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The work of this book continues to stimulate positive personal and professional reflection—on the complexity, advancement, and expansion of our field of pediatric endocrinology, on the insights of countless brilliant contributors to this progress, on the joy and privilege of caring for children, and on the satisfaction of collaborating with such wonderful and talented colleagues: Kristen J. Nadeau, Michael Kappy, Mitch Geffner, and our contributing authors.

For inspiration, I am most indebted to my father, Richard Allen, a dedicated pediatrician in the truest and most profound sense of the word. In spite of my efforts to take a different path, the example he provided in caring for children brought me back to medicine, and then to pediatrics. For whatever perspective and humility I do have, I give thanks to my mother, Joyce, the most centered and loving individual I have ever known. And for everything else, I thank my wife, Sally, who has unselfishly and constantly supported and encouraged me for over 40 years; and my children, Brittany, Doug, and Nick, and now grandchildren Rory and Tess, who provide immeasurable love and joy and the motivation always to do my best.

Professionally, I first acknowledge the generous spirit of Dr. Robert Blizzard for his invaluable advice and support early in my career. I also thank Ann Johanson, Ron Rosenfeld, Ed Reiter, Alan Rogol, Barbara Lippe, Peter Lee, Lew Barness, and Ken Copeland, who have inspired and encouraged me to seek academic and leadership challenges. I am indebted to my University of Wisconsin mentors and colleagues Norm Fost and Aaron Friedman, who instilled in me a love for critical thinking and the importance of challenging conventional wisdom. This work is also dedicated to the memory of Todd Varness, a cherished friend and junior colleague. And finally, a sincere thank you to my University of Wisconsin Endocrinology and Diabetes Division coworkers—Ellen Connor, Aaron Carrel, Tracy Bekx, Jennifer Rehm, and Allison Pollock—who make work in the real world so much fun, and without whose patience and support I could not have pursued so many opportunities.

Nearly 35 years ago, the specialty of pediatric endocrinology captivated my interest because of its elegance, diversity, mystery, and intrinsically pediatric focus on the changes of childhood and adolescence. My hope for this book is that it both captures and conveys these qualities for the reader.


David B. Allen, MD


I would like to thank my co-editors, Drs. Michael Kappy, David Allen, and Mitch Geffner for the unique opportunity to work on this project together. Of note, I would like to give a special thank you to Dr. Allen, who started my interest in pediatric endocrinology while I was an undergraduate student at the University of Wisconsin, Madison when I heard his dynamic point/counterpoint on medical ethics in endocrinology along with Dr. Norman Fost, and the continued inspiration while doing pediatric rotations as a medical student at the University of Wisconsin Medical School.

Professionally, I would first like to acknowledge Drs. Michael Kappy and Philip Zeitler. They were the division head/fellowship director during my fellowship and early training, and Dr. Zeitler remains my current division head. I am incredibly lucky for the opportunities I have been given under their leadership and am blessed to be working in a wonderful Pediatric Endocrinology division with such supportive colleagues at the University of Colorado. I am indebted to my research mentors, Dr. Boris Draznin, Dr. Jane Reusch, Dr. Judith Regensteiner, and Dr. Philip Zeitler. These role models instilled me with a passion for inquiry and discovery and were always available for discussions, support, have tirelessly read and given feedback on countless manuscripts and grants and to advocate on by behalf. I am also indebted to Dr. Georgeanna Klingensmith who was a caring and impactful senior female role model at the earliest stages of my career. I am indebted to the University of Colorado and Children’s Hospital Colorado clinical and research staff, my clinical and research colleagues, my patients and research participants, as well as to the investigators, participants, and staff of the TODAY, RISE, STOPPING-GDM, PEDAL, RESISTANT, EMERALD. Bromocriptine, IMPROVE and STOMP studies and to the NIDDK, NLHBI, JDRF, and ADA for supporting diabetes and obesity research. I am also inspired and grateful to all of my mentees, who infuse creativity into our work, push me to keep up-to-date with their amazing questions and give me hope for the future. I would like to thank the women of my ELAM learning community for the start of what I can already tell will be lifelong friendships. Finally, I would like to thank all of the past, present, and future members of the American Academy of Pediatrics Committee on Native American Child Health (CONACH) for the uplifting opportunity to work with this incredible group and for their tireless efforts to improve the health of Native American and Alaska Native youth.

Personally, I would like to thank my mother JoAnn Nadeau and my father Robert Nadeau for instilling in me a strong work ethic, the priority to live simply and give to those in need, the love of learning and a large and wonderful extended family. I would like to thank my mother-in-law Kathy Kulig and my father-in-law John Kulig for welcoming me into their family and an enormous thank you to my husband Clark Kulig, a transplant hepatologist who helps his patients realize life is worth living again, for introducing to me the love of travel, languages, and the great outdoors. My hopes and dreams I give to my three incredible children, Kalina, Cassie, and Orion, who are the source of smiles, music, and laughter in my life and who never cease to amaze me.

My wish for this book is that it inspires trainees and learners with the passion to help improve the lives of youth.


Kristen J. Nadeau, MD, MS


Once again, we get to acknowledge those mentors, colleagues, family members, and friends, whose influence in our lives is inestimable. I would like to begin by expressing my gratitude for the support given to me over many years by my parents, Jack and Lil; my wife, Peggy; my sons, Doug and Greg, his wife Alice; my granddaughters, Samantha and Summer; my grandson, Leo; my brother, David; and my sister, Ellen and her husband, Joe. Other family members to thank are my brothers-in-law, Joe Suckiel and Jay Markson, and the entire Markson family.

Of the many wonderful mentors and colleagues with whom I have worked for over 60 years, I particularly thank the following for guidance and support at various times in my life: Lennie Lacara, Saul Chavkin, Yvonne Brackbill, Kenneth Monty, Harry Harlow, Harry Waisman, Robert Metzenberg, Alvin Berman, Willam Middleton, Henry Kempe, Henry Silver, Vince Fulginiti, Grant Morrow, Claude Migeon, Bob Blizzard, Harold and Helen Harrison, Phil Zeitler, and Elmer “Whitey” Lightner. A special thanks to Jules Amer, Irwin Redlener, Lew Barness, and Enid Gilbert-Barness for their guidance and friendship. In particular, I would like to dedicate this edition once again to my grandson, Leo M. Kappy—a hope for the future.

It goes without saying that this edition would not have been possible without the incredibly valuable collaboration and support given freely for many years by David Allen and Mitch Geffner. There are many other colleagues and friends who I would like to acknowledge, but space limitations exist. To all of you, you know who you are, thank you. I will be departing as a co-editor of this textbook after this edition, 30 years after the planning of Wilkins’ 4th edition with Drs. Blizzard and Migeon.


Michael S. Kappy, MD, PhD


I have just completed yet another professional thrill ride working with my close friends, Mike Kappy and Dave Allen, on our fourth endeavor (third for McGraw Hill) into the world of textbook writing. Their endless knowledge, strong work ethic, and unyielding camaraderie are unmatched. Our newest partner, Kristen J. Nadeau, is no different.

Once again, I can see that editing and language are key essentials to the art of creating a textbook, talents for which my father (high school chemistry teacher and review book writer) and mother (high school French teacher) must be commended for providing the impetus (and genetics).

In my preface to our first textbook and in the first edition of this book, I acknowledged the many mentors, colleagues, and trainees who had inspired me to that point. The newest on this list are fellows Christina Southern Reh, Karen Huang, Amy Vedin, Parisa Salehi, and Maria LinErin Shih, Isabel Hsu, Anna Ryabets-Lienhard, Cedric Ng, Monica Serrano-Gonzalez, Jessie Ferris, Patrick Shepherd, Alaina Vidmar, Jonathan Weber, Sara Akhtar Ali, and Marwan Bakhach. I also remain indebted to Rob Rapaport, who is such a superb physician, scientist, and, most importantly, friend. I would also like to dedicate my portion of the new edition to Dr. Sol Kaplan, one of my two guiding lights in my early years, who has since passed away. The other, Dr. Barbara Lippe, is my long-standing first mentor in the field, lifelong professional colleague, and personal friend whose inspiration and passion for learning and caring have left an indelible mark on me. As I have in the past, I would again like to pay special tribute to four people who, tragically, met untimely deaths and who had major impacts in my professional life: Dave Golde (mentor), Joao Antunes (international scholar), Alan Herschenfeld (fellow), and Doug Frasier, the person who first piqued my interest in the field of pediatric endocrinology way back in 1976.

But not to dwell on the obvious, I would never have had the opportunity to write this book or to have had any professional success were it not for the unwavering support of my family. My wife, Andrea, has been my rock and my children, Jenny and Eric, have always been there for me. I also want to acknowledge my daughter-in-law, Ashley, and my son-in-law, Neil Rosenberg. Lastly, the future resides in the newest generation and, for me, that is my (incredibly grand) grandson, Brady Rosenberg. I am so fortunate to have them all in my life.


Mitchell E. Geffner, MD

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