The Italian Society of Pediatrics and gender medicine
Isabella Tarissi de Jacobis
Pediatric and Infectious Disease Unit, Bambino Gesù Children’s Hospital IRCCS, Rome, and Secretary of the Study Group on Gender Medicine in Pediatrics, Italian Society of Pediatrics
During the last national congress of the Italian Society of Pediatrics (SIP, Società Italiana di Pediatria ), held in Bologna from May 29 to June 1, 2019, the study group on gender medicine in pediatrics was formed, consisting of doctors who work in several different hospitals in our Country and who are interested in gender medicine and motivated to promote it also in the pediatric field.
The Italian network that deals with gender medicine has already been well formed and outlined for several years now, thanks to the work carried out by the National Study Center on Health and Gender Medicine , the Center for Gender-Specific Medicine of the Italian National Institute of Health and the Italian Health and Gender Group (GISeG).
SIP’s interest in gender medicine is part of this network, having the aim of promoting a new approach to medicine also in pediatrics, by paying more attention and giving more importance to the differences determined by sex and gender.
Also in the pediatric field, in fact, several conditions show differences between male and female with regard to the symptoms, the diagnostic pathways to follow, the therapeutic needs, the effectiveness of drugs and the prevalence and course of the disease.
Let’s consider, by way of example, the following two cases.
In Kawasaki disease – an acute systemic vasculitis affecting small- and medium-caliber vessels – gender has a role in the pathogenesis and course of the disease. More specifically, male gender represents a negative prognostic factor: in males, in fact, a higher incidence of the disease has been found, together with a superior resistance to therapy and a more frequent manifestation of cardiovascular complications. Therefore, it is important to recognize that male gender represents a risk factor for Kawasaki disease, which can also be explained in light of the recent evidence on the different immune responses between the two sexes, already present in children.
Also in bronchiolitis – an acute i nfection of the lower respiratory tract with a viral etiology – gender-related differences are described in the literature. The in cidence of bronchiolitis is higher in males, but the inflammatory response in females shows higher levels of inflammatory indexes. From a clinical point of view, sex acts as a modulating factor on the duration of the oxygen therapy, which is differentiated depending on the etiological agent involved.
Much literature on gender differences is also available with regard to congenital heart disease (cases occurring in men are more serious), infectious diseases (with a higher incidence in men), vaccine response, autoimmune diseases (despite being less pronounced in children than in adults, they still show important differences between the two sexes), autism (more frequent in males) or idiopathic scoliosis (much more frequent in females).
Being able to prevent – thanks to a targeted screening – some of these conditions and to treat them in a more specific way, based on sex, would make it possible to reduce complications and improve prognosis.
On January 31, 2020, the SIP branch of the Veneto Region organized a congress on gender pediatrics, which will certainly be followed by others. The creation, within the SIP, of a national study group has therefore the objective of expanding the patient case history and creating a network of specialists who can work together on several fronts, in order to expand the pathophysiological knowledge underlying these differences and ensure a correct application of gender pediatrics in clinical practice.