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Advancing Pediatric Thyroid Care : The Child and Adolescent Thyroid Consortium (CATC)

Dr. Pesce

Thyroid disorders can affect individuals of any age, including teenagers, children, and infants. Pediatric thyroid disorders can include hypothyroidism (low thyroid hormone levels), hyperthyroidism (excessive thyroid hormone levels), thyroid nodules (growths on the thyroid), and even thyroid cancer. Dr. Liuska Pesce, a pediatric endocrinologist and faculty member of our division, is a thyroid expert focused on providing the best treatments for these conditions in young patients. She is a member of the Child and Adolescent Thyroid Consortium (CATC – click for website). This consortium is a collaboration of leading pediatric thyroid specialists across the country who have the goal of “improving outcomes for children and adolescents with thyroid disease” especially through synergistic research across institutions. Of the 20 member CATC hospitals in the USA, only three are not located in states on the east or west coast. We are fortunate at the University of Iowa Stead Family Children’s Hospital to have a specialist like Dr. Pesce who has devoted her career to compassionate and expert medical care of pediatric thyroid disorders.

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Thyroid Eye Disease in Youth

Dr. Pesce

We have known for a long time that thyroid conditions can be linked to eye problems. This usually happens when someone has hyperthyroidism, especially if it is caused by Graves disease. The various eye problems associated thyroid dysfunction are collectively called “thyroid eye disease”. Sometimes, especially with Graves disease, the muscles behind the eye can become thickened and inflamed. One challenge is that thyroid eye disease has not been as well studied in children compared to adults. To learn more, Dr. Pesce from our Division teamed up with several ophthalmologists from the University of Iowa. They used ultrasound to examine the eye muscles of 20 children with thyroid disease. Most of the 20 children had Graves disease. Nearly all the children had abnormal enlargement of the eye muscles. Importantly, it was not possible to determine the severity of the enlargement from symptoms alone in children under 10 years of age. This suggests that referral to a pediatric ophthalmologist with thyroid eye disease expertise should be considered in young children with Graves disease. The article can be found on Pubmed at this link.

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Using a Scribe to Improve Outpatient Physician Care.

  • Dr. Kanner
  • Dr. Pesce

Endocrine conditions are generally treated at home. Treatment can be complicated. A major purpose of appointments with the endocrinologist is to learn more about treatment. Often, a personalized plan is needed, depending on one’s daily schedules and activities. As a result, visits to the endocrinologist often involve numerous suggestions and details. Recording all of these details into the medical record can be difficult and time consuming. Two physicians in our Division participated in a pilot project whereby a scribe accompanied the physician during outpatient visits with the purpose of documenting the discussions and details. The results from this pilot project have now been published. The findings indicate that scribes have variable impact on visit times and physician charting burden, with improvements seen in one sub-specialty (developmental-behavioral pediatrics) but not another (pediatric endocrinology) . Patient satisfaction was equally high (>95%) with or without scribes. Two physicians from our Division, Dr. Kanner and Dr. Pesce contributed to the project and published manuscript. The paper is entitled “The Value of Adding Scribe Services to Two Distinct Pediatric Subspecialties in the Era of the Electronic Medical Record” and is being published in the journal Clinical Pediatrics. The manuscript’s abstract can be found at Pubmed (link).

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Iowa Well Represented at National Pediatric Endocrine Society Meeting

The Pediatric Endocrine Society (PES) is a professional organization of over 1,600 endocrinologists with the purpose of advancing treatment of youth with endocrine disorders. The PES held its annual meeting May 5-8 in San Diego. Several of our division faculty attended the meeting. Dr. Pesce presented at one of the symposium session on Endocrinology in the Neonatal Intensive Care Unit. Dr. Parra Villasmil presenter her research, conducted under the mentorship of Dr. Pinnaro, on Screening for Turner Syndrome-associated Hyperglycemia. Dr. Parra Villasmil’s work was selected as one of the top-ranking abstracts, receiving a PES Presidential Poster award. In addition, our future fellow, Dr. Kyle Baum, currently a pediatric resident at Sanford School of Medicine, also had an abstract selected for a PES Presidential Poster award.

Dr. Pesce presenting at PES 2023
Dr. Parra Villasmil at PES 2023

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Dr. Pesce Recognized for her Outstanding Clinical Teaching

Dr. Pesce

Dr. Liuska Pesce is being recognized by the Carver College of Medicine for outstanding teaching. Today she is receiving the Collegiate Teaching Award. This award is given to recognize teaching that demonstrates unusually significant and meritorious achievement. The Award includes a plaque and monetary bonus. Those who have trained under her have many laudatory statements, including the following anonymous comment: “Dr. Pesce is the Mary-Poppins of physicians, ‘practically perfect in every way.’ She is an excellent teacher with clear explanations behind her thought processes which are always guided by best practices. She is very professional and thorough in all of her patient interactions and examinations. She provides excellent and timely feedback on presentations, physical exam findings, and clinical notes. She goes out of her way to ensure learners get the feedback they need.” Dr. Pesce is also involved in educational efforts at the national level, for example having just contributed as an author to this educational material “Pediatric ESAP 2023-2024: Pediatric Endocrine Self-Assessment Program. Washington, DC: Endocrine Society; 2023.”

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Patient Choice Award Recipients

We are pleased to report that 6 of the pediatric endocrinology providers in our division have received Patient Choice Awards. These awards are given out by UI Health Care to recognize physicians for consistently providing patients with an excellent healthcare experience. The recipient physicians were:

  • Lauren Kanner
  • Katie Larson Ode
  • Julie Osterhaus
  • Liuska Pesce
  • Catherina Pinnaro
  • Mike Tansey

The Award was given to only 174 providers across the entire institution. The Award recognizes those who scored in the top 10% nationally in response to patient surveys asking whether the physician showed concern for patient questions or worries, gave explanations about problem or condition, made efforts to include the patient in care decisions, discussed proposed treatments (options, risks, benefits, etc), and whether they would be likely to recommend the care provider to others. Our division is fortunate to have these Award winning physicians on our team. We thank each of them for their wonderful work. Find more about the awards at this link.

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Patient Choice Award Recipients

We are pleased to report that 6 of the pediatric endocrinology physicians in our division have received Patient Choice Awards. These awards are given out by UI Health Care to recognize physicians for consistently providing patients with an excellent healthcare experience. The recipient physicians were:

  • Lauren Kanner
  • Katie Larson Ode
  • Liuska Pesce
  • Catherina Pinnaro
  • Mike Tansey
  • Eva Tsalikian

The Award was given to only 156 providers across the entire institution. The Award recognizes those who scored in the top 10% nationally in response to patient surveys asking whether the physician showed concern for patient questions or worries, gave explanations about problem or condition, made efforts to include the patient in care decisions, discussed proposed treatments (options, risks, benefits, etc), and whether they would be likely to recommend the care provider to others. Our division is fortunate to have these Award winning physicians on our team. We thank each of them for their wonderful work. Find more about the awards at this link.

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Dr. Pesce and the University of Iowa Pediatric Thyroid Clinic join the Child and Adolescent Thyroid Consortium (CATC)

Dr. Pesce

Infants, children and adolescents sometimes suffer from a wide range of thyroid disorders. Examples of thyroid conditions experienced by children include hypothyroidism (low thyroid hormone levels), hyperthyroidism (elevated thyroid hormone levels), goiter (enlarged thyroid), thyroid nodules (growths on the thyroid) and thyroid cancer. Pediatric endocrinologist Dr. Liuska Pesce has devoted her career to the treatment of children with these conditions. She has developed a national reputation as a caring and adept physician for pediatric thyroid care. To help develop even better treatments for thyroid conditions, she has now joined a collaborative effort of the leading pediatric thyroid groups across the country. The collaboration is called the Child and Adolescent Thyroid Consortium (CATC). The consortium has the goal of improving knowledge of thyroid disease and identifying ways to improve thyroid disease care for children and adolescents. The consortium member centers include the Children’s Hospital of Philadelphia, Boston Children’s Hospital, Yale University, MD Anderson, and the Hospital for Sick Children in Toronto, all leading institutions. Congratulations to Dr. Pesce for joining this rarefied group and we wish them success in their quest for better treatments.

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Dr. Pesce Appointed to the American Thyroid Association’s Board of Directors

Dr. Pesce

The American Thyroid Association (ATA; link) is arguably the leading organization worldwide dedicated to advancing care of persons with thyroid disorders through research, education, and promotion of clinical excellence. Dr. Liuska Pesce, of the pediatric endocrinologists in our division, has now been named to the ATA’s Board of Directors. As such, she will serve to help guide the ATA as they seek to improve thyroid care. Dr. Pesce has long-standing expertise in thyroid disorders and their treatment. She trained in part under the mentorship renowned thyroid-researcher Peter Kopp. Dr. Pesce joined the faculty at the University of Iowa Stead Family Department of Pediatrics in 2008. Here, she has established herself a leading expert in treatment of pediatric thyroid disorders including hypothyroidism, hyperthyroidism, thyroid hormone resistance, and thyroid cancers. We are enthused that she will share her expertise with the ATA.

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Center of Excellence for Care of Pheochromocytoma and Paraganglioma.

Dr. Pesce

The University of Iowa Hospitals and Clinics has been designated a Center of Excellence for Care of patients with Pheochromocytoma and Paraganglioma. There are only 6 such other centers across the United States. The designation comes from the Pheo Para Alliance, which is a leader in advocacy regarding patients with pheochromocytoma and paraganglioma. Pheochromocytomas and paragangliomas are neuroendocrine tumors that secrete adrenaline-like hormones. The tumors can usually be successfully treated, but require careful expert care to avoid severe complications. Our center of excellence represents a multidisciplinary collaboration between pediatric endocrinology, adult endocrinology, oncologists, surgical specialists, and clinical genetics. A special thanks to Dr. Liuska Pesce, who is the pediatric endocrinologist for the Center. To learn more, visit the centers webportal.