this is good news, she has a chance for treatment, the mri is done on all of my patients before treatment is started,...
lumpy thyroid
Jan 05, 2009 in the Pediatric Endocrinology Expert Forum
Hashimoto's is an autoimmune thyroid disease that causes enlargement of the gland and yes, it can feel enlarged with lumpy bumpy appearance but the ultrasound usually shows overall enlargement and rules out a cyst or nodule that may need monitoring. Waiting 2 months as long as she is well is not unreasonable especially if there is not one area that is overly ...
Could this be early diabetes?
Jan 05, 2009 in the Pediatric Endocrinology Expert Forum
The description you give is not suggestive at all of diabetes, the first episode of low sugar with intussception is expected, during sepsis (high white count) and illness in a small 2 yo child who has not eaten it is not unexpected to find a low sugar, the insulin is normal, NOT too low, this insulin level in the face of a sugar of 85 is appropriate and rules...
toddler thyroid ultrasound
Jan 05, 2009 in the Pediatric Endocrinology Expert Forum
I see alot of kids with some mild abnormal thyroid and repeat is normal, lab is variable and you have to treat the kid, I have not examined your child but think that if the thyroid functions are normal that perhaps you can wait on the ultrasound, ESPECIALLY if you have financial concerns! It is often hard to find the thyroid in someone with normal thyroid fun...
help
Jan 05, 2009 in the Pediatric Endocrinology Expert Forum
Cushing's Disease is very rare in children, not nonexistent but rare, he has a very clear psychiatric history and the medications are very likely contributing to the weight gain along with some unfair metabolism and increased eating and lack of activity related to depression and mood problems. I would work very closely with the psychiatrist, they can test thy...
advanced bone age
Dec 30, 2008 in the Pediatric Endocrinology Expert Forum
I just posted a similar reply to another posting see below, however early puberty is what needs to be assessed, you say that she had a stimulation test, rather than give age level what was the exact level of the hormones tested and what kind of test did she have? if she is indeed having early puberty, at 8 1/2 this takes a little thought, is this normal varia...