The Endocrine service at Alder Hey is one of the largest paediatric endocrine services in the United Kingdom and provides expert management for children and young people with a variety of hormone disorders.
The Endocrine service at Alder Hey provides a tertiary endocrine service to the hospitals within the Merseyside and Cheshire area, North Wales and Isle of Man as well as being the secondary care endocrine service provider to the children of Liverpool.
The service encompasses a full range of endocrine pathology in childhood, including a number of well-developed sub-specialties. An NHS England commissioned supra-regional congenital hyperinsulinism service for the North of England is delivered jointly by Alder Hey and Royal Manchester Children’s Hospitals (NORCHI). A nationally commissioned Tier 3 weight management service (CEW service) provides MDT care for children and young people with complications related to obesity.
The team supports a busy neurosurgical service with an interest in midline brain tumours and there is provision of an on-call service to support the neurosurgical, CHI and other endocrine patients out of hours. We are part of a multidisciplinary team working with children with disorders of sex development comprising surgeons, gynaecologists, geneticists, specialist nurses and a dedicated psychologist to this group of patients. The metabolic bone service has expanded rapidly over the recent years and works closely with the supra-regional service at Sheffield Children’s Hospital in managing the most complex patients with Osteogenesis Imperfecta. The service has well developed transitional care arrangements with adult endocrine services within Liverpool.
What do we do?
The service hosts various endocrine sub-specialties run by a range of consultants and supported by a group of MDT professionals including specialist nurses, psychologists, dieticians, and pathway co-ordinators. The centre offers teaching and training and has been participating in various international research projects. It is one of the 6 global centres of excellence for congenital hyperinsulinism.
Clinical specialities and conditions we manage
- Disorders of growth (tall and short stature)
- Growth Hormone Deficiency
- Turners Syndrome
- Noonan Syndrome
- Prader Willi Syndrome
- Conditions requiring growth hormone therapy
- Klinefelter Syndrome
- Disorders of puberty (precocious and delayed puberty, hypogonadism)
- Adrenal insufficiency (CAH, Addison’s disease, steroid induced adrenal insufficiency)
- Disorders of the adrenal gland including Cushing’s syndrome
- Thyroid disorders (hypo and hyperthyroidism)
- Hypopituitarism, Optic nerve hypoplasia and septo-optic dysplasia
- Calcium and metabolic bone diseases, rickets, Osteoporosis, Osteogenesis Imperfecta (OI)
- Congenital Hyperinsulinism (CHI)
- Disorders of Sexual differentiation (DSD)
- Endocrine late effects related to Neurosurgical/Oncology/Haematology conditions
- Multiple Endocrine Neoplasia
- Neonatal endocrinology
- Obesity and co-morbidities (hyperlipidaemia, fatty liver, diabetes mellitus)
- Endo-Gynaecology (e.g., PCOS)
- Rare endocrine conditions (e.g., APS, IGF1 deficiency, ROHHAD syndrome)
Dr Senthil Senniappan (Clinical Director for Endocrinology & Associate Professor)
Dr Mohammed Didi
Dr Urmi Das
Dr Renuka Ramakrishnan
Professor Jo Blair
Dr Poonam Dharmaraj
Peter Laing – Advanced Nurse Practitioner
Zoe Yung – Advanced Nurse Practitioner
Pauline Blundell – Specialist Nurse
Charlie Jarvis – Specialist Nurse
Kelly Cassidy – Specialist Nurse
Jennifer Parkinson – Specialist Nurse
Other team members
Karen Erlandson-Parry: Dietician
Ellie Clarke: Physician Associate
Charlotte Aspinall: Psychologist
Dr Julie Park: Endocrine Grid Trainee
Samantha Wright: Speech and Language Therapist
Dr Louise Apperley: Clinical Research Fellow
Dr Diliara Gubaeva: Clinical Research Fellow
Pathway coordinators (PCOs)
Nicole Falder: Pathway Co-ordinator for Dr Senthil Senniappan, and CHI Co-Ordinator. Nicole also supports the CEW Service.
Gill Murphy: Pathway Co-ordinator for Professor Jo Blair, Dr Urmi Das, Peter Laing & Zoe Yung Advanced Nurse Practitioners. Gill also supports the DSD Team as DSD Administrator.
Paula O’Leary: Pathway Co-Ordinator for Dr Ramakrishnan, Dr Didi and Dr Dharmaraj and supports the metabolic bone service
Deborah Broad: MDT Co-Ordinator for CEW Service
Christine Pritchard: Support Secretary/Data Clerk
Congenital Hyperinsulinism (CHI) Service
Consultant Endocrinologists: Dr Senthil Senniappan & Dr Mohammad Didi
Advanced Nurse practitioner: Zoe Yung
Specialist Nurse: Kelly Cassidy
Dietician: Karen Erlandson-Parry
SALT: Samantha Wright
PCO: Nicole Falder
Psychologist: Charlotte Aspinall
Alder Hey is one of the 3 nationally commissioned quaternary centres in UK for the management of congenital hyperinsulinism and works closely with the other centres in providing specialist care delivered by an MDT (including support from consultants, dietician, psychologist, speech and language therapist and radiologist). The patients are referred from a large geographical region and the consultants leading the service are well renowned world-wide for the management of this rare condition. The service also supports management of ketotic hypoglycaemia and other rare glycaemic disorders.
The award-winning CHI service at Alder Hey is one of the 6 globally recognised ‘CHI centre of Excellence’.
Metabolic bone service
Consultant Endocrinologists: Dr Renuka Ramakrishnan (Lead) & Dr Poonam Dharmaraj
Specialist nurse: Charlotte Jarvis
PCO: Paula O’Leary
The team work closely with a radiologist with expertise in skeletal dysplasias and interpretation of DEXA and QCT scans, clinical genetics colleagues and orthopaedic, spinal, and neurosurgical colleagues with a special interest in surgical management of OI, XLH, skeletal dysplasias and other metabolic bone disorders.
We manage a number of rare and ultrarare bone disorders with various targeted therapies including bisphosphonates, rPTH therapy, calcimimetics and monoclonal antibody therapies.
The team have the expertise to manage a range of conditions including:
- Disorders of calcium and phosphate metabolism
- Osteogenesis Imperfecta (OI)
- Secondary Osteoporosis
- Hereditary Hypophosphataemic rickets
- Vitamin D deficiency and Vitamin D dependent Rickets
- Skeletal dysplasias
- Fibrous dysplasia
- Disorders of parathyroid glands (pseudohypoparathyroidism, hypoparathyroidism, calcium sensing receptor mutations, hyperparathyroidism including parathyroid adenoma etc))
- Metabolic bone disease of prematurity
- Other disorders of phosphate metabolism
Consultants: Dr Urmi Das, Prof Jo Blair & Dr Cara Williams
The Endocrinology and Gynaecology Departments at Alder Hey have developed a service for girls presenting to their GPs with the following problems:
- Absence of periods by the age of 15
- Evidence of virilisation
- Continued menstrual problems not responding to standard treatment
- No signs of puberty by age 13 years
- Obesity with either delayed menarche or oligomenorrhea
We also see parents of girls with severe learning difficulties to discuss options to halt menstruation.
Differences in Sex Development (DSD) service
Consultant Endocrinologist: Dr Urmi Das
Consultant Gynaecologist: Ms Cara Williams (Lead)
Specialist Nurse: Pauline Blundell
Consultant Urologists: Ms Fiona McAndrew, Mr Harriet Corbett, Ms Charlotte Melling, Mr Simon Kenny
Consultant Geneticist: Natalie Canham
Psychologist: Zoe Edwards
PCO: Gill Murphy
There are a wide range of conditions which fall under the umbrella term of DSD and these conditions are supported by the MDT DSD team.
- Androgen insensitivity (complete or partial)
- Congenital adrenal hyperplasia
- Complete/partial/mixed gonadal dysgenesis
- Hypospadias (usually described as severe with undescended testicles noted at birth)
- Swyer syndrome (46,XY gonadal dysgenesis)
- 5-alpha reductase deficiency (5-AR deficiency)
Complications of Excessive Weight (CEW) Service
Consultant Endocrinologist: Dr Senthil Senniappan (Lead)
Physician Associate: Ellie Clarke
Specialist Nurse: Jennifer Parkinson
Advanced Paediatric Dietitian: Kate Clark
Physiotherapist: Kim Lund
Key Worker: Mark McNulty
Clinical Psychologist: Meghan Owens
MDT co-ordinator: Deborah Broad
The CEW Clinic is a specialist nationally commissioned Tier 3 multidisciplinary weight management service aimed at managing the complications from excessive weight in children and young people. In the Northwest region there are two main CEW clinic hubs. One here at Alder Hey Children’s Hospital and the other at Royal Manchester Children’s Hospital. The CEW service has a range of multidisciplinary team members to help support and manage children and young people’s health needs.
Neuroendocrine and Oncology Late Effects service
Consultant Endocrinologists: Dr Mohammed Didi & Professor Jo Blair
Specialist nurse: Peter Laing – Advanced Nurse Practitioner (ANP)
PCO: Gill Murphy
The team work closely with the Consultant Oncologists and Neurosurgeons to manage patients with mid-line brain tumours and Endocrine late effects related to Neurosurgical/Oncology/Haematology conditions.
Consultant Endocrinologist: Dr Senthil Senniappan
Consultant Fertility specialist: Ms Katerina Bambang
Psychologist: Charlotte Aspinall
Consultant Urologist: Mr Marc Lucky (Aintree)
The team offers support for children and young adolescents with puberty/fertility issues (eg., Klinefelter syndrome)
Genetic Endocrine Tumours Service
We see children who have inherited a genetic condition that increases the risk of developing a tumour of a hormone-producing gland. We work very closely with colleagues in LUHFT and specialists across the United Kingdom to care for patients with these rare conditions.
Consultant Endocrinologist: Professor Jo Blair
- Multiple Endocrine Neoplasia type 1 and 2
- Phaeochromocytoma and paraganglioma syndromes, including von Hippel Lindau disease and conditions associated with changes in the SDH gene
- Carney Complex
- Peutz Jegher syndrome
Growth and puberty clinic for children with inflammatory bowel disease
The Endocrinology and Gastroenterology Departments at Alder Hey have a specialist clinic for children and young people with bowel conditions who are concerned about their growth and / or development in puberty.
Consultant Endocrinologist: Professor Jo Blair
Consultant Gastroenterologist: Dr Elizabeth Renji
- Inflammatory disorders of the gastrointestinal tract associated with poor growth or delayed development in puberty
Department of Endocrinology
Alder Hey Children’s NHS Foundation Trust
Email: [email protected]
Endocrine Department is based on the 2nd floor of the Main Hospital of the Alder Hey site. The team are currently situated next to the Inpatient Pharmacy department.
The department has a strong commitment to clinical research. Our team has key involvement with numerous research project within various aspects of the service. We also recruit patients to NIHR portfolio studies, and at any time a number of clinical studies will be actively recruiting. The department is well supported in these activities by research nurses from the Comprehensive Research Network: Northwest Coast. The University of Liverpool clinical trials unit is located at Alder Hey and supports the development of grant applications through statistical support, clinical trial design and costing. The Department of Research and Development support the department by management and governance of clinical trials.