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Vlaardingerbroek H, Joustra SD, Oostdijk W, de Bruin C, Wit JM. Assessment of Nutritional Status in the Diagnostic Evaluation of the Child with Growth Failure. Horm Res Paediatr 2023; 97:11-21. [PMID: 37054683 DOI: 10.1159/000530644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 03/23/2023] [Indexed: 04/15/2023] Open
Abstract
Current clinical guidelines provide information about the diagnostic workup of children with growth failure. This mini-review focuses on the nutritional assessment, which has received relatively little attention in such guidelines. The past medical history, in particular a low birth size and early feeding problems, can provide information that can increase the likelihood of nutritional deficits or several genetic causes. The current medical history should include a dietary history and can thereby reveal a poorly planned or severely restricted diet, which can be associated with nutritional deficiencies. Children on a vegan diet should receive various nutritional supplements, but insufficient compliance has been reported in one-third of cases. While proper use of nutritional supplements in children consuming a vegan diet appears to be associated with normal growth and development, insufficient intake of supplements may impede growth and bone formation. Physical examination and analysis of height and weight over time can help differentiating between endocrine causes, gastrointestinal disorders, psychosocial problems, or underlying genetic conditions that prevent adequate nutritional intake. Laboratory screening should be part of the workup in every child with short stature, and further laboratory tests can be indicated if warranted by the dietary history, especially in children on a poorly planned vegan diet.
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Affiliation(s)
- Hester Vlaardingerbroek
- Division of Paediatric Endocrinology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Centre, Leiden, The Netherlands
| | - Sjoerd D Joustra
- Division of Paediatric Endocrinology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Centre, Leiden, The Netherlands
| | - Wilma Oostdijk
- Division of Paediatric Endocrinology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Centre, Leiden, The Netherlands
| | - Christiaan de Bruin
- Division of Paediatric Endocrinology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Centre, Leiden, The Netherlands
| | - Jan M Wit
- Division of Paediatric Endocrinology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Centre, Leiden, The Netherlands
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2
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Hoekx CA, Bresters D, le Cessie S, Oostdijk W, Hannema SE. Improved growth with growth hormone treatment in children after hematopoietic stem cell transplantation. Clin Endocrinol (Oxf) 2022; 97:596-603. [PMID: 35606687 PMCID: PMC9796667 DOI: 10.1111/cen.14782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/12/2022] [Accepted: 05/15/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Hematopoietic stem cell transplantation (HSCT) can be a curative treatment for malignant and nonmalignant diseases in children but is associated with significant late effects including growth failure. Growth hormone treatment (GHRx) is offered to improve growth, but limited data are available on its effect on adult height (AH). We aim to evaluate the effectiveness of GHRx. DESIGN Single-center retrospective study. PATIENTS Thirty-four patients who had received GHRx for ≥1 year were matched with two controls each, without GHRx, based on sex, indication for HSCT (malignancy, benign haematological disease or immunodeficiency), age at HSCT and conditioning with/without total body irradiation (TBI). All had reached AH. MEASUREMENTS The primary outcome measure was the difference between AH and predicted AH (PAH) at start of GHRx or the equivalent age in controls (AH-PAH), calculated according to Bailey and Pinneau. RESULTS GHRx was started at age 12.0 ± 2.6 years; median treatment duration was 3.8 years (range 1.7-9.2). AH-PAH standard deviation score (SDS) was significantly higher in growth hormone (GH) treated boys (-0.5 ± 0.7 SDS) than in controls (-1.5 ± 1.0 SDS, p < .001). Girls also had a higher AH-PAH after GHRx (+0.5 ± 0.6 SDS) compared to controls (-0.2 SDS ±0.7, p < .01). AH remained approximately 2 SDS below target height (TH) in treated and untreated individuals. Among GH-treated children, AH-PAH was higher in those who had received busulfan-based compared to TBI-based conditioning. CONCLUSION GHRx had a significant positive effect on AH compared to PAH, although AH remained far below TH. Higher AH-PAH was observed in girls and in those conditioned without TBI.
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Affiliation(s)
- Carlijn A. Hoekx
- Department of PediatricsLeiden University Medical CentreLeidenthe Netherlands
| | - Dorine Bresters
- Department of PediatricsLeiden University Medical CentreLeidenthe Netherlands
- Princess Máxima Center for Pediatric OncologyUtrechtthe Netherlands
| | - Saskia le Cessie
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenthe Netherlands
| | - Wilma Oostdijk
- Department of PediatricsLeiden University Medical CentreLeidenthe Netherlands
| | - Sabine E. Hannema
- Department of PediatricsLeiden University Medical CentreLeidenthe Netherlands
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3
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Joustra SD, Kamp GA, Stalman SE, Donze SH, Losekoot M, Kant SG, de Bruin C, Oostdijk W, Wit JM. Novel Clinical Criteria Allow Detection of Short Stature Homeobox-Containing Gene Haploinsufficiency Caused by Either Gene or Enhancer Region Defects. Horm Res Paediatr 2020; 92:372-381. [PMID: 32344414 DOI: 10.1159/000507215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 03/11/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Short stature homeobox-containing gene (SHOX) haploinsufficiency is associated with short stature, Madelung deformity and mesomelia. Current clinical screening tools are based on patients with intragenic variants or deletions. However, recent discoveries showed that deletions of the enhancer elements are quite common. The majority of these patients show less body disproportion and respond better to recombinant human growth hormone treatment. We redefined clinical criteria for genetic analysis to facilitate detection of the full spectrum of SHOX haploinsufficiency. METHODS We analyzed 51 children with SHOX variants or deletions and 25 children with a deletion in its enhancer region. Data were compared to 277 children referred for suspicion of growth failure without endocrine or genetic pathology. RESULTS Only half of the patients with an enhancer region deletion fulfilled any of the current screening criteria. We propose new clinical criteria based on sitting height to height ratio >1 SDS or arm span ≥3 cm below height, with a sensitivity of 99%. When these criteria are combined with obligatory short stature, the sensitivity to detect SHOX haploinsufficiency is 68.1%, the specificity 80.6%, and the number needed to screen 21 patients. CONCLUSION Novel clinical criteria for screening for SHOX haploinsufficiency allow the detection of patients within the full genetic spectrum, that is, intragenic variants and enhancer region deletions.
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Affiliation(s)
- Sjoerd D Joustra
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands,
| | - Gerdine A Kamp
- Department of Pediatric Endocrinology, Tergooi Hospital, Blaricum, The Netherlands
| | - Susanne E Stalman
- Department of Pediatrics, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Stephany H Donze
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Dutch Growth Research Foundation, Rotterdam, The Netherlands
| | - Monique Losekoot
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Sarina G Kant
- Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Christiaan de Bruin
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Wilma Oostdijk
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Jan M Wit
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
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4
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Wit JM, Bidlingmaier M, de Bruin C, Oostdijk W. A Proposal for the Interpretation of Serum IGF-I Concentration as Part of Laboratory Screening in Children with Growth Failure. J Clin Res Pediatr Endocrinol 2020; 12:130-139. [PMID: 31842524 PMCID: PMC7291410 DOI: 10.4274/jcrpe.galenos.2019.2019.0176] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 12/14/2019] [Indexed: 02/07/2023] Open
Abstract
The serum insulin-like growth factor-I (IGF-I) concentration is commonly used as a screening tool for growth hormone deficiency (GHD), but there is no consensus on the cut-off limit of IGF-I standard deviation score (SDS) to perform GH stimulation tests for confirmation or exclusion of GHD. We argue that the cut-off limit is dependent on the clinical pre-test likelihood of GHD and propose a diagnostic strategy in which the cut-off limit varies between zero to -2 SDS.
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Affiliation(s)
- Jan M. Wit
- Leiden University Medical Center, Department of Paediatrics, Leiden, The Netherlands
| | - Martin Bidlingmaier
- Klinikum der Universität München, Medizinische Klinik und Poliklinik IV, Endocrine Research Laboratories, Munich, Germany
| | - Christiaan de Bruin
- Leiden University Medical Center, Department of Paediatrics, Leiden, The Netherlands
| | - Wilma Oostdijk
- Leiden University Medical Center, Department of Paediatrics, Leiden, The Netherlands
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Joustra SD, Roelfsema F, van Trotsenburg ASP, Schneider HJ, Kosilek RP, Kroon HM, Logan JG, Butterfield NC, Zhou X, Toufaily C, Bak B, Turgeon MO, Brûlé E, Steyn FJ, Gurnell M, Koulouri O, Le Tissier P, Fontanaud P, Bassett JHD, Williams GR, Oostdijk W, Wit JM, Pereira AM, Biermasz NR, Bernard DJ, Schoenmakers N. Response to Letter to the Editor: "IGSF1 Deficiency Results in Human and Murine Somatotrope Neurosecretory Hyperfunction". J Clin Endocrinol Metab 2020; 105:5811425. [PMID: 32211768 PMCID: PMC7159029 DOI: 10.1210/clinem/dgaa147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 03/21/2020] [Indexed: 11/23/2022]
Affiliation(s)
- Sjoerd D Joustra
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Netherlands
- Department of Pediatrics, Leiden University Medical Center, Leiden, Netherlands
- Correspondence and Reprint Requests: Sjoerd D. Joustra, MD, Department of Pediatrics, Leiden University Medical Center, Albinusdreef 2, 2333ZA Leiden, the Netherlands. E-mail:
| | - Ferdinand Roelfsema
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Netherlands
| | - A S Paul van Trotsenburg
- Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Endocrinology, Amsterdam, Netherlands
| | - Harald J Schneider
- Department of Endocrinology, Ludwig-Maximilians University, Munich, Germany
| | - Robert P Kosilek
- Department of Endocrinology, Ludwig-Maximilians University, Munich, Germany
| | - Herman M Kroon
- Department of Radiology, Leiden University Medical Center, Leiden, Netherlands
| | - John G Logan
- Molecular Endocrinology Laboratory, Department of Medicine, Imperial College London, London, UK
| | - Natalie C Butterfield
- Molecular Endocrinology Laboratory, Department of Medicine, Imperial College London, London, UK
| | - Xiang Zhou
- Department of Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Chirine Toufaily
- Department of Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Beata Bak
- Department of Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Marc-Olivier Turgeon
- Department of Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Emilie Brûlé
- Department of Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Frederik J Steyn
- The University of Queensland Centre for Clinical Research, Brisbane, Australia
| | - Mark Gurnell
- University of Cambridge Metabolic Research Laboratories, Wellcome Trust-Medical Research Council Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge, UK
| | - Olympia Koulouri
- University of Cambridge Metabolic Research Laboratories, Wellcome Trust-Medical Research Council Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge, UK
| | - Paul Le Tissier
- Centre for Integrative Physiology, University of Edinburgh, Edinburgh, UK
| | - Pierre Fontanaud
- CNRS, Institut de Génomique Fonctionnelle, INSERM, and Université de Montpellier, Montpellier, France
| | - J H Duncan Bassett
- Molecular Endocrinology Laboratory, Department of Medicine, Imperial College London, London, UK
| | - Graham R Williams
- Molecular Endocrinology Laboratory, Department of Medicine, Imperial College London, London, UK
| | - Wilma Oostdijk
- Department of Pediatrics, Leiden University Medical Center, Leiden, Netherlands
| | - Jan M Wit
- Department of Pediatrics, Leiden University Medical Center, Leiden, Netherlands
| | - Alberto M Pereira
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Netherlands
| | - Nienke R Biermasz
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Netherlands
| | - Daniel J Bernard
- Department of Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Nadia Schoenmakers
- University of Cambridge Metabolic Research Laboratories, Wellcome Trust-Medical Research Council Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge, UK
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Lauffer P, Wit JM, Oostdijk W, Mooij CF, Drewes NAJ, Kamp GA. [The diagnostic evaluation of tall stature in children]. Ned Tijdschr Geneeskd 2020; 164:D4529. [PMID: 32749791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In this case series, we describe four children and adolescents with tall stature or growth acceleration to illustrate the diagnostic evaluation of tall stature according to the new Paediatric Association of the Netherlands (NVK) Guideline on growth disorders. A 14-year-old girl with tall stature and a relatively late onset of puberty was diagnosed with idiopathic familial tall stature, and the patient decided not to opt for epiphysiodesis. A 14-year-old boy with prepubertal growth acceleration and a history of behavioural problems was diagnosed with Klinefelter syndrome. A 7-year-old boy with tall stature, arachnodactyly, pectus excavatum and lumbar scoliosis was diagnosed with Marfan syndrome. Finally, a 16-year-old girl with isolated progressive tall stature was diagnosed with growth hormone excess caused by a pituitary somatotroph adenoma. The most clinically relevant conditions associated with tall stature are Klinefelter and Marfan syndrome, and secondary growth disorders such as precocious puberty and growth hormone excess.
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Affiliation(s)
- Peter Lauffer
- Amsterdam UMC, Emma Kinderziekenhuis, afd. Kinderendocrinologie, Amsterdam
- Contact: Peter Lauffer
| | - Jan Maarten Wit
- Leids Universitair Medisch Centrum, afd. Kindergeneeskunde, Leiden
| | - Wilma Oostdijk
- Leids Universitair Medisch Centrum, afd. Kindergeneeskunde, Leiden
| | - Christiaan F Mooij
- Amsterdam UMC, Emma Kinderziekenhuis, afd. Kinderendocrinologie, Amsterdam
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Joustra SD, Roelfsema F, van Trotsenburg ASP, Schneider HJ, Kosilek RP, Kroon HM, Logan JG, Butterfield NC, Zhou X, Toufaily C, Bak B, Turgeon MO, Brûlé E, Steyn FJ, Gurnell M, Koulouri O, Le Tissier P, Fontanaud P, Duncan Bassett JH, Williams GR, Oostdijk W, Wit JM, Pereira AM, Biermasz NR, Bernard DJ, Schoenmakers N. IGSF1 Deficiency Results in Human and Murine Somatotrope Neurosecretory Hyperfunction. J Clin Endocrinol Metab 2020; 105:5606971. [PMID: 31650157 PMCID: PMC7108761 DOI: 10.1210/clinem/dgz093] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 10/03/2019] [Indexed: 12/11/2022]
Abstract
CONTEXT The X-linked immunoglobulin superfamily, member 1 (IGSF1), gene is highly expressed in the hypothalamus and in pituitary cells of the POU1F1 lineage. Human loss-of-function mutations in IGSF1 cause central hypothyroidism, hypoprolactinemia, and macroorchidism. Additionally, most affected adults exhibit higher than average IGF-1 levels and anecdotal reports describe acromegaloid features in older subjects. However, somatotrope function has not yet been formally evaluated in this condition. OBJECTIVE We aimed to evaluate the role of IGSF1 in human and murine somatotrope function. PATIENTS, DESIGN, AND SETTING We evaluated 21 adult males harboring hemizygous IGSF1 loss-of-function mutations for features of GH excess, in an academic clinical setting. MAIN OUTCOME MEASURES We compared biochemical and tissue markers of GH excess in patients and controls, including 24-hour GH profile studies in 7 patients. Parallel studies were undertaken in male Igsf1-deficient mice and wild-type littermates. RESULTS IGSF1-deficient adult male patients demonstrated acromegaloid facial features with increased head circumference as well as increased finger soft-tissue thickness. Median serum IGF-1 concentrations were elevated, and 24-hour GH profile studies confirmed 2- to 3-fold increased median basal, pulsatile, and total GH secretion. Male Igsf1-deficient mice also demonstrated features of GH excess with increased lean mass, organ size, and skeletal dimensions and elevated mean circulating IGF-1 and pituitary GH levels. CONCLUSIONS We demonstrate somatotrope neurosecretory hyperfunction in IGSF1-deficient humans and mice. These observations define a hitherto uncharacterized role for IGSF1 in somatotropes and indicate that patients with IGSF1 mutations should be evaluated for long-term consequences of increased GH exposure.
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Affiliation(s)
- Sjoerd D Joustra
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Netherlands
- Department of Pediatrics, Leiden University Medical Center, Leiden, Netherlands
- Correspondence and Reprint Requests: Nadia Schoenmakers, University of Cambridge Metabolic Research Laboratories, Level 4, Wellcome Trust-MRC Institute of Metabolic Science, Box 289, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 0QQ UK. E-mail:
| | - Ferdinand Roelfsema
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Netherlands
| | - A S Paul van Trotsenburg
- Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Endocrinology, Amsterdam, Netherlands
| | - Harald J Schneider
- Department of Endocrinology, Ludwig-Maximilians University, Munich, Germany
| | - Robert P Kosilek
- Department of Endocrinology, Ludwig-Maximilians University, Munich, Germany
| | - Herman M Kroon
- Department of Radiology, Leiden University Medical Center, Leiden, Netherlands
| | - John G Logan
- Molecular Endocrinology Laboratory, Department of Medicine, Imperial College London, London, UK
| | - Natalie C Butterfield
- Molecular Endocrinology Laboratory, Department of Medicine, Imperial College London, London, UK
| | - Xiang Zhou
- Departments of Anatomy and Cell Biology & Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Chirine Toufaily
- Departments of Anatomy and Cell Biology & Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Beata Bak
- Departments of Anatomy and Cell Biology & Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Marc-Olivier Turgeon
- Departments of Anatomy and Cell Biology & Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Emilie Brûlé
- Departments of Anatomy and Cell Biology & Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Frederik J Steyn
- The University of Queensland Centre for Clinical Research, Brisbane, Australia
| | - Mark Gurnell
- University of Cambridge Metabolic Research Laboratories, Wellcome Trust-Medical Research Council Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge CB2 0QQ UK
| | - Olympia Koulouri
- University of Cambridge Metabolic Research Laboratories, Wellcome Trust-Medical Research Council Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge CB2 0QQ UK
| | - Paul Le Tissier
- Centre for Integrative Physiology, University of Edinburgh, Edinburgh, UK
| | - Pierre Fontanaud
- CNRS, Institut de Génomique Fonctionnelle, INSERM, and Université de Montpellier, Montpellier, France
| | - J H Duncan Bassett
- Molecular Endocrinology Laboratory, Department of Medicine, Imperial College London, London, UK
| | - Graham R Williams
- Molecular Endocrinology Laboratory, Department of Medicine, Imperial College London, London, UK
| | - Wilma Oostdijk
- Department of Pediatrics, Leiden University Medical Center, Leiden, Netherlands
| | - Jan M Wit
- Department of Pediatrics, Leiden University Medical Center, Leiden, Netherlands
| | - Alberto M Pereira
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Netherlands
| | - Nienke R Biermasz
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Netherlands
| | - Daniel J Bernard
- Departments of Anatomy and Cell Biology & Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Nadia Schoenmakers
- University of Cambridge Metabolic Research Laboratories, Wellcome Trust-Medical Research Council Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge CB2 0QQ UK
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Lauffer P, Kamp GA, Menke LA, Wit JM, Oostdijk W. Towards a Rational and Efficient Diagnostic Approach in Children Referred for Tall Stature and/or Accelerated Growth to the General Paediatrician. Horm Res Paediatr 2020; 91:293-310. [PMID: 31302655 DOI: 10.1159/000500810] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 05/06/2019] [Indexed: 12/11/2022] Open
Abstract
Tall stature and/or accelerated growth (TS/AG) in a child can be the result of a primary or secondary growth disorder, but more frequently no cause can be found (idiopathic TS). The conditions with the most important therapeutic implications are Klinefelter syndrome, Marfan syndrome and secondary growth disorders such as precocious puberty, hyperthyroidism and growth hormone excess. We propose a diagnostic flow chart offering a systematic approach to evaluate children referred for TS/AG to the general paediatrician. Based on the incidence, prevalence and clinical features of medical conditions associated with TS/AG, we identified relevant clues for primary and secondary growth disorders that may be obtained from the medical history, physical evaluation, growth analysis and additional laboratory and genetic testing. In addition to obtaining a diagnosis, a further goal is to predict adult height based on growth pattern, pubertal development and skeletal maturation. We speculate that an improved diagnostic approach in addition to expanding use of genetic testing may increase the diagnostic yield and lower the age at diagnosis of children with a pathologic cause of TS/AG.
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Affiliation(s)
- Peter Lauffer
- Department of Paediatrics, Tergooi Hospital, Blaricum, The Netherlands,
| | - Gerdine A Kamp
- Department of Paediatrics, Tergooi Hospital, Blaricum, The Netherlands
| | - Leonie A Menke
- Department of Paediatrics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jan M Wit
- Department of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Wilma Oostdijk
- Department of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands
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Wit JM, Kamp GA, Oostdijk W. Towards a Rational and Efficient Diagnostic Approach in Children Referred for Growth Failure to the General Paediatrician. Horm Res Paediatr 2020; 91:223-240. [PMID: 31195397 DOI: 10.1159/000499915] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 03/25/2019] [Indexed: 11/19/2022] Open
Abstract
Based on a recent Dutch national guideline, we propose a structured stepwise diagnostic approach for children with growth failure (short stature and/or growth faltering), aiming at high sensitivity for pathologic causes at acceptable specificity. The first step is a detailed clinical assessment, aiming at obtaining relevant clinical clues from the medical history (including family history), physical examination (emphasising head circumference, body proportions and dysmorphic features) and assessment of the growth curve. The second step consists of screening: a radiograph of the hand and wrist (for bone age and assessment of anatomical abnormalities suggestive for a skeletal dysplasia) and laboratory tests aiming at detecting disorders that can present as isolated short stature (anaemia, growth hormone deficiency, hypothyroidism, coeliac disease, renal failure, metabolic bone diseases, renal tubular acidosis, inflammatory bowel disease, Turner syndrome [TS]). We advise molecular array analysis rather than conventional karyotyping for short girls because this detects not only TS but also copy number variants and uniparental isodisomy, increasing diagnostic yield at a lower cost. Third, in case of diagnostic clues for primary growth disorders, further specific testing for candidate genes or a hypothesis-free approach is indicated; suspicion of a secondary growth disorder warrants adequate further targeted testing.
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Affiliation(s)
- Jan M Wit
- Department of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands,
| | - Gerdine A Kamp
- Department of Paediatrics, Tergooi Hospital, Blaricum, The Netherlands
| | - Wilma Oostdijk
- Department of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands
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Kos S, Cobbaert CM, Kuijper TM, Oostdijk W, Hannema SE, Wit JM, Biermasz N, Ballieux BEPB. IGF-1 and IGF-1 SDS - fit for purpose? Eur J Endocrinol 2019; 181:L1-L4. [PMID: 31505458 DOI: 10.1530/eje-19-0458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 09/09/2019] [Indexed: 11/08/2022]
Affiliation(s)
- S Kos
- Department of Clinical Chemistry, Maasstad Hospital, Rotterdam, The Netherlands
| | - C M Cobbaert
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - T M Kuijper
- Department of Science, Maasstad Hospital, Rotterdam, The Netherlands
| | - W Oostdijk
- Department of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - S E Hannema
- Department of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - J M Wit
- Department of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - N Biermasz
- Division of Endocrinology and Center for Endocrine Tumours, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - B E P B Ballieux
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, The Netherlands
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Walenkamp MJE, Robers JML, Wit JM, Zandwijken GRJ, van Duyvenvoorde HA, Oostdijk W, Hokken-Koelega ACS, Kant SG, Losekoot M. Phenotypic Features and Response to GH Treatment of Patients With a Molecular Defect of the IGF-1 Receptor. J Clin Endocrinol Metab 2019; 104:3157-3171. [PMID: 30848790 DOI: 10.1210/jc.2018-02065] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 03/04/2019] [Indexed: 02/06/2023]
Abstract
CONTEXT The phenotype and response to GH treatment of children with an IGF1R defect is insufficiently known. OBJECTIVE To develop a clinical score for selecting children with short stature for genetic testing and evaluate the efficacy of treatment. DESIGN AND SETTING Case series with an IGF1R defect identified in a university genetic laboratory. PATIENTS AND INTERVENTIONS Of all patients with sufficient clinical data, 18 had (likely) pathogenic mutations (group 1) and 7 had 15q deletions including IGF1R (group 2); 19 patients were treated with GH. MAIN OUTCOME MEASURES Phenotype and response to GH treatment. RESULTS In groups 1 and 2, mean (range) birth weight, length, and head circumference (HC) SD scores (SDSs) were -2.1 (-3.7 to -0.4), -2.7 (-5.0 to -1.0), and -1.6 (-3.0 to 0.0), respectively. At presentation, height, HC, and serum IGF-1 SDSs were -3.0 (-5.5 to -1.7), -2.5 (-4.2 to -0.5), and +1.2 (-1.3 to 3.2), respectively. Feeding problems were reported in 15 of 19 patients. A clinical score with 76% sensitivity is proposed. After 3 years of GH treatment [1.1 (0.2) mg/m2/d] height gain in groups 1 (n = 12) and 2 (n = 7) was 0.9 SDS and 1.3 SDS (at a mean IGF-1 of 3.5 SDS), less than reported for small for gestational age (1.8 SDS). CONCLUSION A clinical score encompassing birth weight and/or length, short stature, microcephaly, and IGF-1 is useful for selecting patients for IGF1R analysis. Feeding problems are common and the growth response to GH treatment is moderate.
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Affiliation(s)
- Marie J E Walenkamp
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Jasmijn M L Robers
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, Netherlands
| | - Jan M Wit
- Department of Pediatrics, Leiden University Medical Center, Leiden, Netherlands
| | | | | | - Wilma Oostdijk
- Department of Pediatrics, Leiden University Medical Center, Leiden, Netherlands
| | - Anita C S Hokken-Koelega
- Dutch Growth Research Foundation, Rotterdam, Netherlands
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Sarina G Kant
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, Netherlands
| | - Monique Losekoot
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, Netherlands
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12
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Wit JM, van Dommelen P, Oostdijk W. Letter to the Editor: "Algorithms to Define Abnormal Growth in Children: External Validation and Head-to-Head Comparison". J Clin Endocrinol Metab 2019; 104:3415-3416. [PMID: 30896773 DOI: 10.1210/jc.2019-00468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 03/15/2019] [Indexed: 02/13/2023]
Affiliation(s)
- Jan M Wit
- Department of Pediatrics, Leiden University Medical Center, ZA Leiden, Netherlands
| | | | - Wilma Oostdijk
- Department of Pediatrics, Leiden University Medical Center, ZA Leiden, Netherlands
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13
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Bongers-Schokking JJ, Resing WCM, Oostdijk W, de Rijke YB, de Muinck Keizer-Schrama SMPF. Relation between Early Over- and Undertreatment and Behavioural Problems in Preadolescent Children with Congenital Hypothyroidism. Horm Res Paediatr 2018; 90:247-256. [PMID: 30408796 PMCID: PMC6492506 DOI: 10.1159/000494056] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 09/25/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Congenital hypothyroidism (CH) per se, when not treated or undertreated, may lead to severe behavioural problems (cretinism), whereas overtreatment of CH seems associated with attention problems. DESIGN AND METHODS For 55 CH patients, prospectively followed from birth until 11 years, parents rated the Child Behaviour Checklist and teachers the Teacher's Report Form at children's ages 6 and 11 years. We related scores regarding Attention, Delinquency, and Aggression (ADA scores, indicative for attention deficit hyperactivity syndrome, ADHD), and scores regarding Withdrawn, Anxious, Social, and Thought problems (WAST scores, indicative for autism) to the occurrence of over- and undertreatment in five age periods. Over- and undertreatment were defined as free thyroxine (fT4) concentrations above/below the range of the patient's individual fT4 steady state concentration. RESULTS ADA scores at 6 and 11 years for patients overtreated in the period 1-3 months postnatally were higher than those for patients who were not overtreated. Patients with severe CH undertreated in the period 3-6 months postnatally had higher WAST scores at 6 and 11 years than all other patients. CONCLUSIONS This is the first study suggesting that permanent ADHD as well as autism in CH patients at ages 6 and 11 years are the result of early overtreatment and undertreatment, respectively.
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Affiliation(s)
- Jacoba J Bongers-Schokking
- Department of Pediatrics, Erasmus MC - Sophia Children's Hospital , University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Wilma C M Resing
- Department of Developmental and Educational Psychology, Faculty of Social Sciences, University of Leiden, Leiden, The Netherlands
| | - Wilma Oostdijk
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Yolanda B de Rijke
- Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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14
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Lemaire P, Duhil de Bénazé G, Mul D, Heger S, Oostdijk W, Brauner R. A mathematical model for predicting the adult height of girls with idiopathic central precocious puberty: A European validation. PLoS One 2018; 13:e0205318. [PMID: 30300409 PMCID: PMC6178384 DOI: 10.1371/journal.pone.0205318] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 09/24/2018] [Indexed: 12/23/2022] Open
Abstract
Background A previous single-center study established a mathematical model for predicting the adult height (AH) in girls with idiopathic central precocious puberty (CPP). Objective To perform internal and external validations by comparing the actual AH to the calculated AH established by this model and to update it. Methods The original formula, calculated AH (cm) = 2.21 (height at initial evaluation, SD) + 2.32 (target height, SD) - 1.83 (luteinizing hormone/follicle-stimulating hormone peaks ratio) + 159.68, was established in a sample of 134 girls (group 4) and was applied to additional girls with CPP seen in the same center (group 1, n = 35), in Germany (group 2, n = 43) and in the Netherlands (group 3, n = 72). This formula has been updated based on these extended data, and both versions are available at the following location: http://www.kamick.org/lemaire/med/girls-cpp15.html. Results Despite the differences among the 4 groups in terms of their characteristics at the initial evaluation and the percentages of patients treated with the gonadotropin-releasing hormone analogue, they have similar calculated and actual AHs. The actual AHs are 162.2±7.0, 163.0±7.6, 162.4±7.7 and 162.1±5.6 cm in groups 1 to 4, respectively. They are highly correlated with the AHs calculated by the formula established in the original group (group 4), with R at 0.84, 0.67 and 0.69 in groups 1 to 3, respectively. When the actual AHs and the AHs predicted by the Bayley and Pinneau method are compared, the R is 0.76, 0.51 and 0.64 in groups 1 to 3, respectively. The absolute differences between actual AHs and the calculated AHs are greater than 1 SD (5.6 cm) in 15%, 35% and 28% of the patients in groups 1 to 3, respectively. Conclusion This study validates and updates the previously established formula for predicting AH in girls with CPP. This updated formula can help clinicians to make treatment decisions.
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Affiliation(s)
- Pierre Lemaire
- Univ. Grenoble Alpes, CNRS, Grenoble INP, G-SCOP, Grenoble, France
| | | | - Dick Mul
- Diabeter, centre for pediatric and adolescent diabetes care and research, Rotterdam, The Netherlands
| | - Sabine Heger
- Children’s Hospital Bult, Janusz-Korczak-Allee Hannover, Germany
| | - Wilma Oostdijk
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Raja Brauner
- Fondation Ophtalmologique Adolphe de Rothschild and Université Paris Descartes, Paris, France
- * E-mail:
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15
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Kruis RWJ, Schouten-van Meeteren AYN, Finken MJJ, Oostdijk W, van Trotsenburg ASP, Boot AM, Claahsen-van der Grinten HL, van Lindert EJ, Han KS, Hoving EW, Michiels EMC, van Santen HM. Management and consequences of postoperative fluctuations in plasma sodium concentration after pediatric brain tumor surgery in the sellar region: a national cohort analysis. Pituitary 2018; 21:384-392. [PMID: 29623580 PMCID: PMC6018586 DOI: 10.1007/s11102-018-0886-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE Severe fluctuations in plasma sodium concentration and plasma osmolarity, including central diabetes insipidus (CDI), may have significant influence on postoperative morbidity and mortality after pediatric brain tumor surgery.The aim of this study was to describe the frequency, severity and neurological consequences of these fluctuations in pediatric brain tumor survivors. METHODS A retrospective, multi-institutional chart review was conducted among all children who underwent brain tumor surgery in the sellar or suprasellar region in seven university hospitals in the Netherlands between January 2004 and December 2013. RESULTS Postoperative CDI was observed in 67.5% of 120 included children. Fluctuations of plasma sodium concentration ≥ 10 mmol/L/24 h during the first ten postoperative days were seen in 75.3% of patients with CDI, with a maximum delta of 46 mmol/L/24 h. When compared to patients without CDI, altered mental status occurred more frequently in patients with postoperative CDI (5.1 vs. 23.5% respectively, p = 0.009). Low plasma sodium concentration was related to altered mental status and the occurrence of seizures. Frequency and severity of fluctuations in plasma sodium concentration during the first ten postoperative days were significantly higher in patients with permanent CDI at last follow-up than in patients with transient CDI or without CDI (p = 0.007). CONCLUSION Postoperative CDI is a common complication after pediatric brain tumor surgery in the sellar or suprasellar region. Extreme plasma sodium concentrations and large intra-day fluctuations still occur and seem to influence the postoperative neurological course. These results illustrate the need for intensive monitoring in a highly experienced center.
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Affiliation(s)
- R W J Kruis
- Department of Pediatric Endocrinology, University Medical Center Utrecht - Wilhelmina Children's Hospital, Utrecht, The Netherlands
| | - A Y N Schouten-van Meeteren
- Department of Pediatric Oncology, Academic Medical Center - Emma Children's Hospital, Amsterdam, The Netherlands
| | - M J J Finken
- Department of Pediatric Endocrinology, VU University Medical Center, Amsterdam, The Netherlands
| | - W Oostdijk
- Department of Pediatric Endocrinology, Leiden University Medical Center - Willem-Alexander Children's Hospital, Leiden, The Netherlands
| | - A S P van Trotsenburg
- Department of Pediatric Endocrinology, Academic Medical Center - Emma Children's Hospital, Amsterdam, The Netherlands
| | - A M Boot
- Department of Pediatric Endocrinology, University Medical Center Groningen - Beatrix Children's Hospital, University of Groningen, Groningen, The Netherlands
| | - H L Claahsen-van der Grinten
- Department of Pediatric Endocrinology, Radboud University Medical Center - Amalia Children's Hospital, Nijmegen, The Netherlands
| | - E J van Lindert
- Department of Pediatric Neurosurgery, Radboud University Medical Center - Amalia Children's Hospital, Nijmegen, The Netherlands
| | - K S Han
- Department of Pediatric Neurosurgery, University Medical Center Utrecht - Wilhelmina Children's Hospital, Utrecht, The Netherlands
| | - E W Hoving
- Department of Pediatric Neurosurgery, University Medical Center Utrecht - Princess Máxima Center, Utrecht, The Netherlands
| | - E M C Michiels
- Department of Pediatric Oncology, Erasmus University Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - H M van Santen
- Department of Pediatric Endocrinology, University Medical Center Utrecht - Wilhelmina Children's Hospital, Utrecht, The Netherlands.
- Wilhelmina Children's Hospital, University of Utrecht, Postal adress KC.03.063.0, PO Box 85090, 3508 AB, Utrecht, The Netherlands.
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16
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Kranenburg LJC, Reerds STH, Cools M, Alderson J, Muscarella M, Magrite E, Kuiper M, Abdelgaffar S, Balsamo A, Brauner R, Chanoine JP, Deeb A, Fechner P, German A, Holterhus PM, Juul A, Mendonca BB, Neville K, Nordenstrom A, Oostdijk W, Rey RA, Rutter MM, Shah N, Luo X, Grijpink K, Drop SLS. Global Application of the Assessment of Communication Skills of Paediatric Endocrinology Fellows in the Management of Differences in Sex Development Using the ESPE E-Learning.Org Portal. Horm Res Paediatr 2018; 88:127-139. [PMID: 28689203 DOI: 10.1159/000475992] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 04/19/2017] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Information sharing in chronic conditions such as disorders of/differences in sex development (DSD) is essential for a comprehensive understanding by parents and patients. We report on a qualitative analysis of communication skills of fellows undergoing training in paediatric endocrinology. Guidelines are created for the assessment of communication between health professionals and individuals with DSD and their parents. METHODS Paediatric endocrinology fellows worldwide were invited to study two interactive online cases (www.espe-elearning.org) and to describe a best practice communication with (i) the parents of a newborn with congenital adrenal hyperplasia and (ii) a young woman with 46,XY gonadal dysgenesis. The replies were analysed regarding completeness, quality, and evidence of empathy. Guidelines for structured assessment of responses were developed by 22 senior paediatric endocrinologists worldwide who assessed 10 selected replies. Consensus of assessors was established and the evaluation guidelines were created. RESULTS The replies of the fellows showed considerable variation in completeness, quality of wording, and evidence of empathy. Many relevant aspects of competent clinical communication were not mentioned; 15% (case 1) and 17% (case 2) of the replies were considered poor/insufficient. There was also marked variation between 17 senior experts in the application of the guidelines to assess communication skills. The guidelines were then adjusted to a 3-level assessment with empathy as a separate key item to better reflect the qualitative differences in the replies and for simplicity of use by evaluators. CONCLUSIONS E-learning can play an important role in assessing communication skills. A practical tool is provided to assess how information is shared with patients with DSD and their families and should be refined by all stakeholders, notably interdisciplinary health professionals and patient representatives.
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Affiliation(s)
- Laura J C Kranenburg
- Department of Rheumatology, Maasstad Ziekenhuis, Rotterdam, the Netherlands.,Department of Pediatrics, Division of Pediatric Endocrinology, Sophia Children's Hospital/Erasmus MC, Rotterdam, the Netherlands
| | - Sam T H Reerds
- Department of Pediatrics, Division of Pediatric Endocrinology, Sophia Children's Hospital/Erasmus MC, Rotterdam, the Netherlands
| | - Martine Cools
- Department of Pediatrics, Division of Pediatric Endocrinology, Ghent University, Ghent University Hospital, Ghent, Belgium
| | - Julie Alderson
- Psychological Health Services, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
| | - Miriam Muscarella
- USCF School of Medicine, Class of 2019, San Francisco, California, USA
| | - Ellie Magrite
- Founder and Trustee, dsdfamilies, Edinburgh, United Kingdom
| | - Martijn Kuiper
- Department of Rheumatology, Maasstad Ziekenhuis, Rotterdam, the Netherlands
| | | | - Antonio Balsamo
- Department of Medical and Surgical Sciences, Division of Pediatric Endocrinology, University Hospital S. Orsola-Malpighi, Bologna, Italy
| | - Raja Brauner
- Fondation Ophtalmologique Adolphe de Rothschild and Université Paris Descartes, Paris, France
| | - Jean Pierre Chanoine
- Department of Paediatrics, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Asma Deeb
- Department of Paediatrics, Mafraq Hospital, Abu Dhabi, United Arab Emirates
| | - Patricia Fechner
- Department of Pediatrics, University of Washington, Seattle Children's Hospital, Seattle, Washington, USA
| | - Alina German
- Department of Pediatrics, Bnai-Zion Medical Center, Technion, Haifa, Israel
| | - Paul Martin Holterhus
- Department of Pediatrics, Division of Pediatric Endocrinology and Diabetes, University Hospital of Schleswig-Holstein, Campus Kiel/Christian Albrecht University of Kiel, Kiel, Germany
| | - Anders Juul
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Berenice B Mendonca
- Department of Internal Medicine, Medical School, University of São Paulo, São Paulo, Brazil
| | - Kristen Neville
- Department of Pediatric Endocrinology, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Anna Nordenstrom
- Department of Women's and Children's Health, Karolinka Institutet, Stockholm, Sweden
| | - Wilma Oostdijk
- Department of Pediatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Rodolfo A Rey
- Pediatrics Centro de Investigaciones Endocrinológicas "Dr. César Bergadá" (CEDIE), CONICET-FEI División de Endocrinología, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina
| | - Meilan M Rutter
- Division of Endocrinology, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
| | - Nalini Shah
- Department of Endocrinology, Seth GS Medical College & KEM Hospital, Mumbai, India
| | - Xiaoping Luo
- Department of Pediatrics, Tongji Hospital, Wuhan, China
| | - Kalinka Grijpink
- Division Education and Student Support, Faculty EEMS, Delft University of Technology, Delft, the Netherlands
| | - Stenvert L S Drop
- Department of Pediatrics, Division of Pediatric Endocrinology, Sophia Children's Hospital/Erasmus MC, Rotterdam, the Netherlands
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17
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de Graaf M, Kant SG, Wit JM, Redeker EJW, Santen GWE, Verkerk AJMH, Uitterlinden AG, Losekoot M, Oostdijk W. Successful Growth Hormone Therapy in Cornelia de Lange Syndrome. J Clin Res Pediatr Endocrinol 2017; 9:366-370. [PMID: 28588001 PMCID: PMC5785645 DOI: 10.4274/jcrpe.4349] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Cornelia de Lange syndrome (CdLS) is a both clinically and genetically heterogeneous syndrome. In its classical form, it is characterised by distinctive facial features, intra-uterine growth retardation, short stature, developmental delay, and anomalies in multiple organ systems. NIPBL, SMC1A, SMC3, RAD21 and HDAC8, all involved in the cohesin pathway, have been identified to cause CdLS. Growth hormone (GH) secretion has been reported as normal, and to our knowledge, there are no reports on the effect of recombinant human GH treatment in CdLS patients. We present a patient born small for gestational age with persistent severe growth retardation [height -3.4 standard deviation score (SDS)] and mild dysmorphic features, who was treated with GH from 4.3 years of age onward and was diagnosed 6 years later with CdLS using whole-exome sequencing. Treatment led to a height gain of 1.6 SDS over 8 years. Treatment was interrupted shortly due to high serum insulin-like growth factor-1 serum values. In conclusion, GH therapy may be effective and safe for short children with CdLS.
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Affiliation(s)
- Michael de Graaf
- Leiden University Medical Center, Department of Pediatrics, Leiden, The Netherlands
,* Address for Correspondence: Leiden University Medical Center, Department of Pediatrics, Leiden, The Netherlands Phone: +31 71 526 28 24 E-mail:
| | - Sarina G Kant
- Leiden University Medical Center, Department of Clinical Genetics, Leiden, The Netherlands
| | - Jan Maarten Wit
- Leiden University Medical Center, Department of Pediatrics, Leiden, The Netherlands
| | | | | | | | | | - Monique Losekoot
- Leiden University Medical Center, Department of Clinical Genetics, Leiden, The Netherlands
| | - Wilma Oostdijk
- Leiden University Medical Center, Department of Pediatrics, Leiden, The Netherlands
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18
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Zijlker H, Schagen S, Wit JM, Biermasz N, van Furth W, Oostdijk W. Pituitary Adenoma Apoplexy in an Adolescent: A Case Report and Review of the Literature. J Clin Res Pediatr Endocrinol 2017; 9:265-273. [PMID: 28588003 PMCID: PMC5596809 DOI: 10.4274/jcrpe.4420] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
We present a 13-year-old boy who was admitted with complaints of a state of progressive sleepiness and a sudden headache with vomiting and fever. Laboratory testing showed hypoglycemia, multiple pituitary hormonal deficiencies, and an elevated C-reactive protein level. A cranial magnetic resonance imaging (MRI) showed an opaque sphenoid sinus and an intrasellar mass suggesting hemorrhage, so that we suspected pituitary apoplexy (PA) originating from a non-functioning adenoma, although a pituitary abscess could not completely be excluded. The boy was treated with antibiotics, hydrocortisone, and levothyroxine. Due to his rapid clinical improvement, no surgery was performed and we considered the diagnosis of PA as confirmed. At follow-up, the MRI scan showed a small residual lesion. Pituitary deficiencies of growth hormone, adrenocorticotropic hormone (ACTH), thyroid-stimulating hormone, and vasopressin persisted. A literature search of all well-documented cases of PA in children or adolescents (n=30, 13 boys and 17 girls) indicated that this condition is rare below 20 years of age but must be considered when a patient experiences headache with or without visual disturbances, even in the presence of clinical and laboratory signals suggestive of pituitary abscess. MRI neuroimaging is helpful in the differential diagnosis. In both conditions, the possibility of ACTH deficiency should always be considered, investigated, and treated. In cases without severe neuro-ophthalmological deficits and/or with a rapid and positive response to acute medical management, one can abstain from surgical treatment.
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Affiliation(s)
| | | | | | | | | | - Wilma Oostdijk
- Leiden University Medical Center, Department of Pediatrics, Leiden, The Netherlands
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19
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Hannema SE, Wit JM, Houdijk MECAM, van Haeringen A, Bik EC, Verkerk AJMH, Uitterlinden AG, Kant SG, Oostdijk W, Bakker E, Delemarre-van de Waal HA, Losekoot M. Novel Leptin Receptor Mutations Identified in Two Girls with Severe Obesity Are Associated with Increased Bone Mineral Density. Horm Res Paediatr 2017; 85:412-20. [PMID: 26925581 DOI: 10.1159/000444055] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 01/14/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Recessive mutations in the leptin receptor (LEPR) are a rare cause of hyperphagia and severe early-onset obesity. To date, the phenotype has only been described in 25 obese children, some of whom also had altered immune function, hypogonadotropic hypogonadism, reduced growth hormone secretion, hypothalamic hypothyroidism or reduced adult height. We provide a detailed description of the phenotype of 2 affected girls to add to this knowledge. METHODS Whole-exome sequencing and targeted sequencing were used to detect the LEPR mutations. RNA analysis was performed to assess the effect of splice-site mutations. RESULTS In 2 unrelated girls with severe obesity, three novel LEPR mutations were detected. Longitudinal growth data show normal childhood growth, and in the older girl, a normal adult height despite hypogonadotropic hypogonadism and the lack of an obvious pubertal growth spurt. Bone age is remarkably advanced in the younger (prepubertal) girl, and bone mineral density (BMD) is high in both girls, which might be directly or indirectly related to leptin resistance. CONCLUSION The spectrum of clinical features of LEPR deficiency may be expanded with increased BMD. Future observations in LEPR-deficient subjects should help further unravel the role of leptin in human bone biology.
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Affiliation(s)
- Sabine E Hannema
- Department of Paediatrics, Willem Alexander Children's Hospital, Leiden, The Netherlands
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20
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Bertko E, Klammt J, Dusatkova P, Bahceci M, Gonc N, Ten Have L, Kandemir N, Mansmann G, Obermannova B, Oostdijk W, Pfäffle H, Rockstroh-Lippold D, Schlicke M, Tuzcu AK, Pfäffle R. Combined pituitary hormone deficiency due to gross deletions in the POU1F1 (PIT-1) and PROP1 genes. J Hum Genet 2017; 62:755-762. [PMID: 28356564 PMCID: PMC5537413 DOI: 10.1038/jhg.2017.34] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 01/27/2017] [Accepted: 01/29/2017] [Indexed: 12/04/2022]
Abstract
Pituitary development depends on a complex cascade of interacting transcription factors and signaling molecules. Lesions in this cascade lead to isolated or combined pituitary hormone deficiency (CPHD). The aim of this study was to identify copy number variants (CNVs) in genes known to cause CPHD and to determine their structure. We analyzed 70 CPHD patients from 64 families. Deletions were found in three Turkish families and one family from northern Iraq. In one family we identified a 4.96 kb deletion that comprises the first two exons of POU1F1. In three families a homozygous 15.9 kb deletion including complete PROP1 was discovered. Breakpoints map within highly homologous AluY sequences. Haplotype analysis revealed a shared haplotype of 350 kb among PROP1 deletion carriers. For the first time we were able to assign the boundaries of a previously reported PROP1 deletion. This gross deletion shows strong evidence to originate from a common ancestor in patients with Kurdish descent. No CNVs within LHX3, LHX4, HESX1, GH1 and GHRHR were found. Our data prove multiplex ligation-dependent probe amplification to be a valuable tool for the detection of CNVs as cause of pituitary insufficiencies and should be considered as an analytical method particularly in Kurdish patients.
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Affiliation(s)
- Eleonore Bertko
- Hospital for Children and Adolescents, Division of Pediatric Endocrinology, University of Leipzig, Leipzig, Germany
| | - Jürgen Klammt
- Hospital for Children and Adolescents, Division of Pediatric Endocrinology, University of Leipzig, Leipzig, Germany
| | - Petra Dusatkova
- 2nd Faculty of Medicine, Department of Pediatrics, Charles University in Prague and University Hospital Motol, Prague, Czech Republic
| | - Mithat Bahceci
- Department of Endocrinology, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Nazli Gonc
- Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Ankara, Turkey
| | | | - Nurgun Kandemir
- Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Ankara, Turkey
| | - Georg Mansmann
- PAN Institute for Endocrinology and Reproductive Medicine, Cologne, Germany
| | - Barbora Obermannova
- 2nd Faculty of Medicine, Department of Pediatrics, Charles University in Prague and University Hospital Motol, Prague, Czech Republic
| | - Wilma Oostdijk
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Heike Pfäffle
- Hospital for Children and Adolescents, Division of Pediatric Endocrinology, University of Leipzig, Leipzig, Germany
| | - Denise Rockstroh-Lippold
- Hospital for Children and Adolescents, Division of Pediatric Endocrinology, University of Leipzig, Leipzig, Germany
| | - Marina Schlicke
- Hospital for Children and Adolescents, Division of Pediatric Endocrinology, University of Leipzig, Leipzig, Germany
| | | | - Roland Pfäffle
- Hospital for Children and Adolescents, Division of Pediatric Endocrinology, University of Leipzig, Leipzig, Germany
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Gorter EA, Oostdijk W, Felius A, Krijnen P, Schipper IB. Vitamin D Deficiency in Pediatric Fracture Patients: Prevalence, Risk Factors, and Vitamin D Supplementation. J Clin Res Pediatr Endocrinol 2016; 8:445-451. [PMID: 27550850 PMCID: PMC5198004 DOI: 10.4274/jcrpe.3474] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Although vitamin D levels are not routinely monitored in pediatric fracture patients, identification of children with a vitamin D deficiency may be clinically relevant because of the potential role of vitamin D in fracture healing. This study aimed to determine the prevalence of vitamin D deficiency in a pediatric fracture population and to identify risk factors for deficiency. METHODS All pediatric patients (<18 years) who were treated for a fracture of the upper or lower extremity from September 2012 to October 2013 in the outpatient setting of a level one trauma center were included in this cross-sectional study. Vitamin D deficiency was defined as a serum calcidiol <50 nmol/L. Potential risk factors for vitamin D deficiency were analysed using multivariable logistic regression analysis. RESULTS A total of 108 boys (58%) and 79 girls, of a mean age 11.1 years (standard deviation 3.9), who had undergone 189 fractures were included in the study. Sixty-four children (34%) were vitamin D deficient. Of those with follow-up measurements, 74% were no longer deficient after supplementation. Vitamin D status did not influence the occurrence of complications during fracture treatment. Independent risk factors for vitamin D deficiency were older age, season (spring), and a non-Caucasian skin type. CONCLUSION Clinicians who treat children with a fracture should inform patients and parents on vitamin D supplementation. Vitamin D measurement and supplementation may be needed for children with a non-Caucasian skin type or for those who present with a fracture during spring months.
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Affiliation(s)
- Erwin A. Gorter
- Leiden University Medical Center, Department of Surgery and Traumatology, Leiden, The Netherlands
,* Address for Correspondence: Leiden University Medical Center, Department of Surgery and Traumatology, Leiden, The Netherlands GSM: +31 71 526 1065 E-mail:
| | - Wilma Oostdijk
- Leiden University Medical Center, Department of Pediatrics, Leiden, The Netherlands
| | - Abraham Felius
- Leiden University Medical Center, Department of Pediatrics, Leiden, The Netherlands
| | - Pieta Krijnen
- Leiden University Medical Center, Department of Surgery and Traumatology, Leiden, The Netherlands
| | - Inger B. Schipper
- Leiden University Medical Center, Department of Surgery and Traumatology, Leiden, The Netherlands
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22
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Heinen CA, Losekoot M, Sun Y, Watson PJ, Fairall L, Joustra SD, Zwaveling-Soonawala N, Oostdijk W, van den Akker ELT, Alders M, Santen GWE, van Rijn RR, Dreschler WA, Surovtseva OV, Biermasz NR, Hennekam RC, Wit JM, Schwabe JWR, Boelen A, Fliers E, van Trotsenburg ASP. Mutations in TBL1X Are Associated With Central Hypothyroidism. J Clin Endocrinol Metab 2016; 101:4564-4573. [PMID: 27603907 PMCID: PMC5155687 DOI: 10.1210/jc.2016-2531] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
CONTEXT Isolated congenital central hypothyroidism (CeH) can result from mutations in TRHR, TSHB, and IGSF1, but its etiology often remains unexplained. We identified a missense mutation in the transducin β-like protein 1, X-linked (TBL1X) gene in three relatives diagnosed with isolated CeH. TBL1X is part of the thyroid hormone receptor-corepressor complex. OBJECTIVE The objectives of the study were the identification of TBL1X mutations in patients with unexplained isolated CeH, Sanger sequencing of relatives of affected individuals, and clinical and biochemical characterization; in vitro investigation of functional consequences of mutations; and mRNA expression in, and immunostaining of, human hypothalami and pituitary glands. DESIGN This was an observational study. SETTING The study was conducted at university medical centers. PATIENTS Nineteen individuals with and seven without a mutation participated in the study. MAIN OUTCOME MEASURES Outcome measures included sequencing results, clinical and biochemical characteristics of mutation carriers, and results of in vitro functional and expression studies. RESULTS Sanger sequencing yielded five additional mutations. All patients (n = 8; six males) were previously diagnosed with CeH (free T4 [FT4] concentration below the reference interval, normal thyrotropin). Eleven relatives (two males) also carried mutations. One female had CeH, whereas 10 others had low-normal FT4 concentrations. As a group, adult mutation carriers had 20%-25% lower FT4 concentrations than controls. Twelve of 19 evaluated carriers had hearing loss. Mutations are located in the highly conserved WD40-repeat domain of the protein, influencing its expression and thermal stability. TBL1X mRNA and protein are expressed in the human hypothalamus and pituitary. CONCLUSIONS TBL1X mutations are associated with CeH and hearing loss. FT4 concentrations in mutation carriers vary from low-normal to values compatible with CeH.
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Affiliation(s)
- Charlotte A Heinen
- Department of Endocrinology and Metabolism (C.A.H., O.V.S., A.B., E.F.), Clinical Genetics (M.A.), and Clinical and Experimental Audiology (W.A.D.), Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Paediatric Endocrinology (C.A.H., N.Z.-S., A.S.P.v.T.), Radiology (R.R.v.R.), and Paediatrics (R.C.H.), Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Clinical Genetics (M.L., Y.S., G.W.E.S.), Paediatrics (S.D.J., W.O., J.M.W.), and Endocrinology and Metabolism (S.D.J., N.R.B.), Leiden University Medical Centre, 2300 RC Leiden, The Netherlands; Henry Wellcome Laboratories of Structural Biology (P.J.W., L.F., J.W.R.S.), Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 7RH, United Kingdom; and Department of Paediatric Endocrinology (E.L.T.v.d.A.), Erasmus Medical Centre, 3000 CB Rotterdam, The Netherlands
| | - Monique Losekoot
- Department of Endocrinology and Metabolism (C.A.H., O.V.S., A.B., E.F.), Clinical Genetics (M.A.), and Clinical and Experimental Audiology (W.A.D.), Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Paediatric Endocrinology (C.A.H., N.Z.-S., A.S.P.v.T.), Radiology (R.R.v.R.), and Paediatrics (R.C.H.), Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Clinical Genetics (M.L., Y.S., G.W.E.S.), Paediatrics (S.D.J., W.O., J.M.W.), and Endocrinology and Metabolism (S.D.J., N.R.B.), Leiden University Medical Centre, 2300 RC Leiden, The Netherlands; Henry Wellcome Laboratories of Structural Biology (P.J.W., L.F., J.W.R.S.), Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 7RH, United Kingdom; and Department of Paediatric Endocrinology (E.L.T.v.d.A.), Erasmus Medical Centre, 3000 CB Rotterdam, The Netherlands
| | - Yu Sun
- Department of Endocrinology and Metabolism (C.A.H., O.V.S., A.B., E.F.), Clinical Genetics (M.A.), and Clinical and Experimental Audiology (W.A.D.), Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Paediatric Endocrinology (C.A.H., N.Z.-S., A.S.P.v.T.), Radiology (R.R.v.R.), and Paediatrics (R.C.H.), Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Clinical Genetics (M.L., Y.S., G.W.E.S.), Paediatrics (S.D.J., W.O., J.M.W.), and Endocrinology and Metabolism (S.D.J., N.R.B.), Leiden University Medical Centre, 2300 RC Leiden, The Netherlands; Henry Wellcome Laboratories of Structural Biology (P.J.W., L.F., J.W.R.S.), Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 7RH, United Kingdom; and Department of Paediatric Endocrinology (E.L.T.v.d.A.), Erasmus Medical Centre, 3000 CB Rotterdam, The Netherlands
| | - Peter J Watson
- Department of Endocrinology and Metabolism (C.A.H., O.V.S., A.B., E.F.), Clinical Genetics (M.A.), and Clinical and Experimental Audiology (W.A.D.), Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Paediatric Endocrinology (C.A.H., N.Z.-S., A.S.P.v.T.), Radiology (R.R.v.R.), and Paediatrics (R.C.H.), Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Clinical Genetics (M.L., Y.S., G.W.E.S.), Paediatrics (S.D.J., W.O., J.M.W.), and Endocrinology and Metabolism (S.D.J., N.R.B.), Leiden University Medical Centre, 2300 RC Leiden, The Netherlands; Henry Wellcome Laboratories of Structural Biology (P.J.W., L.F., J.W.R.S.), Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 7RH, United Kingdom; and Department of Paediatric Endocrinology (E.L.T.v.d.A.), Erasmus Medical Centre, 3000 CB Rotterdam, The Netherlands
| | - Louise Fairall
- Department of Endocrinology and Metabolism (C.A.H., O.V.S., A.B., E.F.), Clinical Genetics (M.A.), and Clinical and Experimental Audiology (W.A.D.), Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Paediatric Endocrinology (C.A.H., N.Z.-S., A.S.P.v.T.), Radiology (R.R.v.R.), and Paediatrics (R.C.H.), Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Clinical Genetics (M.L., Y.S., G.W.E.S.), Paediatrics (S.D.J., W.O., J.M.W.), and Endocrinology and Metabolism (S.D.J., N.R.B.), Leiden University Medical Centre, 2300 RC Leiden, The Netherlands; Henry Wellcome Laboratories of Structural Biology (P.J.W., L.F., J.W.R.S.), Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 7RH, United Kingdom; and Department of Paediatric Endocrinology (E.L.T.v.d.A.), Erasmus Medical Centre, 3000 CB Rotterdam, The Netherlands
| | - Sjoerd D Joustra
- Department of Endocrinology and Metabolism (C.A.H., O.V.S., A.B., E.F.), Clinical Genetics (M.A.), and Clinical and Experimental Audiology (W.A.D.), Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Paediatric Endocrinology (C.A.H., N.Z.-S., A.S.P.v.T.), Radiology (R.R.v.R.), and Paediatrics (R.C.H.), Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Clinical Genetics (M.L., Y.S., G.W.E.S.), Paediatrics (S.D.J., W.O., J.M.W.), and Endocrinology and Metabolism (S.D.J., N.R.B.), Leiden University Medical Centre, 2300 RC Leiden, The Netherlands; Henry Wellcome Laboratories of Structural Biology (P.J.W., L.F., J.W.R.S.), Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 7RH, United Kingdom; and Department of Paediatric Endocrinology (E.L.T.v.d.A.), Erasmus Medical Centre, 3000 CB Rotterdam, The Netherlands
| | - Nitash Zwaveling-Soonawala
- Department of Endocrinology and Metabolism (C.A.H., O.V.S., A.B., E.F.), Clinical Genetics (M.A.), and Clinical and Experimental Audiology (W.A.D.), Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Paediatric Endocrinology (C.A.H., N.Z.-S., A.S.P.v.T.), Radiology (R.R.v.R.), and Paediatrics (R.C.H.), Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Clinical Genetics (M.L., Y.S., G.W.E.S.), Paediatrics (S.D.J., W.O., J.M.W.), and Endocrinology and Metabolism (S.D.J., N.R.B.), Leiden University Medical Centre, 2300 RC Leiden, The Netherlands; Henry Wellcome Laboratories of Structural Biology (P.J.W., L.F., J.W.R.S.), Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 7RH, United Kingdom; and Department of Paediatric Endocrinology (E.L.T.v.d.A.), Erasmus Medical Centre, 3000 CB Rotterdam, The Netherlands
| | - Wilma Oostdijk
- Department of Endocrinology and Metabolism (C.A.H., O.V.S., A.B., E.F.), Clinical Genetics (M.A.), and Clinical and Experimental Audiology (W.A.D.), Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Paediatric Endocrinology (C.A.H., N.Z.-S., A.S.P.v.T.), Radiology (R.R.v.R.), and Paediatrics (R.C.H.), Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Clinical Genetics (M.L., Y.S., G.W.E.S.), Paediatrics (S.D.J., W.O., J.M.W.), and Endocrinology and Metabolism (S.D.J., N.R.B.), Leiden University Medical Centre, 2300 RC Leiden, The Netherlands; Henry Wellcome Laboratories of Structural Biology (P.J.W., L.F., J.W.R.S.), Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 7RH, United Kingdom; and Department of Paediatric Endocrinology (E.L.T.v.d.A.), Erasmus Medical Centre, 3000 CB Rotterdam, The Netherlands
| | - Erica L T van den Akker
- Department of Endocrinology and Metabolism (C.A.H., O.V.S., A.B., E.F.), Clinical Genetics (M.A.), and Clinical and Experimental Audiology (W.A.D.), Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Paediatric Endocrinology (C.A.H., N.Z.-S., A.S.P.v.T.), Radiology (R.R.v.R.), and Paediatrics (R.C.H.), Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Clinical Genetics (M.L., Y.S., G.W.E.S.), Paediatrics (S.D.J., W.O., J.M.W.), and Endocrinology and Metabolism (S.D.J., N.R.B.), Leiden University Medical Centre, 2300 RC Leiden, The Netherlands; Henry Wellcome Laboratories of Structural Biology (P.J.W., L.F., J.W.R.S.), Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 7RH, United Kingdom; and Department of Paediatric Endocrinology (E.L.T.v.d.A.), Erasmus Medical Centre, 3000 CB Rotterdam, The Netherlands
| | - Mariëlle Alders
- Department of Endocrinology and Metabolism (C.A.H., O.V.S., A.B., E.F.), Clinical Genetics (M.A.), and Clinical and Experimental Audiology (W.A.D.), Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Paediatric Endocrinology (C.A.H., N.Z.-S., A.S.P.v.T.), Radiology (R.R.v.R.), and Paediatrics (R.C.H.), Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Clinical Genetics (M.L., Y.S., G.W.E.S.), Paediatrics (S.D.J., W.O., J.M.W.), and Endocrinology and Metabolism (S.D.J., N.R.B.), Leiden University Medical Centre, 2300 RC Leiden, The Netherlands; Henry Wellcome Laboratories of Structural Biology (P.J.W., L.F., J.W.R.S.), Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 7RH, United Kingdom; and Department of Paediatric Endocrinology (E.L.T.v.d.A.), Erasmus Medical Centre, 3000 CB Rotterdam, The Netherlands
| | - Gijs W E Santen
- Department of Endocrinology and Metabolism (C.A.H., O.V.S., A.B., E.F.), Clinical Genetics (M.A.), and Clinical and Experimental Audiology (W.A.D.), Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Paediatric Endocrinology (C.A.H., N.Z.-S., A.S.P.v.T.), Radiology (R.R.v.R.), and Paediatrics (R.C.H.), Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Clinical Genetics (M.L., Y.S., G.W.E.S.), Paediatrics (S.D.J., W.O., J.M.W.), and Endocrinology and Metabolism (S.D.J., N.R.B.), Leiden University Medical Centre, 2300 RC Leiden, The Netherlands; Henry Wellcome Laboratories of Structural Biology (P.J.W., L.F., J.W.R.S.), Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 7RH, United Kingdom; and Department of Paediatric Endocrinology (E.L.T.v.d.A.), Erasmus Medical Centre, 3000 CB Rotterdam, The Netherlands
| | - Rick R van Rijn
- Department of Endocrinology and Metabolism (C.A.H., O.V.S., A.B., E.F.), Clinical Genetics (M.A.), and Clinical and Experimental Audiology (W.A.D.), Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Paediatric Endocrinology (C.A.H., N.Z.-S., A.S.P.v.T.), Radiology (R.R.v.R.), and Paediatrics (R.C.H.), Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Clinical Genetics (M.L., Y.S., G.W.E.S.), Paediatrics (S.D.J., W.O., J.M.W.), and Endocrinology and Metabolism (S.D.J., N.R.B.), Leiden University Medical Centre, 2300 RC Leiden, The Netherlands; Henry Wellcome Laboratories of Structural Biology (P.J.W., L.F., J.W.R.S.), Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 7RH, United Kingdom; and Department of Paediatric Endocrinology (E.L.T.v.d.A.), Erasmus Medical Centre, 3000 CB Rotterdam, The Netherlands
| | - Wouter A Dreschler
- Department of Endocrinology and Metabolism (C.A.H., O.V.S., A.B., E.F.), Clinical Genetics (M.A.), and Clinical and Experimental Audiology (W.A.D.), Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Paediatric Endocrinology (C.A.H., N.Z.-S., A.S.P.v.T.), Radiology (R.R.v.R.), and Paediatrics (R.C.H.), Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Clinical Genetics (M.L., Y.S., G.W.E.S.), Paediatrics (S.D.J., W.O., J.M.W.), and Endocrinology and Metabolism (S.D.J., N.R.B.), Leiden University Medical Centre, 2300 RC Leiden, The Netherlands; Henry Wellcome Laboratories of Structural Biology (P.J.W., L.F., J.W.R.S.), Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 7RH, United Kingdom; and Department of Paediatric Endocrinology (E.L.T.v.d.A.), Erasmus Medical Centre, 3000 CB Rotterdam, The Netherlands
| | - Olga V Surovtseva
- Department of Endocrinology and Metabolism (C.A.H., O.V.S., A.B., E.F.), Clinical Genetics (M.A.), and Clinical and Experimental Audiology (W.A.D.), Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Paediatric Endocrinology (C.A.H., N.Z.-S., A.S.P.v.T.), Radiology (R.R.v.R.), and Paediatrics (R.C.H.), Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Clinical Genetics (M.L., Y.S., G.W.E.S.), Paediatrics (S.D.J., W.O., J.M.W.), and Endocrinology and Metabolism (S.D.J., N.R.B.), Leiden University Medical Centre, 2300 RC Leiden, The Netherlands; Henry Wellcome Laboratories of Structural Biology (P.J.W., L.F., J.W.R.S.), Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 7RH, United Kingdom; and Department of Paediatric Endocrinology (E.L.T.v.d.A.), Erasmus Medical Centre, 3000 CB Rotterdam, The Netherlands
| | - Nienke R Biermasz
- Department of Endocrinology and Metabolism (C.A.H., O.V.S., A.B., E.F.), Clinical Genetics (M.A.), and Clinical and Experimental Audiology (W.A.D.), Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Paediatric Endocrinology (C.A.H., N.Z.-S., A.S.P.v.T.), Radiology (R.R.v.R.), and Paediatrics (R.C.H.), Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Clinical Genetics (M.L., Y.S., G.W.E.S.), Paediatrics (S.D.J., W.O., J.M.W.), and Endocrinology and Metabolism (S.D.J., N.R.B.), Leiden University Medical Centre, 2300 RC Leiden, The Netherlands; Henry Wellcome Laboratories of Structural Biology (P.J.W., L.F., J.W.R.S.), Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 7RH, United Kingdom; and Department of Paediatric Endocrinology (E.L.T.v.d.A.), Erasmus Medical Centre, 3000 CB Rotterdam, The Netherlands
| | - Raoul C Hennekam
- Department of Endocrinology and Metabolism (C.A.H., O.V.S., A.B., E.F.), Clinical Genetics (M.A.), and Clinical and Experimental Audiology (W.A.D.), Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Paediatric Endocrinology (C.A.H., N.Z.-S., A.S.P.v.T.), Radiology (R.R.v.R.), and Paediatrics (R.C.H.), Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Clinical Genetics (M.L., Y.S., G.W.E.S.), Paediatrics (S.D.J., W.O., J.M.W.), and Endocrinology and Metabolism (S.D.J., N.R.B.), Leiden University Medical Centre, 2300 RC Leiden, The Netherlands; Henry Wellcome Laboratories of Structural Biology (P.J.W., L.F., J.W.R.S.), Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 7RH, United Kingdom; and Department of Paediatric Endocrinology (E.L.T.v.d.A.), Erasmus Medical Centre, 3000 CB Rotterdam, The Netherlands
| | - Jan M Wit
- Department of Endocrinology and Metabolism (C.A.H., O.V.S., A.B., E.F.), Clinical Genetics (M.A.), and Clinical and Experimental Audiology (W.A.D.), Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Paediatric Endocrinology (C.A.H., N.Z.-S., A.S.P.v.T.), Radiology (R.R.v.R.), and Paediatrics (R.C.H.), Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Clinical Genetics (M.L., Y.S., G.W.E.S.), Paediatrics (S.D.J., W.O., J.M.W.), and Endocrinology and Metabolism (S.D.J., N.R.B.), Leiden University Medical Centre, 2300 RC Leiden, The Netherlands; Henry Wellcome Laboratories of Structural Biology (P.J.W., L.F., J.W.R.S.), Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 7RH, United Kingdom; and Department of Paediatric Endocrinology (E.L.T.v.d.A.), Erasmus Medical Centre, 3000 CB Rotterdam, The Netherlands
| | - John W R Schwabe
- Department of Endocrinology and Metabolism (C.A.H., O.V.S., A.B., E.F.), Clinical Genetics (M.A.), and Clinical and Experimental Audiology (W.A.D.), Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Paediatric Endocrinology (C.A.H., N.Z.-S., A.S.P.v.T.), Radiology (R.R.v.R.), and Paediatrics (R.C.H.), Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Clinical Genetics (M.L., Y.S., G.W.E.S.), Paediatrics (S.D.J., W.O., J.M.W.), and Endocrinology and Metabolism (S.D.J., N.R.B.), Leiden University Medical Centre, 2300 RC Leiden, The Netherlands; Henry Wellcome Laboratories of Structural Biology (P.J.W., L.F., J.W.R.S.), Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 7RH, United Kingdom; and Department of Paediatric Endocrinology (E.L.T.v.d.A.), Erasmus Medical Centre, 3000 CB Rotterdam, The Netherlands
| | - Anita Boelen
- Department of Endocrinology and Metabolism (C.A.H., O.V.S., A.B., E.F.), Clinical Genetics (M.A.), and Clinical and Experimental Audiology (W.A.D.), Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Paediatric Endocrinology (C.A.H., N.Z.-S., A.S.P.v.T.), Radiology (R.R.v.R.), and Paediatrics (R.C.H.), Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Clinical Genetics (M.L., Y.S., G.W.E.S.), Paediatrics (S.D.J., W.O., J.M.W.), and Endocrinology and Metabolism (S.D.J., N.R.B.), Leiden University Medical Centre, 2300 RC Leiden, The Netherlands; Henry Wellcome Laboratories of Structural Biology (P.J.W., L.F., J.W.R.S.), Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 7RH, United Kingdom; and Department of Paediatric Endocrinology (E.L.T.v.d.A.), Erasmus Medical Centre, 3000 CB Rotterdam, The Netherlands
| | - Eric Fliers
- Department of Endocrinology and Metabolism (C.A.H., O.V.S., A.B., E.F.), Clinical Genetics (M.A.), and Clinical and Experimental Audiology (W.A.D.), Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Paediatric Endocrinology (C.A.H., N.Z.-S., A.S.P.v.T.), Radiology (R.R.v.R.), and Paediatrics (R.C.H.), Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Clinical Genetics (M.L., Y.S., G.W.E.S.), Paediatrics (S.D.J., W.O., J.M.W.), and Endocrinology and Metabolism (S.D.J., N.R.B.), Leiden University Medical Centre, 2300 RC Leiden, The Netherlands; Henry Wellcome Laboratories of Structural Biology (P.J.W., L.F., J.W.R.S.), Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 7RH, United Kingdom; and Department of Paediatric Endocrinology (E.L.T.v.d.A.), Erasmus Medical Centre, 3000 CB Rotterdam, The Netherlands
| | - A S Paul van Trotsenburg
- Department of Endocrinology and Metabolism (C.A.H., O.V.S., A.B., E.F.), Clinical Genetics (M.A.), and Clinical and Experimental Audiology (W.A.D.), Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Paediatric Endocrinology (C.A.H., N.Z.-S., A.S.P.v.T.), Radiology (R.R.v.R.), and Paediatrics (R.C.H.), Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; Departments of Clinical Genetics (M.L., Y.S., G.W.E.S.), Paediatrics (S.D.J., W.O., J.M.W.), and Endocrinology and Metabolism (S.D.J., N.R.B.), Leiden University Medical Centre, 2300 RC Leiden, The Netherlands; Henry Wellcome Laboratories of Structural Biology (P.J.W., L.F., J.W.R.S.), Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 7RH, United Kingdom; and Department of Paediatric Endocrinology (E.L.T.v.d.A.), Erasmus Medical Centre, 3000 CB Rotterdam, The Netherlands
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23
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Joustra SD, Andela CD, Oostdijk W, van Trotsenburg ASP, Fliers E, Wit JM, Pereira AM, Middelkoop HAM, Biermasz NR. Mild deficits in attentional control in patients with the IGSF1 deficiency syndrome. Clin Endocrinol (Oxf) 2016; 84:896-903. [PMID: 26387489 DOI: 10.1111/cen.12947] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 09/02/2015] [Accepted: 09/15/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Male patients with the X-linked IGSF1 deficiency syndrome are characterized by central hypothyroidism, delayed pubertal testosterone rise, adult macroorchidism, variable prolactin deficiency and occasionally transient partial growth hormone deficiency. Thyroid hormone plays a vital role in brain development and functioning, and while most patients receive adequate replacement therapy starting shortly after birth, it is unknown whether this syndrome is accompanied by long-term impaired cognitive functioning. We therefore assessed cognitive functioning in male patients with IGSF1 deficiency. METHODS Fifteen adult male patients with IGSF1 deficiency participated in neuropsychological assessment of executive functioning and memory, and completed validated questionnaires on health-related quality of life (HRQoL), mood and fatigue. Results were compared to data from previous studies by our department: 54 healthy controls (76 for the attention task) for the test battery and 191 healthy controls for the questionnaires. RESULTS All patients had central hypothyroidism, and twelve were treated with levothyroxine. Patients performed worse than controls in tasks that required attentional control (Trail Making Test, Letter-Digit Substitution Test, and Sustained Attention to Response Task) (all P < 0·001). Memory was unaffected. In addition, patients reported more mental fatigue and reduction of activity (Multidimensional Fatigue Inventory) (both P < 0·01), while HRQoL and mood reports were not different from controls. Age at the start of replacement therapy and current thyroxine levels were not related to outcome. CONCLUSIONS Adult male patients with IGSF1 deficiency exhibit mild deficits in attentional control on formal testing. This finding was not related to the age at start of replacement therapy, or current levothyroxine treatment.
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Affiliation(s)
- S D Joustra
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - C D Andela
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
| | - W Oostdijk
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - A S P van Trotsenburg
- Department of Pediatric Endocrinology, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - E Fliers
- Department of Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - J M Wit
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - A M Pereira
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
| | - H A M Middelkoop
- Department of Psychology, Section Health, Medical and Neuropsychology, Leiden University, Leiden, The Netherlands
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - N R Biermasz
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
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24
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Marzec M, Hawkes CP, Eletto D, Boyle S, Rosenfeld R, Hwa V, Wit JM, van Duyvenvoorde HA, Oostdijk W, Losekoot M, Pedersen O, Yeap BB, Flicker L, Barzilai N, Atzmon G, Grimberg A, Argon Y. A Human Variant of Glucose-Regulated Protein 94 That Inefficiently Supports IGF Production. Endocrinology 2016; 157:1914-28. [PMID: 26982636 PMCID: PMC4870884 DOI: 10.1210/en.2015-2058] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 03/10/2016] [Indexed: 02/08/2023]
Abstract
IGFs are critical for normal intrauterine and childhood growth and sustaining health throughout life. We showed previously that the production of IGF-1 and IGF-2 requires interaction with the chaperone glucose-regulated protein 94 (GRP94) and that the amount of secreted IGFs is proportional to the GRP94 activity. Therefore, we tested the hypothesis that functional polymorphisms of human GRP94 affect IGF production and thereby human health. We describe a hypomorphic variant of human GRP94, P300L, whose heterozygous carriers have 9% lower circulating IGF-1 concentration. P300L was found first in a child with primary IGF deficiency and was later shown to be a noncommon single-nucleotide polymorphism with frequencies of 1%-4% in various populations. When tested in the grp94(-/-) cell-based complementation assay, P300L supported only approximately 58% of IGF secretion relative to wild-type GRP94. Furthermore, recombinant P300L showed impaired nucleotide binding activity. These in vitro data strongly support a causal relationship between the GRP94 variant and the decreased concentration of circulating IGF-1, as observed in human carriers of P300L. Thus, mutations in GRP94 that affect its IGF chaperone activity represent a novel causal genetic mechanism that limits IGF biosynthesis, quite a distinct mechanism from the known genes in the GH/IGF signaling network.
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Affiliation(s)
- Michal Marzec
- Department of Pathology and Laboratory Medicine (M.M., D.E., S.B., Y.A.), The Children's Hospital of Philadelphia and The University of Pennsylvania, Philadelphia,; Division of Endocrinology and Diabetes (C.P.H., A.G.), The Children's Hospital of Philadelphia, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Pennsylvania 19104; National Children's Research Centre (C.P.H.), Dublin 12, Ireland; STAT5, LLC (R.R.), Los Altos, California 94022; Department of Pediatrics (R.R., V.H.), Oregon Health and Science University, Portland, Oregon 97239; Departments of Pediatrics (J.-M.W., H.A.v.D., W.O.), Endocrinology and Metabolic Diseases (H.A.v.D.), and Clinical Genetics (H.A.v.D., M.L.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands; Faculty of Health and Medical Sciences (O.P.), University of Copenhagen, DK-2400 Copenhagen, Denmark; School of Medicine and Pharmacology (B.B.Y.), Western Australia Centre for Health and Ageing (L.F.), Centre for Medical Research (L.F.), and School of Medicine and Pharmacology (L.F.), University of Western Australia, Perth, Western Australia 6872, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia 6150, Australia; Department of Human Biology (G.A.), Faculty of Natural Sciences, University of Haifa, Haifa 3498838, Israel; and Departments of Medicine and Genetics (N.B., G.A.), Albert Einstein College of Medicine, Bronx, New York 10461
| | - Colin P Hawkes
- Department of Pathology and Laboratory Medicine (M.M., D.E., S.B., Y.A.), The Children's Hospital of Philadelphia and The University of Pennsylvania, Philadelphia,; Division of Endocrinology and Diabetes (C.P.H., A.G.), The Children's Hospital of Philadelphia, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Pennsylvania 19104; National Children's Research Centre (C.P.H.), Dublin 12, Ireland; STAT5, LLC (R.R.), Los Altos, California 94022; Department of Pediatrics (R.R., V.H.), Oregon Health and Science University, Portland, Oregon 97239; Departments of Pediatrics (J.-M.W., H.A.v.D., W.O.), Endocrinology and Metabolic Diseases (H.A.v.D.), and Clinical Genetics (H.A.v.D., M.L.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands; Faculty of Health and Medical Sciences (O.P.), University of Copenhagen, DK-2400 Copenhagen, Denmark; School of Medicine and Pharmacology (B.B.Y.), Western Australia Centre for Health and Ageing (L.F.), Centre for Medical Research (L.F.), and School of Medicine and Pharmacology (L.F.), University of Western Australia, Perth, Western Australia 6872, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia 6150, Australia; Department of Human Biology (G.A.), Faculty of Natural Sciences, University of Haifa, Haifa 3498838, Israel; and Departments of Medicine and Genetics (N.B., G.A.), Albert Einstein College of Medicine, Bronx, New York 10461
| | - Davide Eletto
- Department of Pathology and Laboratory Medicine (M.M., D.E., S.B., Y.A.), The Children's Hospital of Philadelphia and The University of Pennsylvania, Philadelphia,; Division of Endocrinology and Diabetes (C.P.H., A.G.), The Children's Hospital of Philadelphia, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Pennsylvania 19104; National Children's Research Centre (C.P.H.), Dublin 12, Ireland; STAT5, LLC (R.R.), Los Altos, California 94022; Department of Pediatrics (R.R., V.H.), Oregon Health and Science University, Portland, Oregon 97239; Departments of Pediatrics (J.-M.W., H.A.v.D., W.O.), Endocrinology and Metabolic Diseases (H.A.v.D.), and Clinical Genetics (H.A.v.D., M.L.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands; Faculty of Health and Medical Sciences (O.P.), University of Copenhagen, DK-2400 Copenhagen, Denmark; School of Medicine and Pharmacology (B.B.Y.), Western Australia Centre for Health and Ageing (L.F.), Centre for Medical Research (L.F.), and School of Medicine and Pharmacology (L.F.), University of Western Australia, Perth, Western Australia 6872, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia 6150, Australia; Department of Human Biology (G.A.), Faculty of Natural Sciences, University of Haifa, Haifa 3498838, Israel; and Departments of Medicine and Genetics (N.B., G.A.), Albert Einstein College of Medicine, Bronx, New York 10461
| | - Sarah Boyle
- Department of Pathology and Laboratory Medicine (M.M., D.E., S.B., Y.A.), The Children's Hospital of Philadelphia and The University of Pennsylvania, Philadelphia,; Division of Endocrinology and Diabetes (C.P.H., A.G.), The Children's Hospital of Philadelphia, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Pennsylvania 19104; National Children's Research Centre (C.P.H.), Dublin 12, Ireland; STAT5, LLC (R.R.), Los Altos, California 94022; Department of Pediatrics (R.R., V.H.), Oregon Health and Science University, Portland, Oregon 97239; Departments of Pediatrics (J.-M.W., H.A.v.D., W.O.), Endocrinology and Metabolic Diseases (H.A.v.D.), and Clinical Genetics (H.A.v.D., M.L.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands; Faculty of Health and Medical Sciences (O.P.), University of Copenhagen, DK-2400 Copenhagen, Denmark; School of Medicine and Pharmacology (B.B.Y.), Western Australia Centre for Health and Ageing (L.F.), Centre for Medical Research (L.F.), and School of Medicine and Pharmacology (L.F.), University of Western Australia, Perth, Western Australia 6872, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia 6150, Australia; Department of Human Biology (G.A.), Faculty of Natural Sciences, University of Haifa, Haifa 3498838, Israel; and Departments of Medicine and Genetics (N.B., G.A.), Albert Einstein College of Medicine, Bronx, New York 10461
| | - Ron Rosenfeld
- Department of Pathology and Laboratory Medicine (M.M., D.E., S.B., Y.A.), The Children's Hospital of Philadelphia and The University of Pennsylvania, Philadelphia,; Division of Endocrinology and Diabetes (C.P.H., A.G.), The Children's Hospital of Philadelphia, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Pennsylvania 19104; National Children's Research Centre (C.P.H.), Dublin 12, Ireland; STAT5, LLC (R.R.), Los Altos, California 94022; Department of Pediatrics (R.R., V.H.), Oregon Health and Science University, Portland, Oregon 97239; Departments of Pediatrics (J.-M.W., H.A.v.D., W.O.), Endocrinology and Metabolic Diseases (H.A.v.D.), and Clinical Genetics (H.A.v.D., M.L.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands; Faculty of Health and Medical Sciences (O.P.), University of Copenhagen, DK-2400 Copenhagen, Denmark; School of Medicine and Pharmacology (B.B.Y.), Western Australia Centre for Health and Ageing (L.F.), Centre for Medical Research (L.F.), and School of Medicine and Pharmacology (L.F.), University of Western Australia, Perth, Western Australia 6872, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia 6150, Australia; Department of Human Biology (G.A.), Faculty of Natural Sciences, University of Haifa, Haifa 3498838, Israel; and Departments of Medicine and Genetics (N.B., G.A.), Albert Einstein College of Medicine, Bronx, New York 10461
| | - Vivian Hwa
- Department of Pathology and Laboratory Medicine (M.M., D.E., S.B., Y.A.), The Children's Hospital of Philadelphia and The University of Pennsylvania, Philadelphia,; Division of Endocrinology and Diabetes (C.P.H., A.G.), The Children's Hospital of Philadelphia, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Pennsylvania 19104; National Children's Research Centre (C.P.H.), Dublin 12, Ireland; STAT5, LLC (R.R.), Los Altos, California 94022; Department of Pediatrics (R.R., V.H.), Oregon Health and Science University, Portland, Oregon 97239; Departments of Pediatrics (J.-M.W., H.A.v.D., W.O.), Endocrinology and Metabolic Diseases (H.A.v.D.), and Clinical Genetics (H.A.v.D., M.L.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands; Faculty of Health and Medical Sciences (O.P.), University of Copenhagen, DK-2400 Copenhagen, Denmark; School of Medicine and Pharmacology (B.B.Y.), Western Australia Centre for Health and Ageing (L.F.), Centre for Medical Research (L.F.), and School of Medicine and Pharmacology (L.F.), University of Western Australia, Perth, Western Australia 6872, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia 6150, Australia; Department of Human Biology (G.A.), Faculty of Natural Sciences, University of Haifa, Haifa 3498838, Israel; and Departments of Medicine and Genetics (N.B., G.A.), Albert Einstein College of Medicine, Bronx, New York 10461
| | - Jan M Wit
- Department of Pathology and Laboratory Medicine (M.M., D.E., S.B., Y.A.), The Children's Hospital of Philadelphia and The University of Pennsylvania, Philadelphia,; Division of Endocrinology and Diabetes (C.P.H., A.G.), The Children's Hospital of Philadelphia, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Pennsylvania 19104; National Children's Research Centre (C.P.H.), Dublin 12, Ireland; STAT5, LLC (R.R.), Los Altos, California 94022; Department of Pediatrics (R.R., V.H.), Oregon Health and Science University, Portland, Oregon 97239; Departments of Pediatrics (J.-M.W., H.A.v.D., W.O.), Endocrinology and Metabolic Diseases (H.A.v.D.), and Clinical Genetics (H.A.v.D., M.L.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands; Faculty of Health and Medical Sciences (O.P.), University of Copenhagen, DK-2400 Copenhagen, Denmark; School of Medicine and Pharmacology (B.B.Y.), Western Australia Centre for Health and Ageing (L.F.), Centre for Medical Research (L.F.), and School of Medicine and Pharmacology (L.F.), University of Western Australia, Perth, Western Australia 6872, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia 6150, Australia; Department of Human Biology (G.A.), Faculty of Natural Sciences, University of Haifa, Haifa 3498838, Israel; and Departments of Medicine and Genetics (N.B., G.A.), Albert Einstein College of Medicine, Bronx, New York 10461
| | - Hermine A van Duyvenvoorde
- Department of Pathology and Laboratory Medicine (M.M., D.E., S.B., Y.A.), The Children's Hospital of Philadelphia and The University of Pennsylvania, Philadelphia,; Division of Endocrinology and Diabetes (C.P.H., A.G.), The Children's Hospital of Philadelphia, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Pennsylvania 19104; National Children's Research Centre (C.P.H.), Dublin 12, Ireland; STAT5, LLC (R.R.), Los Altos, California 94022; Department of Pediatrics (R.R., V.H.), Oregon Health and Science University, Portland, Oregon 97239; Departments of Pediatrics (J.-M.W., H.A.v.D., W.O.), Endocrinology and Metabolic Diseases (H.A.v.D.), and Clinical Genetics (H.A.v.D., M.L.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands; Faculty of Health and Medical Sciences (O.P.), University of Copenhagen, DK-2400 Copenhagen, Denmark; School of Medicine and Pharmacology (B.B.Y.), Western Australia Centre for Health and Ageing (L.F.), Centre for Medical Research (L.F.), and School of Medicine and Pharmacology (L.F.), University of Western Australia, Perth, Western Australia 6872, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia 6150, Australia; Department of Human Biology (G.A.), Faculty of Natural Sciences, University of Haifa, Haifa 3498838, Israel; and Departments of Medicine and Genetics (N.B., G.A.), Albert Einstein College of Medicine, Bronx, New York 10461
| | - Wilma Oostdijk
- Department of Pathology and Laboratory Medicine (M.M., D.E., S.B., Y.A.), The Children's Hospital of Philadelphia and The University of Pennsylvania, Philadelphia,; Division of Endocrinology and Diabetes (C.P.H., A.G.), The Children's Hospital of Philadelphia, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Pennsylvania 19104; National Children's Research Centre (C.P.H.), Dublin 12, Ireland; STAT5, LLC (R.R.), Los Altos, California 94022; Department of Pediatrics (R.R., V.H.), Oregon Health and Science University, Portland, Oregon 97239; Departments of Pediatrics (J.-M.W., H.A.v.D., W.O.), Endocrinology and Metabolic Diseases (H.A.v.D.), and Clinical Genetics (H.A.v.D., M.L.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands; Faculty of Health and Medical Sciences (O.P.), University of Copenhagen, DK-2400 Copenhagen, Denmark; School of Medicine and Pharmacology (B.B.Y.), Western Australia Centre for Health and Ageing (L.F.), Centre for Medical Research (L.F.), and School of Medicine and Pharmacology (L.F.), University of Western Australia, Perth, Western Australia 6872, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia 6150, Australia; Department of Human Biology (G.A.), Faculty of Natural Sciences, University of Haifa, Haifa 3498838, Israel; and Departments of Medicine and Genetics (N.B., G.A.), Albert Einstein College of Medicine, Bronx, New York 10461
| | - Monique Losekoot
- Department of Pathology and Laboratory Medicine (M.M., D.E., S.B., Y.A.), The Children's Hospital of Philadelphia and The University of Pennsylvania, Philadelphia,; Division of Endocrinology and Diabetes (C.P.H., A.G.), The Children's Hospital of Philadelphia, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Pennsylvania 19104; National Children's Research Centre (C.P.H.), Dublin 12, Ireland; STAT5, LLC (R.R.), Los Altos, California 94022; Department of Pediatrics (R.R., V.H.), Oregon Health and Science University, Portland, Oregon 97239; Departments of Pediatrics (J.-M.W., H.A.v.D., W.O.), Endocrinology and Metabolic Diseases (H.A.v.D.), and Clinical Genetics (H.A.v.D., M.L.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands; Faculty of Health and Medical Sciences (O.P.), University of Copenhagen, DK-2400 Copenhagen, Denmark; School of Medicine and Pharmacology (B.B.Y.), Western Australia Centre for Health and Ageing (L.F.), Centre for Medical Research (L.F.), and School of Medicine and Pharmacology (L.F.), University of Western Australia, Perth, Western Australia 6872, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia 6150, Australia; Department of Human Biology (G.A.), Faculty of Natural Sciences, University of Haifa, Haifa 3498838, Israel; and Departments of Medicine and Genetics (N.B., G.A.), Albert Einstein College of Medicine, Bronx, New York 10461
| | - Oluf Pedersen
- Department of Pathology and Laboratory Medicine (M.M., D.E., S.B., Y.A.), The Children's Hospital of Philadelphia and The University of Pennsylvania, Philadelphia,; Division of Endocrinology and Diabetes (C.P.H., A.G.), The Children's Hospital of Philadelphia, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Pennsylvania 19104; National Children's Research Centre (C.P.H.), Dublin 12, Ireland; STAT5, LLC (R.R.), Los Altos, California 94022; Department of Pediatrics (R.R., V.H.), Oregon Health and Science University, Portland, Oregon 97239; Departments of Pediatrics (J.-M.W., H.A.v.D., W.O.), Endocrinology and Metabolic Diseases (H.A.v.D.), and Clinical Genetics (H.A.v.D., M.L.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands; Faculty of Health and Medical Sciences (O.P.), University of Copenhagen, DK-2400 Copenhagen, Denmark; School of Medicine and Pharmacology (B.B.Y.), Western Australia Centre for Health and Ageing (L.F.), Centre for Medical Research (L.F.), and School of Medicine and Pharmacology (L.F.), University of Western Australia, Perth, Western Australia 6872, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia 6150, Australia; Department of Human Biology (G.A.), Faculty of Natural Sciences, University of Haifa, Haifa 3498838, Israel; and Departments of Medicine and Genetics (N.B., G.A.), Albert Einstein College of Medicine, Bronx, New York 10461
| | - Bu Beng Yeap
- Department of Pathology and Laboratory Medicine (M.M., D.E., S.B., Y.A.), The Children's Hospital of Philadelphia and The University of Pennsylvania, Philadelphia,; Division of Endocrinology and Diabetes (C.P.H., A.G.), The Children's Hospital of Philadelphia, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Pennsylvania 19104; National Children's Research Centre (C.P.H.), Dublin 12, Ireland; STAT5, LLC (R.R.), Los Altos, California 94022; Department of Pediatrics (R.R., V.H.), Oregon Health and Science University, Portland, Oregon 97239; Departments of Pediatrics (J.-M.W., H.A.v.D., W.O.), Endocrinology and Metabolic Diseases (H.A.v.D.), and Clinical Genetics (H.A.v.D., M.L.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands; Faculty of Health and Medical Sciences (O.P.), University of Copenhagen, DK-2400 Copenhagen, Denmark; School of Medicine and Pharmacology (B.B.Y.), Western Australia Centre for Health and Ageing (L.F.), Centre for Medical Research (L.F.), and School of Medicine and Pharmacology (L.F.), University of Western Australia, Perth, Western Australia 6872, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia 6150, Australia; Department of Human Biology (G.A.), Faculty of Natural Sciences, University of Haifa, Haifa 3498838, Israel; and Departments of Medicine and Genetics (N.B., G.A.), Albert Einstein College of Medicine, Bronx, New York 10461
| | - Leon Flicker
- Department of Pathology and Laboratory Medicine (M.M., D.E., S.B., Y.A.), The Children's Hospital of Philadelphia and The University of Pennsylvania, Philadelphia,; Division of Endocrinology and Diabetes (C.P.H., A.G.), The Children's Hospital of Philadelphia, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Pennsylvania 19104; National Children's Research Centre (C.P.H.), Dublin 12, Ireland; STAT5, LLC (R.R.), Los Altos, California 94022; Department of Pediatrics (R.R., V.H.), Oregon Health and Science University, Portland, Oregon 97239; Departments of Pediatrics (J.-M.W., H.A.v.D., W.O.), Endocrinology and Metabolic Diseases (H.A.v.D.), and Clinical Genetics (H.A.v.D., M.L.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands; Faculty of Health and Medical Sciences (O.P.), University of Copenhagen, DK-2400 Copenhagen, Denmark; School of Medicine and Pharmacology (B.B.Y.), Western Australia Centre for Health and Ageing (L.F.), Centre for Medical Research (L.F.), and School of Medicine and Pharmacology (L.F.), University of Western Australia, Perth, Western Australia 6872, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia 6150, Australia; Department of Human Biology (G.A.), Faculty of Natural Sciences, University of Haifa, Haifa 3498838, Israel; and Departments of Medicine and Genetics (N.B., G.A.), Albert Einstein College of Medicine, Bronx, New York 10461
| | - Nir Barzilai
- Department of Pathology and Laboratory Medicine (M.M., D.E., S.B., Y.A.), The Children's Hospital of Philadelphia and The University of Pennsylvania, Philadelphia,; Division of Endocrinology and Diabetes (C.P.H., A.G.), The Children's Hospital of Philadelphia, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Pennsylvania 19104; National Children's Research Centre (C.P.H.), Dublin 12, Ireland; STAT5, LLC (R.R.), Los Altos, California 94022; Department of Pediatrics (R.R., V.H.), Oregon Health and Science University, Portland, Oregon 97239; Departments of Pediatrics (J.-M.W., H.A.v.D., W.O.), Endocrinology and Metabolic Diseases (H.A.v.D.), and Clinical Genetics (H.A.v.D., M.L.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands; Faculty of Health and Medical Sciences (O.P.), University of Copenhagen, DK-2400 Copenhagen, Denmark; School of Medicine and Pharmacology (B.B.Y.), Western Australia Centre for Health and Ageing (L.F.), Centre for Medical Research (L.F.), and School of Medicine and Pharmacology (L.F.), University of Western Australia, Perth, Western Australia 6872, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia 6150, Australia; Department of Human Biology (G.A.), Faculty of Natural Sciences, University of Haifa, Haifa 3498838, Israel; and Departments of Medicine and Genetics (N.B., G.A.), Albert Einstein College of Medicine, Bronx, New York 10461
| | - Gil Atzmon
- Department of Pathology and Laboratory Medicine (M.M., D.E., S.B., Y.A.), The Children's Hospital of Philadelphia and The University of Pennsylvania, Philadelphia,; Division of Endocrinology and Diabetes (C.P.H., A.G.), The Children's Hospital of Philadelphia, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Pennsylvania 19104; National Children's Research Centre (C.P.H.), Dublin 12, Ireland; STAT5, LLC (R.R.), Los Altos, California 94022; Department of Pediatrics (R.R., V.H.), Oregon Health and Science University, Portland, Oregon 97239; Departments of Pediatrics (J.-M.W., H.A.v.D., W.O.), Endocrinology and Metabolic Diseases (H.A.v.D.), and Clinical Genetics (H.A.v.D., M.L.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands; Faculty of Health and Medical Sciences (O.P.), University of Copenhagen, DK-2400 Copenhagen, Denmark; School of Medicine and Pharmacology (B.B.Y.), Western Australia Centre for Health and Ageing (L.F.), Centre for Medical Research (L.F.), and School of Medicine and Pharmacology (L.F.), University of Western Australia, Perth, Western Australia 6872, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia 6150, Australia; Department of Human Biology (G.A.), Faculty of Natural Sciences, University of Haifa, Haifa 3498838, Israel; and Departments of Medicine and Genetics (N.B., G.A.), Albert Einstein College of Medicine, Bronx, New York 10461
| | - Adda Grimberg
- Department of Pathology and Laboratory Medicine (M.M., D.E., S.B., Y.A.), The Children's Hospital of Philadelphia and The University of Pennsylvania, Philadelphia,; Division of Endocrinology and Diabetes (C.P.H., A.G.), The Children's Hospital of Philadelphia, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Pennsylvania 19104; National Children's Research Centre (C.P.H.), Dublin 12, Ireland; STAT5, LLC (R.R.), Los Altos, California 94022; Department of Pediatrics (R.R., V.H.), Oregon Health and Science University, Portland, Oregon 97239; Departments of Pediatrics (J.-M.W., H.A.v.D., W.O.), Endocrinology and Metabolic Diseases (H.A.v.D.), and Clinical Genetics (H.A.v.D., M.L.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands; Faculty of Health and Medical Sciences (O.P.), University of Copenhagen, DK-2400 Copenhagen, Denmark; School of Medicine and Pharmacology (B.B.Y.), Western Australia Centre for Health and Ageing (L.F.), Centre for Medical Research (L.F.), and School of Medicine and Pharmacology (L.F.), University of Western Australia, Perth, Western Australia 6872, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia 6150, Australia; Department of Human Biology (G.A.), Faculty of Natural Sciences, University of Haifa, Haifa 3498838, Israel; and Departments of Medicine and Genetics (N.B., G.A.), Albert Einstein College of Medicine, Bronx, New York 10461
| | - Yair Argon
- Department of Pathology and Laboratory Medicine (M.M., D.E., S.B., Y.A.), The Children's Hospital of Philadelphia and The University of Pennsylvania, Philadelphia,; Division of Endocrinology and Diabetes (C.P.H., A.G.), The Children's Hospital of Philadelphia, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Pennsylvania 19104; National Children's Research Centre (C.P.H.), Dublin 12, Ireland; STAT5, LLC (R.R.), Los Altos, California 94022; Department of Pediatrics (R.R., V.H.), Oregon Health and Science University, Portland, Oregon 97239; Departments of Pediatrics (J.-M.W., H.A.v.D., W.O.), Endocrinology and Metabolic Diseases (H.A.v.D.), and Clinical Genetics (H.A.v.D., M.L.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands; Faculty of Health and Medical Sciences (O.P.), University of Copenhagen, DK-2400 Copenhagen, Denmark; School of Medicine and Pharmacology (B.B.Y.), Western Australia Centre for Health and Ageing (L.F.), Centre for Medical Research (L.F.), and School of Medicine and Pharmacology (L.F.), University of Western Australia, Perth, Western Australia 6872, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia 6150, Australia; Department of Human Biology (G.A.), Faculty of Natural Sciences, University of Haifa, Haifa 3498838, Israel; and Departments of Medicine and Genetics (N.B., G.A.), Albert Einstein College of Medicine, Bronx, New York 10461
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Wit JM, Oostdijk W, Losekoot M, van Duyvenvoorde HA, Ruivenkamp CAL, Kant SG. MECHANISMS IN ENDOCRINOLOGY: Novel genetic causes of short stature. Eur J Endocrinol 2016; 174:R145-73. [PMID: 26578640 DOI: 10.1530/eje-15-0937] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 11/16/2015] [Indexed: 12/17/2022]
Abstract
The fast technological development, particularly single nucleotide polymorphism array, array-comparative genomic hybridization, and whole exome sequencing, has led to the discovery of many novel genetic causes of growth failure. In this review we discuss a selection of these, according to a diagnostic classification centred on the epiphyseal growth plate. We successively discuss disorders in hormone signalling, paracrine factors, matrix molecules, intracellular pathways, and fundamental cellular processes, followed by chromosomal aberrations including copy number variants (CNVs) and imprinting disorders associated with short stature. Many novel causes of GH deficiency (GHD) as part of combined pituitary hormone deficiency have been uncovered. The most frequent genetic causes of isolated GHD are GH1 and GHRHR defects, but several novel causes have recently been found, such as GHSR, RNPC3, and IFT172 mutations. Besides well-defined causes of GH insensitivity (GHR, STAT5B, IGFALS, IGF1 defects), disorders of NFκB signalling, STAT3 and IGF2 have recently been discovered. Heterozygous IGF1R defects are a relatively frequent cause of prenatal and postnatal growth retardation. TRHA mutations cause a syndromic form of short stature with elevated T3/T4 ratio. Disorders of signalling of various paracrine factors (FGFs, BMPs, WNTs, PTHrP/IHH, and CNP/NPR2) or genetic defects affecting cartilage extracellular matrix usually cause disproportionate short stature. Heterozygous NPR2 or SHOX defects may be found in ∼3% of short children, and also rasopathies (e.g., Noonan syndrome) can be found in children without clear syndromic appearance. Numerous other syndromes associated with short stature are caused by genetic defects in fundamental cellular processes, chromosomal abnormalities, CNVs, and imprinting disorders.
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Affiliation(s)
- Jan M Wit
- Departments of PaediatricsClinical GeneticsLeiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - Wilma Oostdijk
- Departments of PaediatricsClinical GeneticsLeiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - Monique Losekoot
- Departments of PaediatricsClinical GeneticsLeiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - Hermine A van Duyvenvoorde
- Departments of PaediatricsClinical GeneticsLeiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - Claudia A L Ruivenkamp
- Departments of PaediatricsClinical GeneticsLeiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - Sarina G Kant
- Departments of PaediatricsClinical GeneticsLeiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
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26
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Joustra SD, Heinen CA, Schoenmakers N, Bonomi M, Ballieux BEPB, Turgeon MO, Bernard DJ, Fliers E, van Trotsenburg ASP, Losekoot M, Persani L, Wit JM, Biermasz NR, Pereira AM, Oostdijk W. IGSF1 Deficiency: Lessons From an Extensive Case Series and Recommendations for Clinical Management. J Clin Endocrinol Metab 2016; 101:1627-36. [PMID: 26840047 PMCID: PMC4880178 DOI: 10.1210/jc.2015-3880] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 01/27/2016] [Indexed: 11/28/2022]
Abstract
CONTEXT Mutations in the immunoglobulin superfamily, member 1 (IGSF1) gene cause the X-linked IGSF1 deficiency syndrome consisting of central hypothyroidism, delayed pubertal testosterone rise, adult macroorchidism, variable prolactin deficiency, and occasionally transient partial GH deficiency. Since our first reports, we discovered 20 new families with 18 new pathogenic IGSF1 mutations. OBJECTIVE We aimed to share data on the largest cohort of patients with IGSF1 deficiency to date and formulate recommendations for clinical management. METHODS We collected clinical and biochemical characteristics of 69 male patients (35 children, 34 adults) and 56 female IGSF1 mutation carriers (three children, 53 adults) from 30 unrelated families according to a standardized clinical protocol. At evaluation, boys were treated with levothyroxine in 89%, adult males in 44%, and females in 5% of cases. RESULTS Additional symptoms in male patients included small thyroid gland volume (74%), high birth weight (25%), and large head circumference (20%). In general, the timing of pubertal testicular growth was normal or even premature, in contrast to a late rise in T levels. Late adrenarche was observed in patients with prolactin deficiency, and adult dehydroepiandrosterone concentrations were decreased in 40%. Hypocortisolism was observed in 6 of 28 evaluated newborns, although cortisol concentrations were normal later. Waist circumference of male patients was increased in 60%, but blood lipids were normal. Female carriers showed low free T4 (FT4) and low-normal FT4 in 18% and 60%, respectively, delayed age at menarche in 31%, mild prolactin deficiency in 22%, increased waist circumference in 57%, and a negative correlation between FT4 concentrations and metabolic parameters. CONCLUSION IGSF1 deficiency represents the most common genetic cause of central hypothyroidism and is associated with multiple other characteristics. Based on these results, we provide recommendations for mutational analysis, endocrine work-up, and long-term care.
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Affiliation(s)
- S D Joustra
- Department of Pediatrics (S.D.J., J.M.W., W.O.), Department of Medicine (S.D.J., N.R.B., A.M.P.), Division of Endocrinology, Department of Clinical Chemistry and Laboratory Medicine (B.E.P.B.), and Department of Clinical Genetics (M.L.), Leiden University Medical Center, 2300 C Leiden, The Netherlands; Department of Pediatric Endocrinology (C.A.H., A.S.P.v.T.), Emma Children's Hospital, and Department of Endocrinology and Metabolism (C.A.H., E.F.), Academic Medical Center, University of Amsterdam, 1100 DE, The Netherlands; University of Cambridge Metabolic Research Laboratories (N.S.), Wellcome Trust-Medical Research Council Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge DB2 2OO, United Kingdom; Division of Endocrine and Metabolic Disorders (M.B.), Instituto di Ricovero e Cura a Carettere Scientifico, Instituto Auxologica Italiano, 20132 Milan, Italy; Department of Clinical Sciences and Community Health (M.B., L.P.), Università degli Studi di Milano, 20122 Milan, Italy; Department of Pharmacology and Therapeutics (M.-O.T., D.J.B.), McGill University, Montréal, Québec, Canada H9X 3V9
| | - C A Heinen
- Department of Pediatrics (S.D.J., J.M.W., W.O.), Department of Medicine (S.D.J., N.R.B., A.M.P.), Division of Endocrinology, Department of Clinical Chemistry and Laboratory Medicine (B.E.P.B.), and Department of Clinical Genetics (M.L.), Leiden University Medical Center, 2300 C Leiden, The Netherlands; Department of Pediatric Endocrinology (C.A.H., A.S.P.v.T.), Emma Children's Hospital, and Department of Endocrinology and Metabolism (C.A.H., E.F.), Academic Medical Center, University of Amsterdam, 1100 DE, The Netherlands; University of Cambridge Metabolic Research Laboratories (N.S.), Wellcome Trust-Medical Research Council Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge DB2 2OO, United Kingdom; Division of Endocrine and Metabolic Disorders (M.B.), Instituto di Ricovero e Cura a Carettere Scientifico, Instituto Auxologica Italiano, 20132 Milan, Italy; Department of Clinical Sciences and Community Health (M.B., L.P.), Università degli Studi di Milano, 20122 Milan, Italy; Department of Pharmacology and Therapeutics (M.-O.T., D.J.B.), McGill University, Montréal, Québec, Canada H9X 3V9
| | - N Schoenmakers
- Department of Pediatrics (S.D.J., J.M.W., W.O.), Department of Medicine (S.D.J., N.R.B., A.M.P.), Division of Endocrinology, Department of Clinical Chemistry and Laboratory Medicine (B.E.P.B.), and Department of Clinical Genetics (M.L.), Leiden University Medical Center, 2300 C Leiden, The Netherlands; Department of Pediatric Endocrinology (C.A.H., A.S.P.v.T.), Emma Children's Hospital, and Department of Endocrinology and Metabolism (C.A.H., E.F.), Academic Medical Center, University of Amsterdam, 1100 DE, The Netherlands; University of Cambridge Metabolic Research Laboratories (N.S.), Wellcome Trust-Medical Research Council Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge DB2 2OO, United Kingdom; Division of Endocrine and Metabolic Disorders (M.B.), Instituto di Ricovero e Cura a Carettere Scientifico, Instituto Auxologica Italiano, 20132 Milan, Italy; Department of Clinical Sciences and Community Health (M.B., L.P.), Università degli Studi di Milano, 20122 Milan, Italy; Department of Pharmacology and Therapeutics (M.-O.T., D.J.B.), McGill University, Montréal, Québec, Canada H9X 3V9
| | - M Bonomi
- Department of Pediatrics (S.D.J., J.M.W., W.O.), Department of Medicine (S.D.J., N.R.B., A.M.P.), Division of Endocrinology, Department of Clinical Chemistry and Laboratory Medicine (B.E.P.B.), and Department of Clinical Genetics (M.L.), Leiden University Medical Center, 2300 C Leiden, The Netherlands; Department of Pediatric Endocrinology (C.A.H., A.S.P.v.T.), Emma Children's Hospital, and Department of Endocrinology and Metabolism (C.A.H., E.F.), Academic Medical Center, University of Amsterdam, 1100 DE, The Netherlands; University of Cambridge Metabolic Research Laboratories (N.S.), Wellcome Trust-Medical Research Council Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge DB2 2OO, United Kingdom; Division of Endocrine and Metabolic Disorders (M.B.), Instituto di Ricovero e Cura a Carettere Scientifico, Instituto Auxologica Italiano, 20132 Milan, Italy; Department of Clinical Sciences and Community Health (M.B., L.P.), Università degli Studi di Milano, 20122 Milan, Italy; Department of Pharmacology and Therapeutics (M.-O.T., D.J.B.), McGill University, Montréal, Québec, Canada H9X 3V9
| | - B E P B Ballieux
- Department of Pediatrics (S.D.J., J.M.W., W.O.), Department of Medicine (S.D.J., N.R.B., A.M.P.), Division of Endocrinology, Department of Clinical Chemistry and Laboratory Medicine (B.E.P.B.), and Department of Clinical Genetics (M.L.), Leiden University Medical Center, 2300 C Leiden, The Netherlands; Department of Pediatric Endocrinology (C.A.H., A.S.P.v.T.), Emma Children's Hospital, and Department of Endocrinology and Metabolism (C.A.H., E.F.), Academic Medical Center, University of Amsterdam, 1100 DE, The Netherlands; University of Cambridge Metabolic Research Laboratories (N.S.), Wellcome Trust-Medical Research Council Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge DB2 2OO, United Kingdom; Division of Endocrine and Metabolic Disorders (M.B.), Instituto di Ricovero e Cura a Carettere Scientifico, Instituto Auxologica Italiano, 20132 Milan, Italy; Department of Clinical Sciences and Community Health (M.B., L.P.), Università degli Studi di Milano, 20122 Milan, Italy; Department of Pharmacology and Therapeutics (M.-O.T., D.J.B.), McGill University, Montréal, Québec, Canada H9X 3V9
| | - M-O Turgeon
- Department of Pediatrics (S.D.J., J.M.W., W.O.), Department of Medicine (S.D.J., N.R.B., A.M.P.), Division of Endocrinology, Department of Clinical Chemistry and Laboratory Medicine (B.E.P.B.), and Department of Clinical Genetics (M.L.), Leiden University Medical Center, 2300 C Leiden, The Netherlands; Department of Pediatric Endocrinology (C.A.H., A.S.P.v.T.), Emma Children's Hospital, and Department of Endocrinology and Metabolism (C.A.H., E.F.), Academic Medical Center, University of Amsterdam, 1100 DE, The Netherlands; University of Cambridge Metabolic Research Laboratories (N.S.), Wellcome Trust-Medical Research Council Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge DB2 2OO, United Kingdom; Division of Endocrine and Metabolic Disorders (M.B.), Instituto di Ricovero e Cura a Carettere Scientifico, Instituto Auxologica Italiano, 20132 Milan, Italy; Department of Clinical Sciences and Community Health (M.B., L.P.), Università degli Studi di Milano, 20122 Milan, Italy; Department of Pharmacology and Therapeutics (M.-O.T., D.J.B.), McGill University, Montréal, Québec, Canada H9X 3V9
| | - D J Bernard
- Department of Pediatrics (S.D.J., J.M.W., W.O.), Department of Medicine (S.D.J., N.R.B., A.M.P.), Division of Endocrinology, Department of Clinical Chemistry and Laboratory Medicine (B.E.P.B.), and Department of Clinical Genetics (M.L.), Leiden University Medical Center, 2300 C Leiden, The Netherlands; Department of Pediatric Endocrinology (C.A.H., A.S.P.v.T.), Emma Children's Hospital, and Department of Endocrinology and Metabolism (C.A.H., E.F.), Academic Medical Center, University of Amsterdam, 1100 DE, The Netherlands; University of Cambridge Metabolic Research Laboratories (N.S.), Wellcome Trust-Medical Research Council Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge DB2 2OO, United Kingdom; Division of Endocrine and Metabolic Disorders (M.B.), Instituto di Ricovero e Cura a Carettere Scientifico, Instituto Auxologica Italiano, 20132 Milan, Italy; Department of Clinical Sciences and Community Health (M.B., L.P.), Università degli Studi di Milano, 20122 Milan, Italy; Department of Pharmacology and Therapeutics (M.-O.T., D.J.B.), McGill University, Montréal, Québec, Canada H9X 3V9
| | - E Fliers
- Department of Pediatrics (S.D.J., J.M.W., W.O.), Department of Medicine (S.D.J., N.R.B., A.M.P.), Division of Endocrinology, Department of Clinical Chemistry and Laboratory Medicine (B.E.P.B.), and Department of Clinical Genetics (M.L.), Leiden University Medical Center, 2300 C Leiden, The Netherlands; Department of Pediatric Endocrinology (C.A.H., A.S.P.v.T.), Emma Children's Hospital, and Department of Endocrinology and Metabolism (C.A.H., E.F.), Academic Medical Center, University of Amsterdam, 1100 DE, The Netherlands; University of Cambridge Metabolic Research Laboratories (N.S.), Wellcome Trust-Medical Research Council Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge DB2 2OO, United Kingdom; Division of Endocrine and Metabolic Disorders (M.B.), Instituto di Ricovero e Cura a Carettere Scientifico, Instituto Auxologica Italiano, 20132 Milan, Italy; Department of Clinical Sciences and Community Health (M.B., L.P.), Università degli Studi di Milano, 20122 Milan, Italy; Department of Pharmacology and Therapeutics (M.-O.T., D.J.B.), McGill University, Montréal, Québec, Canada H9X 3V9
| | - A S P van Trotsenburg
- Department of Pediatrics (S.D.J., J.M.W., W.O.), Department of Medicine (S.D.J., N.R.B., A.M.P.), Division of Endocrinology, Department of Clinical Chemistry and Laboratory Medicine (B.E.P.B.), and Department of Clinical Genetics (M.L.), Leiden University Medical Center, 2300 C Leiden, The Netherlands; Department of Pediatric Endocrinology (C.A.H., A.S.P.v.T.), Emma Children's Hospital, and Department of Endocrinology and Metabolism (C.A.H., E.F.), Academic Medical Center, University of Amsterdam, 1100 DE, The Netherlands; University of Cambridge Metabolic Research Laboratories (N.S.), Wellcome Trust-Medical Research Council Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge DB2 2OO, United Kingdom; Division of Endocrine and Metabolic Disorders (M.B.), Instituto di Ricovero e Cura a Carettere Scientifico, Instituto Auxologica Italiano, 20132 Milan, Italy; Department of Clinical Sciences and Community Health (M.B., L.P.), Università degli Studi di Milano, 20122 Milan, Italy; Department of Pharmacology and Therapeutics (M.-O.T., D.J.B.), McGill University, Montréal, Québec, Canada H9X 3V9
| | - M Losekoot
- Department of Pediatrics (S.D.J., J.M.W., W.O.), Department of Medicine (S.D.J., N.R.B., A.M.P.), Division of Endocrinology, Department of Clinical Chemistry and Laboratory Medicine (B.E.P.B.), and Department of Clinical Genetics (M.L.), Leiden University Medical Center, 2300 C Leiden, The Netherlands; Department of Pediatric Endocrinology (C.A.H., A.S.P.v.T.), Emma Children's Hospital, and Department of Endocrinology and Metabolism (C.A.H., E.F.), Academic Medical Center, University of Amsterdam, 1100 DE, The Netherlands; University of Cambridge Metabolic Research Laboratories (N.S.), Wellcome Trust-Medical Research Council Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge DB2 2OO, United Kingdom; Division of Endocrine and Metabolic Disorders (M.B.), Instituto di Ricovero e Cura a Carettere Scientifico, Instituto Auxologica Italiano, 20132 Milan, Italy; Department of Clinical Sciences and Community Health (M.B., L.P.), Università degli Studi di Milano, 20122 Milan, Italy; Department of Pharmacology and Therapeutics (M.-O.T., D.J.B.), McGill University, Montréal, Québec, Canada H9X 3V9
| | - L Persani
- Department of Pediatrics (S.D.J., J.M.W., W.O.), Department of Medicine (S.D.J., N.R.B., A.M.P.), Division of Endocrinology, Department of Clinical Chemistry and Laboratory Medicine (B.E.P.B.), and Department of Clinical Genetics (M.L.), Leiden University Medical Center, 2300 C Leiden, The Netherlands; Department of Pediatric Endocrinology (C.A.H., A.S.P.v.T.), Emma Children's Hospital, and Department of Endocrinology and Metabolism (C.A.H., E.F.), Academic Medical Center, University of Amsterdam, 1100 DE, The Netherlands; University of Cambridge Metabolic Research Laboratories (N.S.), Wellcome Trust-Medical Research Council Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge DB2 2OO, United Kingdom; Division of Endocrine and Metabolic Disorders (M.B.), Instituto di Ricovero e Cura a Carettere Scientifico, Instituto Auxologica Italiano, 20132 Milan, Italy; Department of Clinical Sciences and Community Health (M.B., L.P.), Università degli Studi di Milano, 20122 Milan, Italy; Department of Pharmacology and Therapeutics (M.-O.T., D.J.B.), McGill University, Montréal, Québec, Canada H9X 3V9
| | - J M Wit
- Department of Pediatrics (S.D.J., J.M.W., W.O.), Department of Medicine (S.D.J., N.R.B., A.M.P.), Division of Endocrinology, Department of Clinical Chemistry and Laboratory Medicine (B.E.P.B.), and Department of Clinical Genetics (M.L.), Leiden University Medical Center, 2300 C Leiden, The Netherlands; Department of Pediatric Endocrinology (C.A.H., A.S.P.v.T.), Emma Children's Hospital, and Department of Endocrinology and Metabolism (C.A.H., E.F.), Academic Medical Center, University of Amsterdam, 1100 DE, The Netherlands; University of Cambridge Metabolic Research Laboratories (N.S.), Wellcome Trust-Medical Research Council Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge DB2 2OO, United Kingdom; Division of Endocrine and Metabolic Disorders (M.B.), Instituto di Ricovero e Cura a Carettere Scientifico, Instituto Auxologica Italiano, 20132 Milan, Italy; Department of Clinical Sciences and Community Health (M.B., L.P.), Università degli Studi di Milano, 20122 Milan, Italy; Department of Pharmacology and Therapeutics (M.-O.T., D.J.B.), McGill University, Montréal, Québec, Canada H9X 3V9
| | - N R Biermasz
- Department of Pediatrics (S.D.J., J.M.W., W.O.), Department of Medicine (S.D.J., N.R.B., A.M.P.), Division of Endocrinology, Department of Clinical Chemistry and Laboratory Medicine (B.E.P.B.), and Department of Clinical Genetics (M.L.), Leiden University Medical Center, 2300 C Leiden, The Netherlands; Department of Pediatric Endocrinology (C.A.H., A.S.P.v.T.), Emma Children's Hospital, and Department of Endocrinology and Metabolism (C.A.H., E.F.), Academic Medical Center, University of Amsterdam, 1100 DE, The Netherlands; University of Cambridge Metabolic Research Laboratories (N.S.), Wellcome Trust-Medical Research Council Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge DB2 2OO, United Kingdom; Division of Endocrine and Metabolic Disorders (M.B.), Instituto di Ricovero e Cura a Carettere Scientifico, Instituto Auxologica Italiano, 20132 Milan, Italy; Department of Clinical Sciences and Community Health (M.B., L.P.), Università degli Studi di Milano, 20122 Milan, Italy; Department of Pharmacology and Therapeutics (M.-O.T., D.J.B.), McGill University, Montréal, Québec, Canada H9X 3V9
| | - A M Pereira
- Department of Pediatrics (S.D.J., J.M.W., W.O.), Department of Medicine (S.D.J., N.R.B., A.M.P.), Division of Endocrinology, Department of Clinical Chemistry and Laboratory Medicine (B.E.P.B.), and Department of Clinical Genetics (M.L.), Leiden University Medical Center, 2300 C Leiden, The Netherlands; Department of Pediatric Endocrinology (C.A.H., A.S.P.v.T.), Emma Children's Hospital, and Department of Endocrinology and Metabolism (C.A.H., E.F.), Academic Medical Center, University of Amsterdam, 1100 DE, The Netherlands; University of Cambridge Metabolic Research Laboratories (N.S.), Wellcome Trust-Medical Research Council Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge DB2 2OO, United Kingdom; Division of Endocrine and Metabolic Disorders (M.B.), Instituto di Ricovero e Cura a Carettere Scientifico, Instituto Auxologica Italiano, 20132 Milan, Italy; Department of Clinical Sciences and Community Health (M.B., L.P.), Università degli Studi di Milano, 20122 Milan, Italy; Department of Pharmacology and Therapeutics (M.-O.T., D.J.B.), McGill University, Montréal, Québec, Canada H9X 3V9
| | - W Oostdijk
- Department of Pediatrics (S.D.J., J.M.W., W.O.), Department of Medicine (S.D.J., N.R.B., A.M.P.), Division of Endocrinology, Department of Clinical Chemistry and Laboratory Medicine (B.E.P.B.), and Department of Clinical Genetics (M.L.), Leiden University Medical Center, 2300 C Leiden, The Netherlands; Department of Pediatric Endocrinology (C.A.H., A.S.P.v.T.), Emma Children's Hospital, and Department of Endocrinology and Metabolism (C.A.H., E.F.), Academic Medical Center, University of Amsterdam, 1100 DE, The Netherlands; University of Cambridge Metabolic Research Laboratories (N.S.), Wellcome Trust-Medical Research Council Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge DB2 2OO, United Kingdom; Division of Endocrine and Metabolic Disorders (M.B.), Instituto di Ricovero e Cura a Carettere Scientifico, Instituto Auxologica Italiano, 20132 Milan, Italy; Department of Clinical Sciences and Community Health (M.B., L.P.), Università degli Studi di Milano, 20122 Milan, Italy; Department of Pharmacology and Therapeutics (M.-O.T., D.J.B.), McGill University, Montréal, Québec, Canada H9X 3V9
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27
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Hulle SV, Craen M, Callewaert B, Joustra S, Oostdijk W, Losekoot M, Wit JM, Turgeon MO, Bernard DJ, Schepper JD. Delayed Adrenarche may be an Additional Feature of Immunoglobulin Super Family Member 1 Deficiency Syndrome. J Clin Res Pediatr Endocrinol 2016; 8:86-91. [PMID: 26757742 PMCID: PMC4805054 DOI: 10.4274/jcrpe.2512] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Immunoglobulin super family member 1 (IGSF1) deficiency syndrome is characterized by central hypothyroidism, delayed surge in testosterone during puberty, macro-orchidism, and in some cases, hypoprolactinemia and/or transient growth hormone (GH) deficiency. Our patient was a 19-year-old male adolescent who had been treated since the age of 9 years with GH and thyroxine for an idiopathic combined GH, thyroid-stimulating hormone (TSH), and prolactin (PRL) deficiency. His GH deficiency proved to be transient, but deficiencies of TSH and PRL persisted, and he had developed macro-orchidism since the end of puberty. Brain magnetic resonance imaging and PROP1 and POU1F1 sequencing were normal. A disharmonious puberty (delayed genital and pubic hair development, bone maturation, and pubertal growth spurt, despite normal testicular growth) was observed as well as a delayed adrenarche, as reflected by very low dehydroepiandrosterone sulfate and delayed pubarche. Direct sequencing of the IGSF1 gene revealed a novel hemizygous mutation, c.3127T>C, p.Cys1043Arg. Pathogenicity of the mutation was demonstrated in vitro. Male children with an idiopathic combined GH, PRL, and TSH deficiency, showing persistent central hypothyroidism but transient GH deficiency upon retesting at adult height, should be screened for mutations in the IGSF1 gene, especially when macro-orchidism and/or hypoprolactinemia are present. We suspect that delayed adrenarche, as a consequence of PRL deficiency, might be part of the clinical phenotype of patients with IGSF1 deficiency.
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Affiliation(s)
| | - Margarita Craen
- University Hospital Gent, Department of Pediatrics, Gent, Belgium
| | - Bert Callewaert
- University Hospital Gent, Department of Medical Genetics, Gent, Belgium
| | - Sjoerd Joustra
- Leiden University Medical Center, Department of Internal Medicine, Division of Endocrinology, Leiden, Netherlands
| | - Wilma Oostdijk
- Leiden University Medical Center, Department of Pediatrics, Leiden, Netherlands
| | - Monique Losekoot
- Leiden University Medical Center, Department of Clinical Genetics, Leiden, Netherlands
| | - Jan Maarten Wit
- Leiden University Medical Center, Department of Pediatrics, Leiden, Netherlands
| | | | - Daniel J. Bernard
- McGill University, Department of Pharmacology and Therapeutics, Quebec, Canada
| | - Jean De Schepper
- University Hospital Gent, Department of Pediatrics, Gent, Belgium
,* Address for Correspondence: University Hospital Gent, Department of Pediatrics, Gent, Belgium Phone: +00 32 9 332 61 19 E-mail:
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Joustra SD, Roelfsema F, Endert E, Ballieux BEPB, van Trotsenburg ASP, Fliers E, Corssmit EPM, Bernard DJ, Oostdijk W, Wit JM, Pereira AM, Biermasz NR. Pituitary Hormone Secretion Profiles in IGSF1 Deficiency Syndrome. Neuroendocrinology 2016; 103:408-16. [PMID: 26336917 DOI: 10.1159/000439433] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 08/15/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Loss-of-function mutations in immunoglobulin superfamily member 1 (IGSF1) cause an X-linked syndrome of central hypothyroidism, macroorchidism, delayed pubertal testosterone rise, variable prolactin deficiency and variable partial GH deficiency in childhood. The clinical features and gene expression pattern suggest a pivotal role for IGSF1 in the pituitary, but detailed knowledge on pituitary hormone secretion in this syndrome is lacking. We therefore aimed to study the 24-hour pituitary hormone secretion in male patients with IGSF1 deficiency. METHODS We collected blood samples every 10 min for 24 h in eight adult male IGSF1-deficient patients and measured circulating TSH, prolactin and gonadotropins. Deconvolution, modified cosinor and approximate entropy analyses were applied to quantify secretion rates, diurnal rhythmicity and regularity of hormone release. Results were compared to healthy controls matched for age and body mass index. RESULTS Compared to healthy controls, IGSF1-deficient patients showed decreased pulsatile secretion of TSH with decreased disorderliness and reduced diurnal variation. Basal and pulsatile secretion of FSH was increased by over 200%, while LH secretion did not differ from healthy controls. We observed a bimodal distribution of prolactin secretion, i.e. severe deficiency in three and increased basal and total secretion in the other five patients. CONCLUSION The altered TSH secretion pattern is consistent with the previously hypothesized defect in thyrotropin-releasing hormone signaling in IGSF1 deficiency. However, the phenotype is more extensive and includes increased FSH secretion without altered LH secretion as well as either undetectable or increased prolactin secretion.
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Affiliation(s)
- Sjoerd D Joustra
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
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Donze SH, Meijer CR, Kant SG, Zandwijken GRJ, van der Hout AH, van Spaendonk RML, van den Ouweland AMW, Wit JM, Losekoot M, Oostdijk W. The growth response to GH treatment is greater in patients with SHOX enhancer deletions compared to SHOX defects. Eur J Endocrinol 2015; 173:611-21. [PMID: 26264720 DOI: 10.1530/eje-15-0451] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 08/11/2015] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Short stature caused by point mutations or deletions of the short stature homeobox (SHOX) gene (SHOX haploinsufficiency (SHI)) is a registered indication for GH treatment. Patients with a SHOX enhancer deletion (SED) have a similar phenotype, but their response to GH is unknown. It is uncertain if duplications of SHOX or its enhancer (SDUP) cause short stature. This study aimed to describe the clinical characteristics and growth response to GH treatment in patients with aberrations of SHOX and its enhancers. DESIGN In this retrospective multi-center study (2002-March 2014) clinical information was available from 130 patients (72 SHI, 44 SED, and 14 SDUP) of whom 52 patients were treated with GH. We evaluated height, sitting height (SH), arm span, dysmorphic features and indicators of the growth response to GH (delta height SDS, height velocity, and index of responsiveness). RESULTS Patients with SEDs showed similar HtSDS to patients with SHI (-2.3 and -2.6, respectively, P=0.2), but they were less disproportionate (SH/height ratio SDS 2.0 vs 3.1 (P<0.01) and extremities/trunk ratio 2.57 vs 2.43 (P=0.03)). The 1st year growth response to GH treatment was significantly greater in prepubertal patients with SEDs than SHI. None of the patients with an SDUP was disproportionate and SDUP cosegregated poorly with short stature; their growth response to GH treatment (n=3) was similar to the other groups. CONCLUSIONS Patients with SEDs are equally short, but less disproportionate than patients with SHI, and show a greater response to GH.
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Affiliation(s)
- S H Donze
- Departments of PediatricsClinical GeneticsLeiden University Medical Center, PO Box 9600, 2300 RC Leiden, The NetherlandsDutch Growth Research Foundation ('Stichting Kind en Groei')PO Box 23068, 3001 KB Rotterdam, The NetherlandsDepartment of GeneticsUniversity Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The NetherlandsDepartment of Clinical GeneticsVU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The NetherlandsDepartment of Clinical GeneticsErasmus Medical Center, PO Box 2060, 3000 CB Rotterdam, The Netherlands
| | - C R Meijer
- Departments of PediatricsClinical GeneticsLeiden University Medical Center, PO Box 9600, 2300 RC Leiden, The NetherlandsDutch Growth Research Foundation ('Stichting Kind en Groei')PO Box 23068, 3001 KB Rotterdam, The NetherlandsDepartment of GeneticsUniversity Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The NetherlandsDepartment of Clinical GeneticsVU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The NetherlandsDepartment of Clinical GeneticsErasmus Medical Center, PO Box 2060, 3000 CB Rotterdam, The Netherlands
| | - S G Kant
- Departments of PediatricsClinical GeneticsLeiden University Medical Center, PO Box 9600, 2300 RC Leiden, The NetherlandsDutch Growth Research Foundation ('Stichting Kind en Groei')PO Box 23068, 3001 KB Rotterdam, The NetherlandsDepartment of GeneticsUniversity Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The NetherlandsDepartment of Clinical GeneticsVU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The NetherlandsDepartment of Clinical GeneticsErasmus Medical Center, PO Box 2060, 3000 CB Rotterdam, The Netherlands
| | - G R J Zandwijken
- Departments of PediatricsClinical GeneticsLeiden University Medical Center, PO Box 9600, 2300 RC Leiden, The NetherlandsDutch Growth Research Foundation ('Stichting Kind en Groei')PO Box 23068, 3001 KB Rotterdam, The NetherlandsDepartment of GeneticsUniversity Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The NetherlandsDepartment of Clinical GeneticsVU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The NetherlandsDepartment of Clinical GeneticsErasmus Medical Center, PO Box 2060, 3000 CB Rotterdam, The Netherlands
| | - A H van der Hout
- Departments of PediatricsClinical GeneticsLeiden University Medical Center, PO Box 9600, 2300 RC Leiden, The NetherlandsDutch Growth Research Foundation ('Stichting Kind en Groei')PO Box 23068, 3001 KB Rotterdam, The NetherlandsDepartment of GeneticsUniversity Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The NetherlandsDepartment of Clinical GeneticsVU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The NetherlandsDepartment of Clinical GeneticsErasmus Medical Center, PO Box 2060, 3000 CB Rotterdam, The Netherlands
| | - R M L van Spaendonk
- Departments of PediatricsClinical GeneticsLeiden University Medical Center, PO Box 9600, 2300 RC Leiden, The NetherlandsDutch Growth Research Foundation ('Stichting Kind en Groei')PO Box 23068, 3001 KB Rotterdam, The NetherlandsDepartment of GeneticsUniversity Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The NetherlandsDepartment of Clinical GeneticsVU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The NetherlandsDepartment of Clinical GeneticsErasmus Medical Center, PO Box 2060, 3000 CB Rotterdam, The Netherlands
| | - A M W van den Ouweland
- Departments of PediatricsClinical GeneticsLeiden University Medical Center, PO Box 9600, 2300 RC Leiden, The NetherlandsDutch Growth Research Foundation ('Stichting Kind en Groei')PO Box 23068, 3001 KB Rotterdam, The NetherlandsDepartment of GeneticsUniversity Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The NetherlandsDepartment of Clinical GeneticsVU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The NetherlandsDepartment of Clinical GeneticsErasmus Medical Center, PO Box 2060, 3000 CB Rotterdam, The Netherlands
| | - J M Wit
- Departments of PediatricsClinical GeneticsLeiden University Medical Center, PO Box 9600, 2300 RC Leiden, The NetherlandsDutch Growth Research Foundation ('Stichting Kind en Groei')PO Box 23068, 3001 KB Rotterdam, The NetherlandsDepartment of GeneticsUniversity Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The NetherlandsDepartment of Clinical GeneticsVU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The NetherlandsDepartment of Clinical GeneticsErasmus Medical Center, PO Box 2060, 3000 CB Rotterdam, The Netherlands
| | - M Losekoot
- Departments of PediatricsClinical GeneticsLeiden University Medical Center, PO Box 9600, 2300 RC Leiden, The NetherlandsDutch Growth Research Foundation ('Stichting Kind en Groei')PO Box 23068, 3001 KB Rotterdam, The NetherlandsDepartment of GeneticsUniversity Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The NetherlandsDepartment of Clinical GeneticsVU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The NetherlandsDepartment of Clinical GeneticsErasmus Medical Center, PO Box 2060, 3000 CB Rotterdam, The Netherlands
| | - W Oostdijk
- Departments of PediatricsClinical GeneticsLeiden University Medical Center, PO Box 9600, 2300 RC Leiden, The NetherlandsDutch Growth Research Foundation ('Stichting Kind en Groei')PO Box 23068, 3001 KB Rotterdam, The NetherlandsDepartment of GeneticsUniversity Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The NetherlandsDepartment of Clinical GeneticsVU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The NetherlandsDepartment of Clinical GeneticsErasmus Medical Center, PO Box 2060, 3000 CB Rotterdam, The Netherlands
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van der Steen M, Lem AJ, van der Kaay DCM, Bakker-van Waarde WM, van der Hulst FJPCM, Neijens FS, Noordam C, Odink RJ, Oostdijk W, Schroor EJ, Westerlaken C, Hokken-Koelega ACS. Metabolic Health in Short Children Born Small for Gestational Age Treated With Growth Hormone and Gonadotropin-Releasing Hormone Analog: Results of a Randomized, Dose-Response Trial. J Clin Endocrinol Metab 2015; 100:3725-34. [PMID: 26259134 DOI: 10.1210/jc.2015-2619] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Previously we showed that pubertal children born small for gestational age (SGA) with a poor adult height (AH) expectation can benefit from treatment with GH 1 mg/m(2) per day (∼ 0.033 mg/kg/d) in combination with 2 years of GnRH analog (GnRHa) and even more so with a double GH dose. GnRHa treatment is thought to have negative effects on body composition and blood pressure. Long-term effects and GH-dose effects on metabolic health in children treated with combined GH/GnRHa are unknown. OBJECTIVE This study aimed to investigate body composition, blood pressure, and lipid profile during GH treatment, either with or without 2 years of additional GnRHa. To assess whether GH 2 mg/m(2) per day (∼ 0.067 mg/kg/d) results in a similar or even more favorable metabolic health at AH than GH 1 mg/m(2) per day. METHODS This was a longitudinal, randomized, dose-response GH trial involving 107 short SGA children (58 girls) treated with GH until AH (GH randomized 1 or 2 mg/m(2)/d during puberty). Sixty-four children received additional GnRHa. At AH, metabolic parameters were compared between children treated with combined GH/GnRHa and those with only GH. The GH dose effect on metabolic health was evaluated in a subgroup of 47 children who started GH treatment in early puberty (randomized 1 or 2 mg/m(2)/d) with 2 years of GnRHa. RESULTS At AH, fat mass percentage (FM%) SD score (SDS), lean body mass (LBM) SDS, blood pressure SDS, and lipid profile were similar between children treated with combined GH/GnRHa and those with only GH. In the pubertal subgroup, FM% SDS was lower during treatment with GH 2 mg/m(2) per day. There was no GH dose-dependent effect on LBM SDS, blood pressure, and lipid profile. CONCLUSIONS Combined GH/GnRHa treatment has no long-term negative effects on metabolic health compared with only GH. Started in early puberty, a GH dose of 2 mg/m(2) per day results in a similar metabolic health at AH and a more favorable FM% than GH 1 mg/m(2) per day.
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Affiliation(s)
- Manouk van der Steen
- Dutch Growth Research Foundation (M.v.d.S., A.J.L., D.C.M.v.d.K., A.C.S.H.K.), Rotterdam, 3001 KB, The Netherlands; Children's Hospital Erasmus MC-Sophia (M.v.d.S., A.C.S.H.K.), 3000 CA, Rotterdam, The Netherlands; Department of Pediatrics (W.M.B.v.W.), University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Pediatrics (F.J.P.C.M.v.d.H.), Zaans Medisch Centrum, 1502 DV Zaandam, The Netherlands; Department of Pediatrics (F.S.N.), Rijnstate Hospital, 6815 AD Arnhem, The Netherlands; Department of Pediatrics (C.N.), Radboud University Medical Center, 6525 HP Nijmegen, The Netherlands; Department of Pediatrics (R.J.O.), Catharina Hospital, 5623 EJ Eindhoven, The Netherlands; Department of Pediatrics (W.O.), Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; Amalia Department of Pediatrics (E.J.S.), Isala Clinics, 8025 AB Zwolle, The Netherlands; and Department of Pediatrics (C.W.), Canisius Hospital, 6532 SZ Nijmegen, The Netherlands
| | - Annemieke J Lem
- Dutch Growth Research Foundation (M.v.d.S., A.J.L., D.C.M.v.d.K., A.C.S.H.K.), Rotterdam, 3001 KB, The Netherlands; Children's Hospital Erasmus MC-Sophia (M.v.d.S., A.C.S.H.K.), 3000 CA, Rotterdam, The Netherlands; Department of Pediatrics (W.M.B.v.W.), University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Pediatrics (F.J.P.C.M.v.d.H.), Zaans Medisch Centrum, 1502 DV Zaandam, The Netherlands; Department of Pediatrics (F.S.N.), Rijnstate Hospital, 6815 AD Arnhem, The Netherlands; Department of Pediatrics (C.N.), Radboud University Medical Center, 6525 HP Nijmegen, The Netherlands; Department of Pediatrics (R.J.O.), Catharina Hospital, 5623 EJ Eindhoven, The Netherlands; Department of Pediatrics (W.O.), Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; Amalia Department of Pediatrics (E.J.S.), Isala Clinics, 8025 AB Zwolle, The Netherlands; and Department of Pediatrics (C.W.), Canisius Hospital, 6532 SZ Nijmegen, The Netherlands
| | - Danielle C M van der Kaay
- Dutch Growth Research Foundation (M.v.d.S., A.J.L., D.C.M.v.d.K., A.C.S.H.K.), Rotterdam, 3001 KB, The Netherlands; Children's Hospital Erasmus MC-Sophia (M.v.d.S., A.C.S.H.K.), 3000 CA, Rotterdam, The Netherlands; Department of Pediatrics (W.M.B.v.W.), University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Pediatrics (F.J.P.C.M.v.d.H.), Zaans Medisch Centrum, 1502 DV Zaandam, The Netherlands; Department of Pediatrics (F.S.N.), Rijnstate Hospital, 6815 AD Arnhem, The Netherlands; Department of Pediatrics (C.N.), Radboud University Medical Center, 6525 HP Nijmegen, The Netherlands; Department of Pediatrics (R.J.O.), Catharina Hospital, 5623 EJ Eindhoven, The Netherlands; Department of Pediatrics (W.O.), Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; Amalia Department of Pediatrics (E.J.S.), Isala Clinics, 8025 AB Zwolle, The Netherlands; and Department of Pediatrics (C.W.), Canisius Hospital, 6532 SZ Nijmegen, The Netherlands
| | - Willie M Bakker-van Waarde
- Dutch Growth Research Foundation (M.v.d.S., A.J.L., D.C.M.v.d.K., A.C.S.H.K.), Rotterdam, 3001 KB, The Netherlands; Children's Hospital Erasmus MC-Sophia (M.v.d.S., A.C.S.H.K.), 3000 CA, Rotterdam, The Netherlands; Department of Pediatrics (W.M.B.v.W.), University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Pediatrics (F.J.P.C.M.v.d.H.), Zaans Medisch Centrum, 1502 DV Zaandam, The Netherlands; Department of Pediatrics (F.S.N.), Rijnstate Hospital, 6815 AD Arnhem, The Netherlands; Department of Pediatrics (C.N.), Radboud University Medical Center, 6525 HP Nijmegen, The Netherlands; Department of Pediatrics (R.J.O.), Catharina Hospital, 5623 EJ Eindhoven, The Netherlands; Department of Pediatrics (W.O.), Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; Amalia Department of Pediatrics (E.J.S.), Isala Clinics, 8025 AB Zwolle, The Netherlands; and Department of Pediatrics (C.W.), Canisius Hospital, 6532 SZ Nijmegen, The Netherlands
| | - Flip J P C M van der Hulst
- Dutch Growth Research Foundation (M.v.d.S., A.J.L., D.C.M.v.d.K., A.C.S.H.K.), Rotterdam, 3001 KB, The Netherlands; Children's Hospital Erasmus MC-Sophia (M.v.d.S., A.C.S.H.K.), 3000 CA, Rotterdam, The Netherlands; Department of Pediatrics (W.M.B.v.W.), University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Pediatrics (F.J.P.C.M.v.d.H.), Zaans Medisch Centrum, 1502 DV Zaandam, The Netherlands; Department of Pediatrics (F.S.N.), Rijnstate Hospital, 6815 AD Arnhem, The Netherlands; Department of Pediatrics (C.N.), Radboud University Medical Center, 6525 HP Nijmegen, The Netherlands; Department of Pediatrics (R.J.O.), Catharina Hospital, 5623 EJ Eindhoven, The Netherlands; Department of Pediatrics (W.O.), Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; Amalia Department of Pediatrics (E.J.S.), Isala Clinics, 8025 AB Zwolle, The Netherlands; and Department of Pediatrics (C.W.), Canisius Hospital, 6532 SZ Nijmegen, The Netherlands
| | - Floor S Neijens
- Dutch Growth Research Foundation (M.v.d.S., A.J.L., D.C.M.v.d.K., A.C.S.H.K.), Rotterdam, 3001 KB, The Netherlands; Children's Hospital Erasmus MC-Sophia (M.v.d.S., A.C.S.H.K.), 3000 CA, Rotterdam, The Netherlands; Department of Pediatrics (W.M.B.v.W.), University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Pediatrics (F.J.P.C.M.v.d.H.), Zaans Medisch Centrum, 1502 DV Zaandam, The Netherlands; Department of Pediatrics (F.S.N.), Rijnstate Hospital, 6815 AD Arnhem, The Netherlands; Department of Pediatrics (C.N.), Radboud University Medical Center, 6525 HP Nijmegen, The Netherlands; Department of Pediatrics (R.J.O.), Catharina Hospital, 5623 EJ Eindhoven, The Netherlands; Department of Pediatrics (W.O.), Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; Amalia Department of Pediatrics (E.J.S.), Isala Clinics, 8025 AB Zwolle, The Netherlands; and Department of Pediatrics (C.W.), Canisius Hospital, 6532 SZ Nijmegen, The Netherlands
| | - Cees Noordam
- Dutch Growth Research Foundation (M.v.d.S., A.J.L., D.C.M.v.d.K., A.C.S.H.K.), Rotterdam, 3001 KB, The Netherlands; Children's Hospital Erasmus MC-Sophia (M.v.d.S., A.C.S.H.K.), 3000 CA, Rotterdam, The Netherlands; Department of Pediatrics (W.M.B.v.W.), University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Pediatrics (F.J.P.C.M.v.d.H.), Zaans Medisch Centrum, 1502 DV Zaandam, The Netherlands; Department of Pediatrics (F.S.N.), Rijnstate Hospital, 6815 AD Arnhem, The Netherlands; Department of Pediatrics (C.N.), Radboud University Medical Center, 6525 HP Nijmegen, The Netherlands; Department of Pediatrics (R.J.O.), Catharina Hospital, 5623 EJ Eindhoven, The Netherlands; Department of Pediatrics (W.O.), Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; Amalia Department of Pediatrics (E.J.S.), Isala Clinics, 8025 AB Zwolle, The Netherlands; and Department of Pediatrics (C.W.), Canisius Hospital, 6532 SZ Nijmegen, The Netherlands
| | - Roelof J Odink
- Dutch Growth Research Foundation (M.v.d.S., A.J.L., D.C.M.v.d.K., A.C.S.H.K.), Rotterdam, 3001 KB, The Netherlands; Children's Hospital Erasmus MC-Sophia (M.v.d.S., A.C.S.H.K.), 3000 CA, Rotterdam, The Netherlands; Department of Pediatrics (W.M.B.v.W.), University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Pediatrics (F.J.P.C.M.v.d.H.), Zaans Medisch Centrum, 1502 DV Zaandam, The Netherlands; Department of Pediatrics (F.S.N.), Rijnstate Hospital, 6815 AD Arnhem, The Netherlands; Department of Pediatrics (C.N.), Radboud University Medical Center, 6525 HP Nijmegen, The Netherlands; Department of Pediatrics (R.J.O.), Catharina Hospital, 5623 EJ Eindhoven, The Netherlands; Department of Pediatrics (W.O.), Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; Amalia Department of Pediatrics (E.J.S.), Isala Clinics, 8025 AB Zwolle, The Netherlands; and Department of Pediatrics (C.W.), Canisius Hospital, 6532 SZ Nijmegen, The Netherlands
| | - Wilma Oostdijk
- Dutch Growth Research Foundation (M.v.d.S., A.J.L., D.C.M.v.d.K., A.C.S.H.K.), Rotterdam, 3001 KB, The Netherlands; Children's Hospital Erasmus MC-Sophia (M.v.d.S., A.C.S.H.K.), 3000 CA, Rotterdam, The Netherlands; Department of Pediatrics (W.M.B.v.W.), University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Pediatrics (F.J.P.C.M.v.d.H.), Zaans Medisch Centrum, 1502 DV Zaandam, The Netherlands; Department of Pediatrics (F.S.N.), Rijnstate Hospital, 6815 AD Arnhem, The Netherlands; Department of Pediatrics (C.N.), Radboud University Medical Center, 6525 HP Nijmegen, The Netherlands; Department of Pediatrics (R.J.O.), Catharina Hospital, 5623 EJ Eindhoven, The Netherlands; Department of Pediatrics (W.O.), Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; Amalia Department of Pediatrics (E.J.S.), Isala Clinics, 8025 AB Zwolle, The Netherlands; and Department of Pediatrics (C.W.), Canisius Hospital, 6532 SZ Nijmegen, The Netherlands
| | - Eelco J Schroor
- Dutch Growth Research Foundation (M.v.d.S., A.J.L., D.C.M.v.d.K., A.C.S.H.K.), Rotterdam, 3001 KB, The Netherlands; Children's Hospital Erasmus MC-Sophia (M.v.d.S., A.C.S.H.K.), 3000 CA, Rotterdam, The Netherlands; Department of Pediatrics (W.M.B.v.W.), University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Pediatrics (F.J.P.C.M.v.d.H.), Zaans Medisch Centrum, 1502 DV Zaandam, The Netherlands; Department of Pediatrics (F.S.N.), Rijnstate Hospital, 6815 AD Arnhem, The Netherlands; Department of Pediatrics (C.N.), Radboud University Medical Center, 6525 HP Nijmegen, The Netherlands; Department of Pediatrics (R.J.O.), Catharina Hospital, 5623 EJ Eindhoven, The Netherlands; Department of Pediatrics (W.O.), Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; Amalia Department of Pediatrics (E.J.S.), Isala Clinics, 8025 AB Zwolle, The Netherlands; and Department of Pediatrics (C.W.), Canisius Hospital, 6532 SZ Nijmegen, The Netherlands
| | - Ciska Westerlaken
- Dutch Growth Research Foundation (M.v.d.S., A.J.L., D.C.M.v.d.K., A.C.S.H.K.), Rotterdam, 3001 KB, The Netherlands; Children's Hospital Erasmus MC-Sophia (M.v.d.S., A.C.S.H.K.), 3000 CA, Rotterdam, The Netherlands; Department of Pediatrics (W.M.B.v.W.), University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Pediatrics (F.J.P.C.M.v.d.H.), Zaans Medisch Centrum, 1502 DV Zaandam, The Netherlands; Department of Pediatrics (F.S.N.), Rijnstate Hospital, 6815 AD Arnhem, The Netherlands; Department of Pediatrics (C.N.), Radboud University Medical Center, 6525 HP Nijmegen, The Netherlands; Department of Pediatrics (R.J.O.), Catharina Hospital, 5623 EJ Eindhoven, The Netherlands; Department of Pediatrics (W.O.), Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; Amalia Department of Pediatrics (E.J.S.), Isala Clinics, 8025 AB Zwolle, The Netherlands; and Department of Pediatrics (C.W.), Canisius Hospital, 6532 SZ Nijmegen, The Netherlands
| | - Anita C S Hokken-Koelega
- Dutch Growth Research Foundation (M.v.d.S., A.J.L., D.C.M.v.d.K., A.C.S.H.K.), Rotterdam, 3001 KB, The Netherlands; Children's Hospital Erasmus MC-Sophia (M.v.d.S., A.C.S.H.K.), 3000 CA, Rotterdam, The Netherlands; Department of Pediatrics (W.M.B.v.W.), University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Pediatrics (F.J.P.C.M.v.d.H.), Zaans Medisch Centrum, 1502 DV Zaandam, The Netherlands; Department of Pediatrics (F.S.N.), Rijnstate Hospital, 6815 AD Arnhem, The Netherlands; Department of Pediatrics (C.N.), Radboud University Medical Center, 6525 HP Nijmegen, The Netherlands; Department of Pediatrics (R.J.O.), Catharina Hospital, 5623 EJ Eindhoven, The Netherlands; Department of Pediatrics (W.O.), Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; Amalia Department of Pediatrics (E.J.S.), Isala Clinics, 8025 AB Zwolle, The Netherlands; and Department of Pediatrics (C.W.), Canisius Hospital, 6532 SZ Nijmegen, The Netherlands
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de Bruin CDE, van der Lugt NM, Visser R, Oostdijk W, van Zwet EW, te Pas AB, Lopriore E. Dysglycaemia in small-for-gestational-age neonates: a matched case–control study in monochorionic twins. J Matern Fetal Neonatal Med 2015; 29:2114-9. [DOI: 10.3109/14767058.2015.1076787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | | | - Remco Visser
- Division of Neonatology, Department of Pediatrics,
| | - Wilma Oostdijk
- Division of Pediatric Endocrinology, Department of Pediatrics, and
| | - Erik W. van Zwet
- Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
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32
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Joustra SD, Meijer OC, Heinen CA, Mol IM, Laghmani EH, Sengers RMA, Carreno G, van Trotsenburg ASP, Biermasz NR, Bernard DJ, Wit JM, Oostdijk W, van Pelt AMM, Hamer G, Wagenaar GTM. Spatial and temporal expression of immunoglobulin superfamily member 1 in the rat. J Endocrinol 2015; 226:181-91. [PMID: 26163525 DOI: 10.1530/joe-15-0204] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2015] [Indexed: 11/08/2022]
Abstract
Loss-of-function mutations in the immunoglobulin superfamily member 1 (IGSF1) gene cause an X-linked syndrome of central hypothyroidism, macroorchidism, variable prolactin and GH deficiency, delayed pubertal testosterone rise, and obesity. To understand the pathophysiology of this syndrome, knowledge on IGSF1's place in normal development is imperative. Therefore, we investigated spatial and temporal protein and mRNA expression of IGSF1 in rats using immunohistochemistry, real-time quantitative PCR (qPCR), and in situ hybridization. We observed high levels of IGSF1 expression in the brain, specifically the embryonic and adult choroid plexus and hypothalamus (principally in glial cells), and in the pituitary gland (PIT1-lineage of GH, TSH, and PRL-producing cells). IGSF1 is also expressed in the embryonic and adult zona glomerulosa of the adrenal gland, islets of Langerhans of the pancreas, and costameres of the heart and skeletal muscle. IGSF1 is highly expressed in fetal liver, but is absent shortly after birth. In the adult testis, IGSF1 is present in Sertoli cells (epithelial stages XIII-VI), and elongating spermatids (stages X-XII). Specificity of protein expression was corroborated with Igsf1 mRNA expression in all tissues. The expression patterns of IGSF1 in the pituitary gland and testis are consistent with the pituitary hormone deficiencies and macroorchidism observed in patients with IGSF1 deficiency. The expression in the brain, adrenal gland, pancreas, liver, and muscle suggest IGSF1's function in endocrine physiology might be more extensive than previously considered.
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Affiliation(s)
- Sjoerd D Joustra
- Department of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of MedicineDivision of Endocrinology, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Pediatric EndocrinologyEmma Children's Hospital, Academic Medical Center, Amsterdam, The NetherlandsEndocrinology and MetabolismAcademic Medical Center, The NetherlandsDevelopmental Biology and Cancer ProgrammeInstitute of Child Health, London, UKDepartment of Pharmacology and TherapeuticsMcGill University, Montreal, Quebec, CanadaCenter for Reproductive MedicineWomen's and Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands Department of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of MedicineDivision of Endocrinology, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Pediatric EndocrinologyEmma Children's Hospital, Academic Medical Center, Amsterdam, The NetherlandsEndocrinology and MetabolismAcademic Medical Center, The NetherlandsDevelopmental Biology and Cancer ProgrammeInstitute of Child Health, London, UKDepartment of Pharmacology and TherapeuticsMcGill University, Montreal, Quebec, CanadaCenter for Reproductive MedicineWomen's and Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - Onno C Meijer
- Department of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of MedicineDivision of Endocrinology, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Pediatric EndocrinologyEmma Children's Hospital, Academic Medical Center, Amsterdam, The NetherlandsEndocrinology and MetabolismAcademic Medical Center, The NetherlandsDevelopmental Biology and Cancer ProgrammeInstitute of Child Health, London, UKDepartment of Pharmacology and TherapeuticsMcGill University, Montreal, Quebec, CanadaCenter for Reproductive MedicineWomen's and Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - Charlotte A Heinen
- Department of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of MedicineDivision of Endocrinology, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Pediatric EndocrinologyEmma Children's Hospital, Academic Medical Center, Amsterdam, The NetherlandsEndocrinology and MetabolismAcademic Medical Center, The NetherlandsDevelopmental Biology and Cancer ProgrammeInstitute of Child Health, London, UKDepartment of Pharmacology and TherapeuticsMcGill University, Montreal, Quebec, CanadaCenter for Reproductive MedicineWomen's and Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands Department of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of MedicineDivision of Endocrinology, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Pediatric EndocrinologyEmma Children's Hospital, Academic Medical Center, Amsterdam, The NetherlandsEndocrinology and MetabolismAcademic Medical Center, The NetherlandsDevelopmental Biology and Cancer ProgrammeInstitute of Child Health, London, UKDepartment of Pharmacology and TherapeuticsMcGill University, Montreal, Quebec, CanadaCenter for Reproductive MedicineWomen's and Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - Isabel M Mol
- Department of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of MedicineDivision of Endocrinology, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Pediatric EndocrinologyEmma Children's Hospital, Academic Medical Center, Amsterdam, The NetherlandsEndocrinology and MetabolismAcademic Medical Center, The NetherlandsDevelopmental Biology and Cancer ProgrammeInstitute of Child Health, London, UKDepartment of Pharmacology and TherapeuticsMcGill University, Montreal, Quebec, CanadaCenter for Reproductive MedicineWomen's and Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - El Houari Laghmani
- Department of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of MedicineDivision of Endocrinology, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Pediatric EndocrinologyEmma Children's Hospital, Academic Medical Center, Amsterdam, The NetherlandsEndocrinology and MetabolismAcademic Medical Center, The NetherlandsDevelopmental Biology and Cancer ProgrammeInstitute of Child Health, London, UKDepartment of Pharmacology and TherapeuticsMcGill University, Montreal, Quebec, CanadaCenter for Reproductive MedicineWomen's and Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - Rozemarijn M A Sengers
- Department of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of MedicineDivision of Endocrinology, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Pediatric EndocrinologyEmma Children's Hospital, Academic Medical Center, Amsterdam, The NetherlandsEndocrinology and MetabolismAcademic Medical Center, The NetherlandsDevelopmental Biology and Cancer ProgrammeInstitute of Child Health, London, UKDepartment of Pharmacology and TherapeuticsMcGill University, Montreal, Quebec, CanadaCenter for Reproductive MedicineWomen's and Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - Gabriela Carreno
- Department of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of MedicineDivision of Endocrinology, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Pediatric EndocrinologyEmma Children's Hospital, Academic Medical Center, Amsterdam, The NetherlandsEndocrinology and MetabolismAcademic Medical Center, The NetherlandsDevelopmental Biology and Cancer ProgrammeInstitute of Child Health, London, UKDepartment of Pharmacology and TherapeuticsMcGill University, Montreal, Quebec, CanadaCenter for Reproductive MedicineWomen's and Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - A S Paul van Trotsenburg
- Department of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of MedicineDivision of Endocrinology, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Pediatric EndocrinologyEmma Children's Hospital, Academic Medical Center, Amsterdam, The NetherlandsEndocrinology and MetabolismAcademic Medical Center, The NetherlandsDevelopmental Biology and Cancer ProgrammeInstitute of Child Health, London, UKDepartment of Pharmacology and TherapeuticsMcGill University, Montreal, Quebec, CanadaCenter for Reproductive MedicineWomen's and Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - Nienke R Biermasz
- Department of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of MedicineDivision of Endocrinology, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Pediatric EndocrinologyEmma Children's Hospital, Academic Medical Center, Amsterdam, The NetherlandsEndocrinology and MetabolismAcademic Medical Center, The NetherlandsDevelopmental Biology and Cancer ProgrammeInstitute of Child Health, London, UKDepartment of Pharmacology and TherapeuticsMcGill University, Montreal, Quebec, CanadaCenter for Reproductive MedicineWomen's and Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - Daniel J Bernard
- Department of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of MedicineDivision of Endocrinology, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Pediatric EndocrinologyEmma Children's Hospital, Academic Medical Center, Amsterdam, The NetherlandsEndocrinology and MetabolismAcademic Medical Center, The NetherlandsDevelopmental Biology and Cancer ProgrammeInstitute of Child Health, London, UKDepartment of Pharmacology and TherapeuticsMcGill University, Montreal, Quebec, CanadaCenter for Reproductive MedicineWomen's and Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - Jan M Wit
- Department of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of MedicineDivision of Endocrinology, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Pediatric EndocrinologyEmma Children's Hospital, Academic Medical Center, Amsterdam, The NetherlandsEndocrinology and MetabolismAcademic Medical Center, The NetherlandsDevelopmental Biology and Cancer ProgrammeInstitute of Child Health, London, UKDepartment of Pharmacology and TherapeuticsMcGill University, Montreal, Quebec, CanadaCenter for Reproductive MedicineWomen's and Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - Wilma Oostdijk
- Department of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of MedicineDivision of Endocrinology, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Pediatric EndocrinologyEmma Children's Hospital, Academic Medical Center, Amsterdam, The NetherlandsEndocrinology and MetabolismAcademic Medical Center, The NetherlandsDevelopmental Biology and Cancer ProgrammeInstitute of Child Health, London, UKDepartment of Pharmacology and TherapeuticsMcGill University, Montreal, Quebec, CanadaCenter for Reproductive MedicineWomen's and Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - Ans M M van Pelt
- Department of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of MedicineDivision of Endocrinology, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Pediatric EndocrinologyEmma Children's Hospital, Academic Medical Center, Amsterdam, The NetherlandsEndocrinology and MetabolismAcademic Medical Center, The NetherlandsDevelopmental Biology and Cancer ProgrammeInstitute of Child Health, London, UKDepartment of Pharmacology and TherapeuticsMcGill University, Montreal, Quebec, CanadaCenter for Reproductive MedicineWomen's and Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - Geert Hamer
- Department of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of MedicineDivision of Endocrinology, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Pediatric EndocrinologyEmma Children's Hospital, Academic Medical Center, Amsterdam, The NetherlandsEndocrinology and MetabolismAcademic Medical Center, The NetherlandsDevelopmental Biology and Cancer ProgrammeInstitute of Child Health, London, UKDepartment of Pharmacology and TherapeuticsMcGill University, Montreal, Quebec, CanadaCenter for Reproductive MedicineWomen's and Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - Gerry T M Wagenaar
- Department of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of MedicineDivision of Endocrinology, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Pediatric EndocrinologyEmma Children's Hospital, Academic Medical Center, Amsterdam, The NetherlandsEndocrinology and MetabolismAcademic Medical Center, The NetherlandsDevelopmental Biology and Cancer ProgrammeInstitute of Child Health, London, UKDepartment of Pharmacology and TherapeuticsMcGill University, Montreal, Quebec, CanadaCenter for Reproductive MedicineWomen's and Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
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Renes JS, Willemsen RH, Mulder JC, Bakker-van Waarde WM, Rotteveel J, Oostdijk W, Houdijk ECAM, Westerlaken C, Noordam C, Verrijn Stuart AA, Odink RJ, de Ridder MAJ, Hokken-Koelega ACS. New insights into factors influencing adult height in short SGA children: Results of a large multicentre growth hormone trial. Clin Endocrinol (Oxf) 2015; 82:854-61. [PMID: 25409576 DOI: 10.1111/cen.12677] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 06/05/2014] [Accepted: 11/15/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Growth hormone (GH) treatment is effective in improving adult height (AH) in short children born SGA. However, there is a wide variation in height gain, even after adjustment for predictive variables. It is therefore important to investigate new factors which can influence the response to GH. OBJECTIVE To investigate the efficacy of GH treatment (1 mg/m(2/) day) in short SGA children on AH. To assess the relation between spontaneous catch-up growth after birth and growth during puberty on the total height gain SDS to AH. PATIENTS Longitudinal GH trial in 170 children. RESULTS Median age at start of GH was 7·1 years and height -3·0 SDS. AH was -1·8 SDS (TH-corrected AH -1·1 SDS) in boys and -1·9 SDS (TH-corrected AH -1·3 SDS) in girls. Spontaneous catch-up growth after birth was ≥0·5 SDS in 42% of children. In contrast to expectation, spontaneous catch-up growth was negatively correlated with total height gain SDS during GH (P = 0·009). During puberty, height SDS declined (-0·4 SDS in boys and -0·5 SDS in girls) resulting in a lower total height gain SDS than expected. Pubertal height gain was 25·5 cm in boys and 15·3 cm in girls, significantly lower compared to AGA children (P < 0·001). At onset of puberty, BA for boys and girls was moderately advanced (P = 0·02 and P < 0·001, respectively). Growth velocity was comparable to AGA children during the first two years of puberty, but thereafter significantly lower until reaching AH (P < 0·001). CONCLUSION In contrast to our hypothesis, children with greater spontaneous catch-up growth after birth show a lower total height gain SDS during GH. Height SDS declines from mid-puberty, due to a marked early deceleration of growth velocity.
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Affiliation(s)
- J S Renes
- Department of Pediatrics, Division of Endocrinology, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - R H Willemsen
- Department of Pediatrics, Division of Endocrinology, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - J C Mulder
- Department of Pediatrics, Rijnstate Hospital, Arnhem, The Netherlands
| | - W M Bakker-van Waarde
- Department of Pediatrics, Division of Endocrinology, University Medical Center Groningen, Groningen, The Netherlands
| | - J Rotteveel
- Department of Pediatrics, Division of Endocrinology, VU University Medical Center, Amsterdam, The Netherlands
| | - W Oostdijk
- Department of Pediatrics, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
| | - E C A M Houdijk
- Department of Pediatrics, Haga Hospitals - Juliana Children's Hospital, Den Haag, The Netherlands
| | - C Westerlaken
- Department of Pediatrics, Canisius Hospital, Nijmegen, The Netherlands
| | - C Noordam
- Department of Pediatrics, Division of Endocrinology, University Medical Center Radboud, Nijmegen, The Netherlands
| | - A A Verrijn Stuart
- Department of Pediatrics, Division of Endocrinology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R J Odink
- Department of Pediatrics, Catharina Hospital, Eindhoven, The Netherlands
| | - M A J de Ridder
- Department of Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - A C S Hokken-Koelega
- Department of Pediatrics, Division of Endocrinology, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands
- Dutch Growth Research Foundation, Rotterdam, The Netherlands
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34
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Kant SG, Cervenkova I, Balek L, Trantirek L, Santen GWE, de Vries MC, van Duyvenvoorde HA, van der Wielen MJR, Verkerk AJMH, Uitterlinden AG, Hannema SE, Wit JM, Oostdijk W, Krejci P, Losekoot M. A novel variant of FGFR3 causes proportionate short stature. Eur J Endocrinol 2015; 172:763-70. [PMID: 25777271 DOI: 10.1530/eje-14-0945] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 03/16/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Mutations of the fibroblast growth factor receptor 3 (FGFR3) cause various forms of short stature, of which the least severe phenotype is hypochondroplasia, mainly characterized by disproportionate short stature. Testing for an FGFR3 mutation is currently not part of routine diagnostic testing in children with short stature without disproportion. DESIGN A three-generation family A with dominantly transmitted proportionate short stature was studied by whole-exome sequencing to identify the causal gene mutation. Functional studies and protein modeling studies were performed to confirm the pathogenicity of the mutation found in FGFR3. We performed Sanger sequencing in a second family B with dominant proportionate short stature and identified a rare variant in FGFR3. METHODS Exome sequencing and/or Sanger sequencing was performed, followed by functional studies using transfection of the mutant FGFR3 into cultured cells; homology modeling was used to construct a three-dimensional model of the two FGFR3 variants. RESULTS A novel p.M528I mutation in FGFR3 was detected in family A, which segregates with short stature and proved to be activating in vitro. In family B, a rare variant (p.F384L) was found in FGFR3, which did not segregate with short stature and showed normal functionality in vitro compared with WT. CONCLUSIONS Proportionate short stature can be caused by a mutation in FGFR3. Sequencing of this gene can be considered in patients with short stature, especially when there is an autosomal dominant pattern of inheritance. However, functional studies and segregation studies should be performed before concluding that a variant is pathogenic.
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Affiliation(s)
- Sarina G Kant
- Department of Clinical GeneticsLeiden University Medical Center, PO Box 9600, 2300RC, Leiden, The NetherlandsDepartment of BiologyFaculty of MedicineCentral European Institute of TechnologyMasaryk University, Brno, Czech RepublicDepartment of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of Internal MedicineErasmus Medical Center, Rotterdam, The NetherlandsDepartment of Orthopaedic SurgeryDavid Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Iveta Cervenkova
- Department of Clinical GeneticsLeiden University Medical Center, PO Box 9600, 2300RC, Leiden, The NetherlandsDepartment of BiologyFaculty of MedicineCentral European Institute of TechnologyMasaryk University, Brno, Czech RepublicDepartment of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of Internal MedicineErasmus Medical Center, Rotterdam, The NetherlandsDepartment of Orthopaedic SurgeryDavid Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Lukas Balek
- Department of Clinical GeneticsLeiden University Medical Center, PO Box 9600, 2300RC, Leiden, The NetherlandsDepartment of BiologyFaculty of MedicineCentral European Institute of TechnologyMasaryk University, Brno, Czech RepublicDepartment of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of Internal MedicineErasmus Medical Center, Rotterdam, The NetherlandsDepartment of Orthopaedic SurgeryDavid Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Lukas Trantirek
- Department of Clinical GeneticsLeiden University Medical Center, PO Box 9600, 2300RC, Leiden, The NetherlandsDepartment of BiologyFaculty of MedicineCentral European Institute of TechnologyMasaryk University, Brno, Czech RepublicDepartment of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of Internal MedicineErasmus Medical Center, Rotterdam, The NetherlandsDepartment of Orthopaedic SurgeryDavid Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Gijs W E Santen
- Department of Clinical GeneticsLeiden University Medical Center, PO Box 9600, 2300RC, Leiden, The NetherlandsDepartment of BiologyFaculty of MedicineCentral European Institute of TechnologyMasaryk University, Brno, Czech RepublicDepartment of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of Internal MedicineErasmus Medical Center, Rotterdam, The NetherlandsDepartment of Orthopaedic SurgeryDavid Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Martine C de Vries
- Department of Clinical GeneticsLeiden University Medical Center, PO Box 9600, 2300RC, Leiden, The NetherlandsDepartment of BiologyFaculty of MedicineCentral European Institute of TechnologyMasaryk University, Brno, Czech RepublicDepartment of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of Internal MedicineErasmus Medical Center, Rotterdam, The NetherlandsDepartment of Orthopaedic SurgeryDavid Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Hermine A van Duyvenvoorde
- Department of Clinical GeneticsLeiden University Medical Center, PO Box 9600, 2300RC, Leiden, The NetherlandsDepartment of BiologyFaculty of MedicineCentral European Institute of TechnologyMasaryk University, Brno, Czech RepublicDepartment of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of Internal MedicineErasmus Medical Center, Rotterdam, The NetherlandsDepartment of Orthopaedic SurgeryDavid Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Michiel J R van der Wielen
- Department of Clinical GeneticsLeiden University Medical Center, PO Box 9600, 2300RC, Leiden, The NetherlandsDepartment of BiologyFaculty of MedicineCentral European Institute of TechnologyMasaryk University, Brno, Czech RepublicDepartment of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of Internal MedicineErasmus Medical Center, Rotterdam, The NetherlandsDepartment of Orthopaedic SurgeryDavid Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Annemieke J M H Verkerk
- Department of Clinical GeneticsLeiden University Medical Center, PO Box 9600, 2300RC, Leiden, The NetherlandsDepartment of BiologyFaculty of MedicineCentral European Institute of TechnologyMasaryk University, Brno, Czech RepublicDepartment of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of Internal MedicineErasmus Medical Center, Rotterdam, The NetherlandsDepartment of Orthopaedic SurgeryDavid Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - André G Uitterlinden
- Department of Clinical GeneticsLeiden University Medical Center, PO Box 9600, 2300RC, Leiden, The NetherlandsDepartment of BiologyFaculty of MedicineCentral European Institute of TechnologyMasaryk University, Brno, Czech RepublicDepartment of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of Internal MedicineErasmus Medical Center, Rotterdam, The NetherlandsDepartment of Orthopaedic SurgeryDavid Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Sabine E Hannema
- Department of Clinical GeneticsLeiden University Medical Center, PO Box 9600, 2300RC, Leiden, The NetherlandsDepartment of BiologyFaculty of MedicineCentral European Institute of TechnologyMasaryk University, Brno, Czech RepublicDepartment of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of Internal MedicineErasmus Medical Center, Rotterdam, The NetherlandsDepartment of Orthopaedic SurgeryDavid Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Jan M Wit
- Department of Clinical GeneticsLeiden University Medical Center, PO Box 9600, 2300RC, Leiden, The NetherlandsDepartment of BiologyFaculty of MedicineCentral European Institute of TechnologyMasaryk University, Brno, Czech RepublicDepartment of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of Internal MedicineErasmus Medical Center, Rotterdam, The NetherlandsDepartment of Orthopaedic SurgeryDavid Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Wilma Oostdijk
- Department of Clinical GeneticsLeiden University Medical Center, PO Box 9600, 2300RC, Leiden, The NetherlandsDepartment of BiologyFaculty of MedicineCentral European Institute of TechnologyMasaryk University, Brno, Czech RepublicDepartment of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of Internal MedicineErasmus Medical Center, Rotterdam, The NetherlandsDepartment of Orthopaedic SurgeryDavid Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Pavel Krejci
- Department of Clinical GeneticsLeiden University Medical Center, PO Box 9600, 2300RC, Leiden, The NetherlandsDepartment of BiologyFaculty of MedicineCentral European Institute of TechnologyMasaryk University, Brno, Czech RepublicDepartment of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of Internal MedicineErasmus Medical Center, Rotterdam, The NetherlandsDepartment of Orthopaedic SurgeryDavid Geffen School of Medicine at UCLA, Los Angeles, California, USA Department of Clinical GeneticsLeiden University Medical Center, PO Box 9600, 2300RC, Leiden, The NetherlandsDepartment of BiologyFaculty of MedicineCentral European Institute of TechnologyMasaryk University, Brno, Czech RepublicDepartment of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of Internal MedicineErasmus Medical Center, Rotterdam, The NetherlandsDepartment of Orthopaedic SurgeryDavid Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Monique Losekoot
- Department of Clinical GeneticsLeiden University Medical Center, PO Box 9600, 2300RC, Leiden, The NetherlandsDepartment of BiologyFaculty of MedicineCentral European Institute of TechnologyMasaryk University, Brno, Czech RepublicDepartment of PediatricsLeiden University Medical Center, Leiden, The NetherlandsDepartment of Internal MedicineErasmus Medical Center, Rotterdam, The NetherlandsDepartment of Orthopaedic SurgeryDavid Geffen School of Medicine at UCLA, Los Angeles, California, USA
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Abstract
Besides growth hormone, several pharmaceutical products have been investigated for efficacy and safety in increasing short term growth or adult height. Short-term treatment with testosterone esters in boys with constitutional delay of growth and puberty is efficacious in generating secondary sex characteristics and growth acceleration. The addition of oxandrolone to growth hormone (GH) in Turner syndrome has an additive effect on adult height gain. Treatment with GnRH analogs is the established treatment of central precocious puberty, and its addition to GH therapy appears effective in increasing adult height in GH deficient children, and possibly short children born SGA or with SHOX deficiency, who are still short at pubertal onset. Aromatase inhibitors appear effective in several rare disorders, but their value in increasing adult height in early pubertal boys with GH deficiency or idiopathic short stature is uncertain. A trial with a C-natriuretic peptide analog offers hope for children with achondroplasia.
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Affiliation(s)
- Jan M Wit
- Department of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands.
| | - Wilma Oostdijk
- Department of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands.
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36
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Joustra SD, van der Plas EM, Goede J, Oostdijk W, Delemarre-van de Waal HA, Hack WW, van Buuren S, Wit JM. New reference charts for testicular volume in Dutch children and adolescents allow the calculation of standard deviation scores. Acta Paediatr 2015; 104:e271-8. [PMID: 25664405 DOI: 10.1111/apa.12972] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 11/20/2014] [Accepted: 02/05/2015] [Indexed: 01/21/2023]
Abstract
AIM Accurate calculations of testicular volume standard deviation (SD) scores are not currently available. We constructed LMS-smoothed age-reference charts for testicular volume in healthy boys. METHODS The LMS method was used to calculate reference data, based on testicular volumes from ultrasonography and Prader orchidometer of 769 healthy Dutch boys aged 6 months to 19 years. We also explored the association between testicular growth and pubic hair development, and data were compared to orchidometric testicular volumes from the 1997 Dutch nationwide growth study. RESULTS The LMS-smoothed reference charts showed that no revision of the definition of normal onset of male puberty - from nine to 14 years of age - was warranted. In healthy boys, the pubic hair stage SD scores corresponded with testicular volume SD scores (r = 0.394). However, testes were relatively small for pubic hair stage in Klinefelter's syndrome and relatively large in immunoglobulin superfamily member 1 deficiency syndrome. CONCLUSION The age-corrected SD scores for testicular volume will aid in the diagnosis and follow-up of abnormalities in the timing and progression of male puberty and in research evaluations. The SD scores can be compared with pubic hair SD scores to identify discrepancies between cell functions that result in relative microorchidism or macroorchidism.
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Affiliation(s)
- Sjoerd D. Joustra
- Department of Pediatrics; Leiden University Medical Center; Leiden Netherlands
- Department of Medicine; Division of Endocrinology; Leiden University Medical Center; Leiden Netherlands
| | | | - Joery Goede
- Department of Pediatrics; Medical Centre Alkmaar; Alkmaar Netherlands
| | - Wilma Oostdijk
- Department of Pediatrics; Leiden University Medical Center; Leiden Netherlands
| | | | | | - Stef van Buuren
- Netherlands Organisation for Applied Scientific Research TNO; Leiden Netherlands
- Department of Methodology and Statistics; FSBS, University of Utrecht; Utrecht Netherlands
| | - Jan M. Wit
- Department of Pediatrics; Leiden University Medical Center; Leiden Netherlands
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Bakker NE, Kuppens RJ, Siemensma EPC, Tummers-de Lind van Wijngaarden RFA, Festen DAM, Bindels-de Heus GCB, Bocca G, Haring DAJP, Hoorweg-Nijman JJG, Houdijk ECAM, Jira PE, Lunshof L, Odink RJ, Oostdijk W, Rotteveel J, Van Alfen AAEM, Van Leeuwen M, Van Wieringen H, Wegdam-den Boer MEJ, Zwaveling-Soonawala N, Hokken-Koelega ACS. Bone mineral density in children and adolescents with Prader-Willi syndrome: a longitudinal study during puberty and 9 years of growth hormone treatment. J Clin Endocrinol Metab 2015; 100:1609-18. [PMID: 25668198 DOI: 10.1210/jc.2014-4347] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Longitudinal data on bone mineral density (BMD) in children and adolescents with Prader-Willi Syndrome (PWS) during long-term GH treatment are not available. OBJECTIVE This study aimed to determine effects of long-term GH treatment and puberty on BMD of total body (BMDTB), lumbar spine (BMDLS), and bone mineral apparent density of the lumbar spine (BMADLS) in children with PWS. DESIGN AND SETTING This was a prospective longitudinal study of a Dutch PWS cohort. PARTICIPANTS Seventy-seven children with PWS who remained prepubertal during GH treatment for 4 years and 64 children with PWS who received GH treatment for 9 years participated in the study. INTERVENTION The children received GH treatment, 1 mg/m(2)/day (≅ 0.035 mg/kg/d). MAIN OUTCOME MEASURES BMDTB, BMDLS, and BMADLS was measured by using the same dual-energy x-ray absorptiometry machine for all annual measurements. RESULTS In the prepubertal group, BMDTB standard deviation score (SDS) and BMDLSSDS significantly increased during 4 years of GH treatment whereas BMADLSSDS remained stable. During adolescence, BMDTBSDS and BMADLSSDS decreased significantly, in girls from the age of 11 years and in boys from the ages of 14 and 16 years, respectively, but all BMD parameters remained within the normal range. Higher Tanner stages tended to be associated with lower BMDTBSDS (P = .083) and a significantly lower BMADLSSDS (P = .016). After 9 years of GH treatment, lean body mass SDS was the most powerful predictor of BMDTBSDS and BMDLSSDS in adolescents with PWS. CONCLUSIONS This long-term GH study demonstrates that BMDTB, BMDLS, and BMADLS remain stable in prepubertal children with PWS but decreases during adolescence, parallel to incomplete pubertal development. Based on our findings, clinicians should start sex hormone therapy from the age of 11 years in girls and 14 years in boys unless there is a normal progression of puberty.
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Affiliation(s)
- N E Bakker
- Dutch Growth Research Foundation (N.E.B., R.J.K., E.P.C.S., R.F.A.T.d. L.v.W., D.A.M.F., A.C.S.H.-K), 3000 CA Rotterdam, The Netherlands; Children's Hospital Erasmus MC-Sophia (N.E.B., R.J.K., E.P.C.S., G.C.B.B.d.H., A.C.S.H.-K.), 3000 CA Rotterdam, The Netherlands; University of Groningen (G.B.), University Medical Center Groningen/Beatrix Children's Hospital, Department of Pediatrics, 9713 GZ Groningen, The Netherlands; Diaconessen Hospital (D.A.J.P.), 2334 CK Leiden, The Netherlands; St. Antonius Hospital (J.J.G.H.-N., H.V.W.), 3430 EM Nieuwegein, The Netherlands; Haga Hospitals/Juliana Children's Hospital (E.C.A.M.H.), 2566 MJ The Hague, The Netherlands; Department of Pediatrics (P.E.J.), Jeroen Bosch Hospital, 5200 ME's-Hertogenbosch, The Netherlands; Gelre Hospitals (L.L.), 7300 SD Apeldoorn, The Netherlands; St. Catharina Hospital (R.J.O.), 5623 EJ Eindhoven, The Netherlands; Department of Pediatrics (W.O.), Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; VU University Medical Center (J.R.), 1081 HV Amsterdam, The Netherlands; Radboud University Nijmegen Medical Center (A.A.E.M.V.A.); 6500 HB Nijmegen, The Netherlands; St. Jansdal Hospital (M.V.L.), 3844 DG Harderwijk, The Netherlands; Medical Center Twente (M.E.J.W.B.), 7511 JX Enschede, The Netherlands; Academic Medical Center (N.Z.-S.), University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
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Oostdijk W, Idkowiak J, Mueller JW, House PJ, Taylor AE, O'Reilly MW, Hughes BA, de Vries MC, Kant SG, Santen GWE, Verkerk AJMH, Uitterlinden AG, Wit JM, Losekoot M, Arlt W. PAPSS2 deficiency causes androgen excess via impaired DHEA sulfation--in vitro and in vivo studies in a family harboring two novel PAPSS2 mutations. J Clin Endocrinol Metab 2015; 100:E672-80. [PMID: 25594860 PMCID: PMC4399300 DOI: 10.1210/jc.2014-3556] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
CONTEXT PAPSS2 (PAPS synthase 2) provides the universal sulfate donor PAPS (3'-phospho-adenosine-5'-phosphosulfate) to all human sulfotransferases, including SULT2A1, responsible for sulfation of the crucial androgen precursor dehydroepiandrosterone (DHEA). Impaired DHEA sulfation is thought to increase the conversion of DHEA toward active androgens, a proposition supported by the previous report of a girl with inactivating PAPSS2 mutations who presented with low serum DHEA sulfate and androgen excess, clinically manifesting with premature pubarche and early-onset polycystic ovary syndrome. PATIENTS AND METHODS We investigated a family harboring two novel PAPSS2 mutations, including two compound heterozygous brothers presenting with disproportionate short stature, low serum DHEA sulfate, but normal serum androgens. Patients and parents underwent a DHEA challenge test comprising frequent blood sampling and urine collection before and after 100 mg DHEA orally, with subsequent analysis of DHEA sulfation and androgen metabolism by mass spectrometry. The functional impact of the mutations was investigated in silico and in vitro. RESULTS We identified a novel PAPSS2 frameshift mutation, c.1371del, p.W462Cfs*3, resulting in complete disruption, and a novel missense mutation, c.809G>A, p.G270D, causing partial disruption of DHEA sulfation. Both patients and their mother, who was heterozygous for p.W462Cfs*3, showed increased 5α-reductase activity at baseline and significantly increased production of active androgens after DHEA intake. The mother had a history of oligomenorrhea and chronic anovulation that required clomiphene for ovulation induction. CONCLUSIONS We provide direct in vivo evidence for the significant functional impact of mutant PAPSS2 on DHEA sulfation and androgen activation. Heterozygosity for PAPSS2 mutations can be associated with a phenotype resembling polycystic ovary syndrome.
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Affiliation(s)
- Wilma Oostdijk
- Department of Pediatrics (W.O., M.C.d.V., J.M.W.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands; Centre for Endocrinology, Diabetes, and Metabolism (J.I., J.W.M., P.J.H., A.E.T., M.W.O., B.A.H., W.A.), School of Clinical and Experimental Medicine, University of Birmingham, Birmingham B15 2TT, United Kingdom; Department of Clinical Genetics (S.G.K., G.W.E.S., M.L.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands; and Department of Internal Medicine (A.J.M.H.V., A.G.U.), Erasmus Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
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van der Kamp HJ, Kant SG, Ruivenkamp CAL, Gijsbers ACJ, Haring D, Oostdijk W. Pseudoisodicentric Xp chromosome [46,X,psu idic(X)(q21.1)] and its effect on growth and pubertal development. Horm Res Paediatr 2015; 81:416-21. [PMID: 24714330 DOI: 10.1159/000357141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 10/31/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Most isodicentric (Xp) and (Xq) chromosomes occur as a mosaic with a 45,X cell line. Patients with a nonmosaic 46,X,idic(Xq) are rare. CASES The first girl was referred at 13 years with a short stature and pubertal delay (M1, P2, A1). Her height was 141.6 cm (-3.1 SDS). Ovarian failure was present. The second girl was referred because of her short stature at 12.5 years. Her height was 142.2 cm (-2.4 SDS). She had spontaneous puberty (M3, P1, A1). RESULTS In both girls, conventional karyotyping of lymphocytes revealed an aberrant X chromosome consisting of twice the short arm and a small part of the long arm of the X chromosome [nonmosaic 46,X,psu idic(X)(q21.1)]. FISH analysis of the aberrant X chromosome showed the presence of two centromeres, two copies of the XIST gene and two copies of the SHOX gene. CONCLUSIONS The presence of two XIST genes on the isodicentric X chromosome with Xq deletion indicates the inactivation of this chromosome. This inactivation also concerned the pseudoautosomal regions which caused haploinsufficiency of the SHOX genes. The girls were treated with growth hormones. The critical region (Xq23 to Xq28) for the ovarian function was deleted in both patients, but the gonadal function was variable. .
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Affiliation(s)
- H J van der Kamp
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
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40
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Schrier L, de Kam ML, McKinnon R, Che Bakri A, Oostdijk W, Sas TCJ, Menke LA, Otten BJ, de Muinck Keizer-Schrama SMPF, Kristrom B, Ankarberg-Lindgren C, Burggraaf J, Albertsson-Wikland K, Wit JM. Comparison of body surface area versus weight-based growth hormone dosing for girls with Turner syndrome. Horm Res Paediatr 2015; 81:319-30. [PMID: 24776754 DOI: 10.1159/000357844] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 12/09/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Growth Hormone (GH) dosage in childhood is adjusted for body size, but there is no consensus whether body weight (BW) or body surface area (BSA) should be used. We aimed at comparing the biological effect and cost-effectiveness of GH treatment dosed per m2 BSA in comparison with dosing per kg BW in girls with Turner syndrome (TS). METHODS Serum IGF-I, GH dose, and adult height gain (AHG) from girls participating in two Dutch and five Swedish studies on the efficacy of GH were analyzed, and the cumulative GH dose and costs were calculated for both dose adjustment methods. Additional medication included estrogens (if no spontaneous puberty occurred) and oxandrolone in some studies. RESULTS At each GH dose, the serum IGF-I standard deviation score remained stable over time after an initial increase after the start of treatment. On a high dose (at 1 m2 equivalent to 0.056-0.067 mg/kg/day), AHG was at least equal on GH dosed per m2 BSA compared with dosing per kg BW. The cumulative dose and cost were significantly lower if the GH dose was adjusted for m2 BSA. CONCLUSION Dosing GH per m2 BSA is at least as efficacious as dosing per kg BW, and is more cost-effective.
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Bresters D, Emons JAM, Nuri N, Ball LM, Kollen WJW, Hannema SE, Bakker-Steeneveld JDJ, van der Bom JG, Oostdijk W. Ovarian insufficiency and pubertal development after hematopoietic stem cell transplantation in childhood. Pediatr Blood Cancer 2014; 61:2048-53. [PMID: 25111958 DOI: 10.1002/pbc.25162] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 06/03/2014] [Indexed: 11/07/2022]
Abstract
BACKGROUND Ovarian insufficiency (OI) and infertility are common and devastating late effects of cancer treatment and hematopoietic stem cell transplantation (HSCT). In children, gonadal insufficiency may subsequently lead to abnormal pubertal development. The aim of this study was to assess the cumulative incidence of OI and the need for hormonal induction of pubertal development after HSCT in childhood. We additionally assessed HSCT-related risk factors for OI. PROCEDURES A single center cohort study was undertaken of female patients transplanted during childhood, surviving at least 2 years post-HSCT and who were at least 10 years old at initiation of the study. Of 141 eligible patients, 109 were included and hormone levels and clinical data of these patients during follow-up were collected. Risk factors for OI were analyzed by multivariate Cox regression analysis. RESULTS Cumulative incidence of OI was 56% at a median follow-up of 7.2 years. Eight patients, initially diagnosed with OI, showed recovery of ovarian function over time. Hormonal induction of puberty was necessary in 44% of females who were pre-pubertal or pubertal at HSCT. In multivariate analysis, more advanced pubertal stage at HSCT was associated with OI. We found a trend for an association of busulfan with OI in patients conditioned with chemotherapy only. CONCLUSIONS The incidence of OI after HSCT was high and associated with more advanced pubertal stage at HSCT. Almost half of the females who were pre-pubertal or pubertal at HSCT required hormonal induction of pubertal development.
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Affiliation(s)
- Dorine Bresters
- Leiden University Medical Center (LUMC), Willem-Alexander Children's Hospital, Leiden, The Netherlands
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42
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Rump P, de Leeuw N, van Essen AJ, Verschuuren-Bemelmans CC, Veenstra-Knol HE, Swinkels MEM, Oostdijk W, Ruivenkamp C, Reardon W, de Munnik S, Ruiter M, Frumkin A, Lev D, Evers C, Sikkema-Raddatz B, Dijkhuizen T, van Ravenswaaij-Arts CM. Central 22q11.2 deletions. Am J Med Genet A 2014; 164A:2707-23. [PMID: 25123976 DOI: 10.1002/ajmg.a.36711] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 05/29/2014] [Indexed: 11/11/2022]
Abstract
22q11.2 deletion syndrome is one of the most common microdeletion syndromes. Most patients have a deletion resulting from a recombination of low copy repeat blocks LCR22-A and LCR22-D. Loss of the TBX1 gene is considered the most important cause of the phenotype. A limited number of patients with smaller, overlapping deletions distal to the TBX1 locus have been described in the literature. In these patients, the CRKL gene is deleted. Haploinsufficiency of this gene has also been implicated in the pathogenesis of 22q11.2 deletion syndrome. To distinguish these deletions (comprising the LCR22-B to LCR22-D region) from the more distal 22q11.2 deletions (located beyond LCR22-D), we propose the term "central 22q11.2 deletions". In the present study we report on 27 new patients with such a deletion. Together with information on previously published cases, we review the clinical findings of 52 patients. The prevalence of congenital heart anomalies and the frequency of de novo deletions in patients with a central deletion are substantially lower than in patients with a common or distal 22q11.2 deletion. Renal and urinary tract malformations, developmental delays, cognitive impairments and behavioral problems seem to be equally frequent as in patients with a common deletion. None of the patients had a cleft palate. Patients with a deletion that also encompassed the MAPK1 gene, located just distal to LCR22-D, have a different and more severe phenotype, characterized by a higher prevalence of congenital heart anomalies, growth restriction and microcephaly. Our results further elucidate genotype-phenotype correlations in 22q11.2 deletion syndrome spectrum.
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Affiliation(s)
- Patrick Rump
- University of Groningen, University Medical Centre Groningen, Department of Genetics, Groningen, The Netherlands
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Verhagen JMA, Oostdijk W, Terwisscha van Scheltinga CEJ, Schalij-Delfos NE, van Bever Y. An unusual presentation of Kabuki syndrome: clinical overlap with CHARGE syndrome. Eur J Med Genet 2014; 57:510-2. [PMID: 24862881 DOI: 10.1016/j.ejmg.2014.05.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2013] [Accepted: 05/15/2014] [Indexed: 10/25/2022]
Abstract
Kabuki syndrome is a rare genetic disorder characterized by intellectual disability and multiple congenital anomalies, including short stature, peculiar facial appearance, skeletal anomalies, a variety of visceral malformations and abnormal dermatoglyphic patterns. We describe a case of Kabuki syndrome presenting with atypical features, consisting of bilateral microphthalmia, coloboma, anal atresia and panhypopituitarism, showing considerable phenotypic overlap with CHARGE syndrome. This report demonstrates that clinical follow-up and molecular genetic testing can be useful for establishing the correct diagnosis.
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Affiliation(s)
- Judith M A Verhagen
- Department of Clinical Genetics, Erasmus Medical Center Rotterdam, The Netherlands
| | - Wilma Oostdijk
- Department of Pediatrics, Leiden University Medical Center, The Netherlands
| | | | | | - Yolande van Bever
- Department of Clinical Genetics, Erasmus Medical Center Rotterdam, The Netherlands.
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Klein RH, Alvarez-Jimenez R, Sukhai RN, Oostdijk W, Bakker B, Reeser HM, Ballieux BEPB, Hu P, Klaassen ES, Freijer J, Burggraaf J, Cohen AF, Wit JM. Pharmacokinetics and pharmacodynamics of orally administered clonidine: a model-based approach. Horm Res Paediatr 2014; 79:300-9. [PMID: 23735833 DOI: 10.1159/000350819] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 03/13/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS The oral clonidine test is a diagnostic procedure performed in children with suspected growth hormone (GH) deficiency. It is associated with untoward effects, including bradycardia, hypotension and sedation. Serum clonidine levels have not previously been assessed during this test. METHODS In 40 children referred for an oral clonidine test, blood samples were drawn for clonidine and GH. Vital statistics and sedation scores were recorded until 210 min post-dose. We explored the relationship between clonidine concentrations and effects such as GH peak and blood pressure. RESULTS Of 40 participants, 5 children were GH deficient. Peak clonidine concentrations of 0.846 ± 0.288 ng/ml were reached after 1 h. Serum levels declined slowly, with concentrations of 0.701 ± 0.189 ng/ml 210 min post-dose. A large interindividual variation of serum levels was observed. During the procedure, systolic blood pressure dropped by 12.8%, diastolic blood pressure by 19.7% and heart rate by 8.4%. Moderate sedation levels were observed. Concentration-effect modeling showed that the amount of GH available for secretion as determined by previous bursts was an important factor influencing GH response. CONCLUSION Clonidine concentrations during the test were higher than necessary according to model-based predictions. A lower clonidine dose may be sufficient and may produce fewer side effects.
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Affiliation(s)
- R H Klein
- Centre for Human Drug Research, Leiden University Medical Center, NL-2300 RC Leiden, The Netherlands.
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45
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Wit JM, van Duyvenvoorde HA, van Klinken JB, Caliebe J, Bosch CA, Lui JC, Gijsbers AC, Bakker E, Breuning MH, Oostdijk W, Losekoot M, Baron J, Binder G, Ranke MB, Ruivenkamp CA. Copy number variants in short children born small for gestational age. Horm Res Paediatr 2014; 82:310-8. [PMID: 25300501 PMCID: PMC4236248 DOI: 10.1159/000367712] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 08/18/2014] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND/AIMS In addition to genome-wide association studies (GWAS), height-associated genes may be uncovered by studying individuals with extreme short or tall stature. METHODS Genome-wide analysis for copy number variants (CNVs), using single nucleotide polymorphism (SNP) arrays, was performed in 49 index cases born small for gestational age with persistent short stature. Segregation analysis was performed, and genes in CNVs were compared with information from GWAS, gene expression in rodents' growth plates, and published information. RESULTS CNVs were detected in 13 cases. In 5 children a known cause of short stature was found: UPD7, UPD14, a duplication of the SHOX enhancer region, an IGF1R deletion, and a 22q11.21 deletion. In the remaining 8 cases, potential pathogenic CNVs were detected, either de novo (n = 1), segregating (n = 2), or not segregating with short stature (n = 5). Bioinformatic analysis of the de novo and segregating CNVs suggested that HOXD4, AGPS, PDE11A, OSBPL6, PRKRA and PLEKHA3, and possibly DGKB and TNFRSF11B are potential candidate genes. A SERPINA7 or NRK defect may be associated with an X-linked form of short stature. CONCLUSION SNP arrays detected 5 known causes of short stature with prenatal onset and suggested several potential candidate genes.
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Affiliation(s)
- Jan M. Wit
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Jan B. van Klinken
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Janina Caliebe
- Paediatric Endocrinology Section, Children’s Hospital, University of Tübingen, Tübingen, Germany
| | - Cathy A.J. Bosch
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Julian C. Lui
- Section on Growth and Development, National Institutes of Health, Bethesda, MD, USA
| | - Antoinet C.J. Gijsbers
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Egbert Bakker
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Martijn H. Breuning
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Wilma Oostdijk
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Monique Losekoot
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Jeffrey Baron
- Section on Growth and Development, National Institutes of Health, Bethesda, MD, USA
| | - Gerhard Binder
- Paediatric Endocrinology Section, Children’s Hospital, University of Tübingen, Tübingen, Germany
| | - Michael B. Ranke
- Paediatric Endocrinology Section, Children’s Hospital, University of Tübingen, Tübingen, Germany
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Verkerk PH, van Trotsenburg ASP, Hoorweg-Nijman JJG, Oostdijk W, van Tijn DA, Kempers MJE, van den Akker ELT, Loeber JG, Elvers LHB, Vulsma T. [Neonatal screening for congenital hypothyroidism: more than 30 years of experience in the Netherlands]. Ned Tijdschr Geneeskd 2014; 158:A6564. [PMID: 25248730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To describe the Dutch neonatal screening programme for congenital hypothyroidism (CH). DESIGN Descriptive study. METHOD Data on neonatal screening for CH in the period 1 January 1981 through 31 December 2011 were obtained from the Department for Vaccine Supply and Prevention Programmes of the Dutch National Institute for Public Health and the Environment (RIVM), laboratories and paediatricians to whom babies with abnormal screening results were referred. The screening procedure has been amended several times. In the period 1981-1994, only T4 and TSH were measured in heel prick blood, for example. From 1995, thyroxine-binding globulin (TBG) was added to the screening protocol. RESULTS The participation rate was 99.7%. Before 1995 the sensitivity, specificity and positive predictive value were 94%, 99.51% and 6%, respectively. From 1995 these percentages were 98%, 99.85% and 21%, respectively. The total prevalence of CH was 1:2670 (prevalence of CH of thyroidal origin was 1:3100 and CH of central origin was 1:21,600). The percentages of patients with severe CH treated before day 15 in the periods 1981-1990, 1991-2000 and 2001-2011 were 24% (63/263), 63% (170/269) and 96% (176/184), respectively. CONCLUSION The sensitivity and specificity of the screening procedure has considerably increased since 1995 compared with the period before 1995. In recent years patients with severe CH were treated considerably earlier than in the first years of the screening. Neonatal screening for CH may be considered as an important success for public health care.
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Hannema SE, van Duyvenvoorde HA, Premsler T, Yang RB, Mueller TD, Gassner B, Oberwinkler H, Roelfsema F, Santen GWE, Prickett T, Kant SG, Verkerk AJMH, Uitterlinden AG, Espiner E, Ruivenkamp CAL, Oostdijk W, Pereira AM, Losekoot M, Kuhn M, Wit JM. An activating mutation in the kinase homology domain of the natriuretic peptide receptor-2 causes extremely tall stature without skeletal deformities. J Clin Endocrinol Metab 2013; 98:E1988-98. [PMID: 24057292 DOI: 10.1210/jc.2013-2358] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND C-type natriuretic peptide (CNP)/natriuretic peptide receptor 2 (NPR2) signaling is essential for long bone growth. Enhanced CNP production caused by chromosomal translocations results in tall stature, a Marfanoid phenotype, and skeletal abnormalities. A similar phenotype was described in a family with an activating NPR2 mutation within the guanylyl cyclase domain. CASE Here we describe an extremely tall male without skeletal deformities, with a novel NPR2 mutation (p.Arg655Cys) located in the kinase homology domain. OBJECTIVES The objective of the study was to investigate the functional and structural effects of the NPR2 mutation. METHODS Guanylyl cyclase activities of wild-type vs mutant NPR2 were analyzed in transfected human embryonic kidney 293 cells and in skin fibroblasts. The former were also used to study possible interactions between both isoforms. Homology modeling was performed to understand the molecular impact of the mutation. RESULTS CNP-stimulated cGMP production by the mutant NPR2 was markedly increased in patient skin fibroblasts and transfected human embryonic kidney 293 cells. The stimulatory effects of ATP on CNP-dependent guanylyl cyclase activity were augmented, suggesting that this novel mutation enhances both the responsiveness of NPR2 to CNP and its allosteric modulation/stabilization by ATP. Coimmunoprecipitation showed that wild-type and mutant NPR2 can form stable heterodimers, suggesting a dominant-positive effect. In accordance with augmented endogenous receptor activity, plasma N-terminal pro-CNP (a marker of CNP production in tissues) was reduced in the proband. CONCLUSIONS We report the first activating mutation within the kinase homology domain of NPR2, resulting in extremely tall stature. Our observations emphasize the important role of this domain in the regulation of guanylyl cyclase activity and bone growth in response to CNP.
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Affiliation(s)
- Sabine E Hannema
- MD, PhD, Department of Paediatrics, Leiden University Medical Centre, Postbus 9600, 2300 RC Leiden, The Netherlands.
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Joustra SD, Schoenmakers N, Persani L, Campi I, Bonomi M, Radetti G, Beck-Peccoz P, Zhu H, Davis TME, Sun Y, Corssmit EP, Appelman-Dijkstra NM, Heinen CA, Pereira AM, Varewijck AJ, Janssen JAMJL, Endert E, Hennekam RC, Lombardi MP, Mannens MMAM, Bak B, Bernard DJ, Breuning MH, Chatterjee K, Dattani MT, Oostdijk W, Biermasz NR, Wit JM, van Trotsenburg ASP. The IGSF1 deficiency syndrome: characteristics of male and female patients. J Clin Endocrinol Metab 2013; 98:4942-52. [PMID: 24108313 DOI: 10.1210/jc.2013-2743] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Ig superfamily member 1 (IGSF1) deficiency was recently discovered as a novel X-linked cause of central hypothyroidism (CeH) and macro-orchidism. However, clinical and biochemical data regarding growth, puberty, and metabolic outcome, as well as features of female carriers, are scarce. OBJECTIVE Our objective was to investigate clinical and biochemical characteristics associated with IGSF1 deficiency in both sexes. METHODS All patients (n = 42, 24 males) from 10 families examined in the university clinics of Leiden, Amsterdam, Cambridge, and Milan were included in this case series. Detailed clinical data were collected with an identical protocol, and biochemical measurements were performed in a central laboratory. RESULTS Male patients (age 0-87 years, 17 index cases and 7 from family studies) showed CeH (100%), hypoprolactinemia (n = 16, 67%), and transient partial GH deficiency (n = 3, 13%). Pubertal testosterone production was delayed, as were the growth spurt and pubic hair development. However, testicular growth started at a normal age and attained macro-orchid size in all evaluable adults. Body mass index, percent fat, and waist circumference tended to be elevated. The metabolic syndrome was present in 4 of 5 patients over 55 years of age. Heterozygous female carriers (age 32-80 years) showed CeH in 6 of 18 cases (33%), hypoprolactinemia in 2 (11%), and GH deficiency in none. As in men, body mass index, percent fat, and waist circumference were relatively high, and the metabolic syndrome was present in 3 cases. CONCLUSION In male patients, the X-linked IGSF1 deficiency syndrome is characterized by CeH, hypoprolactinemia, delayed puberty, macro-orchidism, and increased body weight. A subset of female carriers also exhibits CeH.
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Affiliation(s)
- S D Joustra
- MD, Department of Endocrinology and Metabolism C7-Q, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands.
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Affiliation(s)
- Jan M Wit
- Leiden University Medical Center, Leiden, The Netherlands
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Bakker NE, Kuppens RJ, Siemensma EPC, Tummers-de Lind van Wijngaarden RFA, Festen DAM, Bindels-de Heus GCB, Bocca G, Haring DAJP, Hoorweg-Nijman JJG, Houdijk ECAM, Jira PE, Lunshof L, Odink RJ, Oostdijk W, Rotteveel J, Schroor EJ, Van Alfen AAEM, Van Leeuwen M, Van Pinxteren-Nagler E, Van Wieringen H, Vreuls RCFM, Zwaveling-Soonawala N, de Ridder MAJ, Hokken-Koelega ACS. Eight years of growth hormone treatment in children with Prader-Willi syndrome: maintaining the positive effects. J Clin Endocrinol Metab 2013; 98:4013-22. [PMID: 24001750 DOI: 10.1210/jc.2013-2012] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The most important reason for treating children with Prader-Willi syndrome (PWS) with GH is to optimize their body composition. OBJECTIVES The aim of this ongoing study was to determine whether long-term GH treatment can counteract the clinical course of increasing obesity in PWS by maintaining the improved body composition brought during early treatment. SETTING This was a multicenter prospective cohort study. METHODS We have been following 60 prepubertal children for 8 years of continuous GH treatment (1 mg/m(2)/d ≈ 0.035 mg/kg/d) and used the same dual-energy x-ray absorptiometry machine for annual measurements of lean body mass and percent fat. RESULTS After a significant increase during the first year of GH treatment (P < .0001), lean body mass remained stable for 7 years at a level above baseline (P < .0001). After a significant decrease in the first year, percent fat SD score (SDS) and body mass index SDS remained stable at a level not significantly higher than at baseline (P = .06, P = .14, resp.). However, body mass index SDSPWS was significantly lower after 8 years of GH treatment than at baseline (P < .0001). After 8 years of treatment, height SDS and head circumference SDS had completely normalized. IGF-1 SDS increased to +2.36 SDS during the first year of treatment (P < .0001) and remained stable since then. GH treatment did not adversely affect glucose homeostasis, serum lipids, blood pressure, and bone maturation. CONCLUSION This 8-year study demonstrates that GH treatment is a potent force for counteracting the clinical course of obesity in children with PWS.
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Affiliation(s)
- N E Bakker
- Westzeedijk 106, 3016 AH Rotterdam, The Netherlands.
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