Endocrinology

Endocrinology Section Services

Inpatient

The section is committed to provide consultation services to the University Pediatric Hospital 24 hours a day, 7 days a week.  Transfers are accepted from the entire island of Puerto Rico and from the Virgin Islands.

Outpatient

Services are provided at the University Pediatric Hospital Continuity Clinics twice in a week throughout the year but July.  Pediatric endocrine trained nurse performs stimulation tests to assess for hormonal disorders.

Conditions treated include:

Adrenal disorders

Ambiguous genitalia

Congenital hypothyroidism, hyperthyroidism (Graves’ disease), thyroid cancer and other thyroid disorders

Diabetes Insipidus and syndrome of inappropriate antidiuretic hormone secretion secretion (SIADH)

Diabetes mellitus (type 1 and 2, and neonatal)

Endocrine complications of cancer

Glycogen storage disease

Growth disorders (e.g., growth hormone deficiency, short stature)

Hypercalcemia and hypocalcemia

Hypoglycemia (newborn and older children)

Hypopituitarism

Metabolic bone diseases (e.g., rickets, low bone mass and osteopenia/osteoporosis)

Obesity

Pheochromocytoma

Pituitary tumors (e.g., craniopharyngiomas)

Precocious puberty and delayed puberty (e.g., Turner and Klinefelter syndromes)

Premature adrenarche

Premature thelarche

Contact:

Appointments: 787-777-3535 ext. 7286/7287

Francisco Nieves-Rivera, M.D. 787-756-4020

Endocrinology Section Research

Francisco Nieves-Rivera, M.D.

Professor

Department of Pediatrics

School of Medicine

University of Puerto Rico

Tel – 787-756-4020

francisco.nieves2@upr.edu

Research

The section is committed to participate in research in endocrinology and diabetes with special interest in those related to Hispanics and Puerto  Ricans.

We are currently studying our pediatric population with adrenal hyperplasia.  These to be obtain from the PR Neonatal Screening repository database and records.  The study would allow us to determine incidence and prevalence of CAH in PR.  Second, it would also allow us to compare our data against other populations, our second aim.

Publications

Books

1. Rogol A.D., Link K., Romero G., Ball M., Martha Jr., P.M., Mauras N., Parker M., Nieves-Rivera F., Blizzard R.M. Alterations in growth hormone release during pubertal development in boys. In: Grave GD, Cutler GB, eds.  Sexual Precocity:  Etiology, Diagnosis, and Management.  New York: Raven Press Ltd; 1993:121-131.
2. Silva Frieda, Nieves-Rivera Francisco, Laguna Reinaldo. Chapter 8 Thyroid cancer in the pediatric population. In: Fahey TJ, ed. Updates in the understanding and management of thyroid cancer. In Tech; March 2012:189-198

Articles

1. Nieves-Rivera F., Pumarejo M.M., Villavicencio R. Kawasaki disease:  Management guidelines.  Asoc. Med. P. Rico. 80:51-53, 1988.
2. Nieves-Rivera F., Kerrigan J.R., Krieg Jr. R., et al. Altered growth hormone (GH) secretion in vivo and in vitro in the diabetes-prone BB/Worcester rat.  Growth Regulation. 3:235-244, 1993.
3. Nieves-Rivera F., Rogol A.D., Veldhuis J.D., Branscom D.K., Martha, Jr. P.M., Clarke W.L. Alterations in growth hormone secretion and clearance in adolescent boys with insulin-dependent diabetes mellitus.  J Clin Endocrinol Metab 77:638-643, 1993.
4. Nieves-Rivera F., González-Pijem L. Primary hyperparathyroidism:  An unusual cause of pancreatitis in adolescence.  PR Health Sci J 14:233-236, 1995.
5. Clark P.A., Clarke W.L., Pedadda S., Reiss A., Langlois C., Nieves-Rivera F., Rogol A.D. The effects of pubertal status and glycemic control on the growth hormone-IGF-I axis in boys with insulin-dependent diabetes mellitus.  J Pediatr Endocrinol Metab 11(3):427-435, 1998.
6. Nieves-Rivera F., González-Pijem L., Mirabal B. Reversible growth among Hispanic children:  Instances of psychosocial short stature .  PR Health Sci J 17:107-112, 1998.
7. González-Pijem L., Nieves-Rivera F. Insulin autoantibodies:  Evidence of autoimmune disease among a group of Puerto Rican children with newly diagnosed type 1 diabetes mellitus.  PR Health Sci J 20(2):161-164, 2001.
8. Fournier J.R., Báez-Trinidad L., Acosta A., Marrero M., Correa-Rivas M., Rodríguez-Becerra J., Nieves-Rivera F. Bladder pheochromocytoma: Case preentation and the use of OctreoScan^® for localization of extra-adrenal tumor sites in a pediatric patient.  PR Health Sci J 27:107-111, 2008.
9. Nieves-Rivera F. and González-Pijem L. Developmental sex disorders: Brief review on current ethical aspects.  Asoc. Med. P. Rico. 100:47-51, 2008.
10. Silva F, Laguna R, Nieves-Rivera F, Negrón J. Pediatric thyroid cancer with extensive disease in a Hispanic population: Outcome and long-term survival. J Ped Endo Metabol 23:59-64, 2010.
11. Nieves-Rivera F and González-Pijem L. Neonatal diabetes mellitus: Description of two Puertorrican children with KCNJ11 activating gene mutation (PR Health Sci 30(2):87-89, 2011)

Abstracts

1. Hall J.G., Pedden J.N., Blizzard R., Nieves-Rivera F., Christie M., Stephan M. Microcephalic osteodysplastic dwarfism – Majewski Type II.  David Smith Dysmorphology Meeting, August 1990.
2. Nieves-Rivera F., Rogol A.D., Ball M., Clarke W.L. Altered circulating growth hormone (GH) patterns in adolescent boys with type I diabetes mellitus (IDDM).  Prog of Annual Meeting of the American Pediatric Society and the Society for Pediatric Research, New Orleans, LA. P197A, 1991.
3. Nieves-Rivera F., Kerrigan J.R., Krieg Jr. R.J., Evans W.S., Rogol A.D. Decreased circulating growth hormone (GH) levels in the diabetic rat:  Altered pituitary dynamics.  Prog of the 73^rd Meeting of the Endocrine Society, Washington, D.C. p80, 1991.
4. Egan J., Nieves-Rivera F., Trumees E., Booth Jr. R., Asplin C.M. Evidence of altered somatotropes sensitivity to somatostatin (SRIF) in the diabetic rat. Prog of the 73^rd Meeting of the Endocrine Society, Washington, D.C. p351, 1991.
5. Martha, Jr. P.M., Blizzard R.M., Nieves-Rivera F., Rogol A.D. The relationship among GH secretion, growth and body mass index examined longitudinally during normal puberty in boys.  Prog of the Annual Meeting of the American Pediatric Society and the Society for Pediatric Research, Baltimore, MD. p172A, 1992.
6. Nieves-Rivera F., Rogol A.D., Branscom D.K., Veldhuis J.D., Clarke W.L. Augmented somatotrope secretory activity in adolescent boys with type I diabetes mellitus in moderate control.  Annual Meeting of the American Diabetes Association, San Antonio, TX. P 224, 1992.
7. Nieves-Rivera F., (Sponsored: Clarke WL). Diminished hypothalamic growth hormone-releasing hormone gene expression in the BB/Worcester diabetic rat.  74^th Annual Meeting of the Endocrine Society, San Antonio, TX. P396, 1992.
8. Rogol A.D., Martha, Jr. P.M., Mauras N., Kerrigan J., Nieves-Rivera F., Ball M., Bishop M., Blizzard R. Effects of the sex steroids on GH secretion and growth.  International Congress on growth hormone and somatomedins during lifespan, Milan, Italy 1992.
9. González-Pijem L, Nieves-Rivera F., Wiscovitch A. Recovery of hypothalamic-pituitary-gonadal axis in nine girls with central precocious puberty treated with leuprolide acetate (GnRHa).  Eight Annual Meeting of the North American Society for Pediatric and Adolescent Gynecology, Atlanta, GA, 1994.
10. González-Pijem L., Nieves-Rivera F., Wiscovitch A. Final height in a cohort of Hispanic children with central precocious puberty treated with a GnRH analogue. Prog of the Annual American Pediatric Society and the Society for Pediatric Research, Seattle, WA. P99A, 1994.
11. Schwarz S, Nieves-Rivera F. Pitfalls in the diagnosis of congenital adrenal hyperplasia.  Sixteenth Annual Research Forum at the University of Puerto Rico, Medical Sciences Campus, San Juan, PR 1995 (published in PR Health Sci J 14:170, 1995).
12. Nieves-Rivera F., González-Pijem L, Mirabal B. Three Puerto Rican children with growth hormone deficiency-like state secondary to psychosocial short stature. Eighteenth Annual Research Forum at the University of Puerto Rico, Medical Sciences Campus, San Juan, PR p 94, 1997.
13. González A, Concepción C, Nieves-Rivera F., Valcárcel M. Microphallus and hypoglycemia:  Hallmark of hypopituitarism in the newborn period. Eighteenth Annual Research Forum at the University of Puerto Rico, Medical Sciences Campus, San Juan, PR p 94, 1997.
14. González-Pijem L, Nieves-Rivera F., Arroyo I. Musculoskeletal anomalies in girls with Turner syndrome treated with recombinant growth hormone.  79^th Annual Meeting of the Endocrine Society, Minneapolis, MN p 160, 1997.
15. Nieves-Rivera F., González-Pijem L., Navarro L.N. Alternatives to enhance survival skills’ knowledge.  Sixteenth International Diabetes Federation Congress, Helsinki, Finland p 622A, 1997.
16. Nieves-Rivera F., González-Pijem L, Valcárcel M, Reyes G., Concepción C.B. Low frequency of rickets and fractures among very low birth weight infants born in Puerto Rico.  Prog of the Annual American Pediatric Society and the Society for Pediatric Research, New Orleans, LA p266A, 1998.
17. Nieves-Rivera F., González-Pijem L. Rickets secondary to vitamin D deficiency:  An uncommon disease that still could happen nowdays.  Nineteenth Annual Research Forum at the University of Puerto Rico, Medical Sciences Campus, San Juan, PR p 50, 1998.
18. Nieves-Rivera F., González-Pijem L. Growth Failure:  Hallmark of Cushing’s syndrome in childhood.  Twentieth Annual Research Forum at the University of Puerto Rico, Medical Sciences Campus, San Juan, PR, 1999.
19. González-Pijem L, Nieves-Rivera F. Predicted height underestimated among a cohort of Hispanic children treated with growth hormone.  81^st Annual meeting of the Endocrine Society, San Diego, CA, 1999.
20. Loza-Ruiz S., Colón V., González-Pijem L, Nieves-Rivera F. Final height standard deviation score for height improved among a cohort of Hispanic children treated with growth hormone. Twenty-first Annual Research Forum at the University of Puerto Rico, Medical Sciences Campus, San Juan, PR, 2000.
21. Gotay F., Nieves-Rivera F., López A, Fernández-Seín A, González-Pijem L. Diabetic ketoacidosis:  Stilla challenge to the intensivist .  Twenty-first Annual Research Forum at the University of Puerto Rico, Medical Sciences Campus, San Juan, PR, 2000.
22. Nieves-Rivera F., González-Pijem L., Concepción C.B., Rodríguez L., Valcárcel M. Neonatal persistent tachycardia:  Hallmark of neonatal’s Graves’ disease. Twenty-first Annual Research Forum at the University of Puerto Rico, Medical Sciences Campus, San Juan, PR, 2000.
23. Nieves-Rivera F., Alicea MN, Lugo-Pérez M., Rivera M.A., González-Pijem L. CEBNAD:  An instance of group support for children and adolescents with type 1 diabetes.  Seventeenth International Diabetes Federation Congress, Mexico, p1609, 2000.
24. Lliteras-Colón O., Nieves-Rivera F., González-Pijem L. Improved predicted-adult-height in a cohort of girls treated with gonadotropin-releasing hormone analogue. Twenty-second Annual Research Forum at the University of Puerto Rico, Medical Sciences Campus, San Juan, PR, 2001.
25. Fernández-Repollet E., Meléndez J., González-Pijem L, Nieves-Rivera F., Lenkei R., Vogt R., Schwartz A. Quantification of T-cells CD95 expression in Puerto Rican children with type 1 diabetes mellitus. Annual Meeting of the American Diabetes Association, Philadelphia, PA. pA259, 2001.
26. Nieves-Rivera F., Avilés T, González-Pijem L. Thyroid function imaging studies:  Should it be done on Hashimoto’s thyroiditis?  83^rd Annual Meeting of the Endocrine Society, Denver, CO, p272, 2001.
27. Nieves-Rivera F., Avilés T, González-Pijem L. Intersex:  A novel approach to sex assignment.  84^th Annual Meeting of the Endocrine Society, San Fco., CA, p714, 2002.
28. Nieves-Rivera F., Rodríguez-Santana J.R., Silva F., Márquez E., González-Pijem L.  Metastatic papillary thyroid cancer:  An infrequent presentation during childhood.  Twenty-third Annual Research and Educational Forum, University of Puerto Rico, Medical Sciences Campus, San Juan, PR, 2003.
29. Nieves-Rivera F., Báez L, Marrero M, González-Pijem L.  Diltiazem as an effective therapy in preparation for pheocromocytma surgery.  Twenty-fifth Medical Sciences Campus Annual Research and Educational Forum, University of Puerto Rico, Medical Sciences Campus, San Juan, PR, 2005.
30. Silva F, Olmo A, Laguna R, Nieves-Rivera F., Negrón JA, Mercado Z. Report of the evaluation, treatment outcome and survival of well differentiated thyroid cancer in a hispanic pediatric population.  52^nd Society of Nuclear Medicine Annual Meeting, Toronto, Canada, 2005.
31. Nieves-Rivera F., González-Pijem L., Navarro LN., Lugo-Pérez M. Neonatal Diabetes Mellitus Secondary to an Activating Mutation in the K_ir2 Gene in a Puerto Rican Child Successfully Switched to an Oral Hypoglycemic Agent. 90^th Annual Meeting of the Endocrine Society, San Francisco, CA, p375, 2008.
32. Rivera-Vega Michelle Y., Nieves-Rivera F. Effect of growth hormone treatment on the final height of children with growth hormone deficiency.  Thirty-first Medical Sciences Campus Annual Research and Educational Forum, University of Puerto Rico, Medical Sciences Campus, San Juan, PR, 2011.
33. Ruiz Marina, Nieves-Rivera F. Outcomes of Puerto Rican girls with central precocious puberty treated with leuprolide (Lupron^®) and followed at the UPH endocrinology clinics.  Thirty-second Medical Sciences Campus Annual Research and Educational Forum, University of Puerto Rico, Medical Sciences Campus, San Juan, PR, 2012.
34. Nieves-Rivera F, Henriquéz-Marrero N, Cruz-Tirado E, González-Pijem l. Ten years of neonatal screening for congenital adrenal hyperplasia in PR:  Is investment really worth?  16^th International Congress of Endocrinology & 96^th Annual Meeting of the Endocrine Society, Chicago, IL, 445, 2014.
35. Nieves-Rivera F, Santiago-Borrero PJ, Rivera-Sánchez S. Enhanced capability to identify non-affected newborns with congenital adrenal hyperplasia by fluoroimmunoassay in a neonatal screening program.  Thirty-fifth Medical Sciences Campus Annual Research and Educational Forum, University of Puerto Rico, Medical Sciences Campus, San Juan, PR, 2015.