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Gomathy S, Manda G, Das A, Suri A, Srivastava AK. Flash Pleural Effusion in a Post-Operative Case of Hypothalamic Hamartoma : Is it Due to Autonomic Havoc? Indian J Pediatr 2024; 91:513. [PMID: 37964095 DOI: 10.1007/s12098-023-04945-7] [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: 09/09/2023] [Accepted: 11/09/2023] [Indexed: 11/16/2023]
Affiliation(s)
- Saranya Gomathy
- Department of Neurology, Sri Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India
| | - Goveen Manda
- Department of Neurology, Room no 602, CN Centre, AIIMS, New Delhi, 110029, India
| | - Animesh Das
- Department of Neurology, Room no 602, CN Centre, AIIMS, New Delhi, 110029, India.
| | - Ashish Suri
- Department of Neurosurgery, AIIMS, New Delhi, 110029, India
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Goel K, Niazi F, Chen JS, Hadjinicolaou A, Keezer M, Gallagher A, Fallah A, Weil AG. Outcomes following surgical interventions for hypothalamic hamartomas: protocol for a systematic review and individual patient data meta-analysis. BMJ Open 2024; 14:e080870. [PMID: 38346878 PMCID: PMC10862293 DOI: 10.1136/bmjopen-2023-080870] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/12/2023] [Indexed: 02/15/2024] Open
Abstract
INTRODUCTION Hypothalamic hamartomas (HHs) are deep-seated congenital lesions that typically lead to pharmacoresistant epilepsy and a catastrophic encephalopathic syndrome characterised by severe neuropsychological impairment and decline in quality of life. A variety of surgical approaches and technologies are available for the treatment of HH-related pharmacoresistant epilepsy. There remains, however, a paucity of literature directly comparing their relative efficacy and safety. This protocol aims to facilitate a systematic review and meta-analysis that will characterise and compare the probability of seizure freedom and relevant postoperative complications across different surgical techniques performed for the treatment of HH-related pharmacoresistant epilepsy. METHODS AND ANALYSIS This protocol was developed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Individual Participant Data guidelines. Three major databases, PubMed, Embase and Scopus, will be systematically searched from database inception and without language restrictions for relevant articles using our predefined search strategy. Title-abstract and full text screening using inclusion and exclusion criteria created a priori will be performed by two independent reviewers to identify eligible articles. Conflicts will be resolved via discussion with a third team member. Following data extraction of both study-level and individual patient data (IPD), a study-level and IPD meta-analysis will be performed. Study-level analysis will focus on assessing the degree of heterogeneity in the data and quantifying overall seizure outcomes for each surgical technique. The IPD analysis will use multivariable regression to determine perioperative predictors of seizure freedom and complications that can guide patient and technique selection. ETHICS AND DISSEMINATION This work will not require ethics approval as it will be solely based on previously published and available data. The results of this review will be shared via conference presentation and submission to peer-reviewed neurosurgical journals. PROSPERO REGISTRATION CRD42022378876.
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Affiliation(s)
- Keshav Goel
- University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA
| | - Farbod Niazi
- Department of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Jia-Shu Chen
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Aristides Hadjinicolaou
- Department of Pediatrics, Sainte-Justine University Hospital Center, Montreal, Quebec, Canada
- Department of Neuroscience, University of Montreal, Montreal, Quebec, Canada
| | - Mark Keezer
- Department of Neuroscience, University of Montreal, Montreal, Quebec, Canada
| | - Anne Gallagher
- Laboratoire d'Imagerie Optique en Neurodéveloppement (LIONlab), Saint Justine University Hospital Research Centre, Montreal, Quebec, Canada
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
| | - Aria Fallah
- University of California Los Angeles, Los Angeles, California, USA
| | - Alexander G Weil
- Brain and Development Research Axis, Saint Justine University Hospital Research Centre, Montreal, Quebec, Canada
- Department of Surgery, Division of Neurosurgery, Sainte-Justine University Hospital Center, Montreal, Quebec, Canada
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Nakamura-Utsunomiya A, Yamaguchi K, Goshima N. Anti-ZSCAN1 Autoantibodies Are a Feasible Diagnostic Marker for ROHHAD Syndrome Not Associated with a Tumor. Int J Mol Sci 2024; 25:1794. [PMID: 38339072 PMCID: PMC10855538 DOI: 10.3390/ijms25031794] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/28/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
Recent studies have reported the presence of autoantibodies against zinc finger and SCAN domain-containing protein 1 (ZSCAN1) in the sera of patients with rapid-onset obesity with hypoventilation, hypothalamic and autonomic dysregulation (ROHHAD) syndrome associated with neuroendocrine tumors, suggesting immunologic and paraneoplastic processes as the pathologic underpinnings. Moreover, several hypothalamic regions, including the subfornical organ (SFO), were reported to exhibit antibody reactivity in a patient with ROHHAD syndrome not associated with a tumor. Whether ROHHAD syndrome not associated with a tumor is associated with anti-ZSCAN1 autoantibodies remains unclear. We used a comprehensive protein array analysis to identify candidate molecules in the sera of patients with ROHHAD syndrome and identified ZSCAN1 as a target antigen. We also found that ZSCAN1 was co-expressed at the site of antibody reactivity to the IgG in the patient serum observed in mouse SFOs and an enzyme-linked immunosorbent assay showed that >85% of the patients with ROHHAD syndrome were positive for anti-ZSCAN1 autoantibodies. These results suggest anti-ZSCAN1 autoantibodies as a feasible diagnostic marker in ROHHAD syndrome regardless of the presence of a tumor.
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Affiliation(s)
- Akari Nakamura-Utsunomiya
- Department of Pediatrics/Medical Genetics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan
- Department of Pediatrics, Hiroshima Medical Center, Asa Citizens Hospital, Hiroshima 731-0293, Japan
- Division of Neonatal Screening, National Center for Child Health and Development, Tokyo 157-8535, Japan
| | - Kei Yamaguchi
- Molecular Profiling Research Center for Drug Discovery, National Institute of Advanced Industrial Science and Technology, Tokyo 135-0064, Japan
- ProteoBridge Corporation, Tokyo 135-0064, Japan
| | - Naoki Goshima
- Molecular Profiling Research Center for Drug Discovery, National Institute of Advanced Industrial Science and Technology, Tokyo 135-0064, Japan
- ProteoBridge Corporation, Tokyo 135-0064, Japan
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Hinojosa J, Candela-Cantó S, Becerra V, Muchart J, Gómez-Chiari M, Rumia J, Aparicio J. Multimodal Approach for the Treatment of Complex Hypothalamic Hamartomas. Adv Tech Stand Neurosurg 2024; 50:119-145. [PMID: 38592529 DOI: 10.1007/978-3-031-53578-9_4] [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] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Hypothalamic hamartomas (HHs) are rare congenital lesions formed by heterotopic neuronal and glial cells attached to the mammillary bodies, tuber cinereum, and hypothalamus.They often present with an intractable epilepsy typically characterized by gelastic seizures but commonly associated with other types of refractory seizures. The clinical course is progressive in most of the cases, starting with gelastic seizures in infancy and deteriorating into complex seizure disorders that result in catastrophic epilepsy associated with cognitive decline and behavioral disturbances.Hamartomas are known to be intrinsically epileptogenic and the site of origin for the gelastic seizures. As antiepileptic drugs are typically ineffective in controlling HH-related epilepsy, different surgical options have been proposed as a treatment to achieve seizure control. Resection or complete disconnection of the hamartoma from the mammillothalamic tract has proved to achieve a long-lasting control of the epileptic syndrome.Usually, symptoms and their severity are typically related to the size, localization, and type of attachment. Precocious puberty appears mostly in the pedunculated type, while epileptic syndrome and behavioral decline are frequently related to the sessile type. For this reason, different classifications of HHs have been developed based on their size, extension, and type of attachment to the hypothalamus.The bigger and more complex hypothalamic hamartomas typically present with severe refractory epilepsy, behavioral disturbances, and progressive cognitive decline posing a formidable challenge for the control of these symptoms.We present here our experience with the multimodal treatment for complex hypothalamic hamartomas. After an in-depth review of the literature, we systematize our approach for the different types of hypothalamic hamartomas.
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Affiliation(s)
- José Hinojosa
- Department of Neurosurgery, Hospital Sant Joan de Déu, Barcelona, Spain.
- Unit for Epilepsy Surgery, Hospital Sant Joan de Déu, Barcelona, Spain.
| | - Santiago Candela-Cantó
- Department of Neurosurgery, Hospital Sant Joan de Déu, Barcelona, Spain
- Unit for Epilepsy Surgery, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Victoria Becerra
- Department of Neurosurgery, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Jordi Muchart
- Unit for Epilepsy Surgery, Hospital Sant Joan de Déu, Barcelona, Spain
- Department of Diagnostic Imaging, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Marta Gómez-Chiari
- Unit for Epilepsy Surgery, Hospital Sant Joan de Déu, Barcelona, Spain
- Department of Diagnostic Imaging, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Jordi Rumia
- Department of Neurosurgery, Hospital Sant Joan de Déu, Barcelona, Spain
- Unit for Epilepsy Surgery, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Javier Aparicio
- Unit for Epilepsy Surgery, Hospital Sant Joan de Déu, Barcelona, Spain
- Department of Neurology, Hospital Sant Joan de Déu, Barcelona, Spain
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Koukoubanis K, Stefanaki K, Karagiannakis DS, Kalampalikis A, Michala L. Comparison of salivary cortisol levels between women with functional hypothalamic amenorrhea and healthy women: a pilot study. Endocrine 2023; 82:399-405. [PMID: 37440104 DOI: 10.1007/s12020-023-03448-x] [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: 03/26/2023] [Accepted: 07/02/2023] [Indexed: 07/14/2023]
Abstract
INTRODUCTION Functional Hypothalamic Amenorrhea (FHA) has been associated with excessive-chronic stress, eating disorders, and weight loss. A common feature is the increased serum cortisol, but its measurement has many limitations. Currently, salivary cortisol (SC) has been proposed as a more sensitive and adequate index. AIM To investigate the SC alterations through a 24-h period and the possible correlation with the severity of stress in women with FHA. METHODS Between July 2019 and March 2021, 12 FHA women and 12 healthy controls of comparable age were included. Psychological, eating, and physical abnormalities were evaluated by applying equivalent validated self-questionnaires. RESULTS No significant differences were found between FHA women and healthy individuals with respect to morning (8:00 am) serum cortisol and ACTH (522.5 ± 162.2 vs 442 ± 138.5 nmol/l; p = 0.204 and 37 ± 44.8 vs 17.4 ± 10.8 pg/ml; p = 0.186, respectively). Women with FHA had statistically significant higher morning SC compared to control subjects (21.8 ± 5.9 nmol/l vs 12.8 ± 3.8 nmol/l; p < 0.001), while no significant differences were found regarding the afternoon (4:00 pm) and midnight (12:00 am) SC. A significant positive correlation was found between morning SC and morning serum cortisol (rho = 0.532; p = 0.007), EAT-26 (rho = 0.527; p = 0.008) and HADS-Anxiety score (rho = 0.471; p = 0.02). Additionally, a significant negative correlation between morning SC and BMI was observed (rho = -0.53; p = 0.009). CONCLUSION Compared to serum cortisol, SC seems to express better the hypercortisolemic state of women with FHA and correlates well with the underlying contributing factors. Larger studies are needed in order to confirm these results and validate the optimal SC cut-off value associated with the development of FHA.
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Affiliation(s)
- Konstantinos Koukoubanis
- 1st Department of Obstetrics and Gynecology, "Alexandra" Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Katerina Stefanaki
- Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios S Karagiannakis
- Academic Department of Gastroenterology, "Laiko" General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
| | - Andreas Kalampalikis
- 1st Department of Obstetrics and Gynecology, "Alexandra" Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Lina Michala
- 1st Department of Obstetrics and Gynecology, "Alexandra" Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Soni L, Girish K, Sirivella PK, Maitra S, Agarwal S, Chhabra A. Anesthetic management of a child with ROHHAD syndrome for major abdominal surgery. Paediatr Anaesth 2023; 33:771-772. [PMID: 37219024 DOI: 10.1111/pan.14698] [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: 06/17/2022] [Revised: 04/26/2023] [Accepted: 05/09/2023] [Indexed: 05/24/2023]
Affiliation(s)
- Lipika Soni
- Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
| | - Kavitha Girish
- Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
| | - Prasanna Kumar Sirivella
- Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
| | - Souvik Maitra
- Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
| | - Sandeep Agarwal
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Anjolie Chhabra
- Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
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Fontana-García N, Ivanovic-Barbeito YP, Martín-Palomeque G, Buenache-Espartosa R, Valera-Dávila CE, Pedrera-Mazarro A. [Narcolepsy secondary to a rare fatal disease]. Rev Neurol 2023; 77:S3-S5. [PMID: 37477027 PMCID: PMC10831719 DOI: 10.33588/rn.77s01.2023196] [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] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Indexed: 07/22/2023]
Abstract
INTRODUCTION ROHHAD (rapid-onset obesity with hypothalamic dysfunction, hypoventilation and autonomic dysregulation) is a rare disease, with only about two hundred cases reported to date, that starts in previously healthy children. The first sign is usually obesity, followed by hypothalamic dysfunction and sleep-disordered breathing, which rapidly progresses until the death of the patient. ROHHAD with narcolepsy is even rarer, with only two cases described so far. CASE REPORT We report the case of a boy who showed signs of obesity and sleepiness since he was 5 years old. At the age of 7, he suffered two tonic-clonic seizures and, over the next four years, displayed signs and symptoms of significant hypothalamic dysfunction; after multiple tests, he was then diagnosed with ROHHAD. Despite receiving a large number of treatments, the patient died at the age of 11. CONCLUSION The pathophysiology of this disease needs to be clarified in order to investigate effective treatments in the future.
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Gaspar JM. Is polycystic ovary syndrome a hypothalamic disease? EBioMedicine 2023; 92:104598. [PMID: 37126991 PMCID: PMC10172690 DOI: 10.1016/j.ebiom.2023.104598] [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] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/18/2023] [Indexed: 05/03/2023] Open
Affiliation(s)
- Joana M Gaspar
- Laboratory of Neuroimmune-Metabolism, Federal University of Santa Catarina, Brazil; Graduate Program in Biochemistry, Federal University of Santa Catarina, Florianopolis 88040-900, SC, Brazil.
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Dischinger U, Kötzner L, Kovatcheva-Datchary P, Kleinschmidt H, Haas C, Perez J, Presek C, Koschker AC, Miras AD, Hankir MK, Vogel J, Germer CT, Fassnacht M, Herrmann MJ, Seyfried F. Hypothalamic integrity is necessary for sustained weight loss after bariatric surgery: A prospective, cross-sectional study. Metabolism 2023; 138:155341. [PMID: 36341838 DOI: 10.1016/j.metabol.2022.155341] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 04/27/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The hypothalamus is the main integrator of peripheral and central signals in the control of energy homeostasis. Its functional relevance for the effectivity of bariatric surgery is not entirely elucidated. Studying the effects of bariatric surgery in patients with hypothalamic damage might provide insight. SUMMARY BACKGROUND DATA Prospective study to analyze the effects of bariatric surgery in patients with hypothalamic obesity (HO) vs. matched patients with common obesity (CO) with and without bariatric surgery. METHODS 65 participants were included (HO-surgery: n = 8, HO-control: n = 10, CO-surgery: n = 12, CO-control: n = 12, Lean-control: n = 23). Body weight, levels of anorexic hormones, gut microbiota, as well as subjective well-being/health status, eating behavior, and brain activity (via functional MRI) were evaluated. RESULTS Patients with HO lost significantly less weight after bariatric surgery than CO-participants (total body weight loss %: 5.5 % vs. 26.2 %, p = 0.0004). After a mixed meal, satiety and abdominal fullness tended to be lowest in HO-surgery and did not correlate with levels of GLP-1 or PYY. Levels of PYY (11,151 ± 1667 pmol/l/h vs. 8099 ± 1235 pmol/l/h, p = 0.028) and GLP-1 (20,975 ± 2893 pmol/l/h vs. 13,060 ± 2357 pmol/l/h, p = 0.009) were significantly higher in the HO-surgery vs. CO-surgery group. Abundance of Enterobacteriaceae and Streptococcus was increased in feces of HO and CO after bariatric surgery. Comparing HO patients with lean-controls revealed an increased activation in insula and cerebellum to viewing high-caloric foods in left insula and cerebellum in fMRI. CONCLUSIONS Hypothalamic integrity is necessary for the effectiveness of bariatric surgery in humans. Peripheral changes after bariatric surgery are not sufficient to induce satiety and long-term weight loss in patients with hypothalamic damage.
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Affiliation(s)
- Ulrich Dischinger
- Department of Internal Medicine, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Germany.
| | - Laura Kötzner
- Department of Internal Medicine, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Germany
| | | | - Helena Kleinschmidt
- Department of Internal Medicine, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Germany
| | - Christina Haas
- Department of Internal Medicine, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Germany
| | - Jose Perez
- Department of Neurosurgery, University Hospital, University of Würzburg, Germany
| | - Cornelius Presek
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital, University of Würzburg, Germany
| | - Ann-Cathrin Koschker
- Department of Internal Medicine, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Germany
| | - Alexander D Miras
- Department of Metabolism, Digestion and Reproduction, Imperial College London, United Kingdom
| | - Mohammed K Hankir
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital, University of Würzburg, Germany
| | - Jörg Vogel
- Institute of Molecular Infection Biology, University of Würzburg, Würzburg, Germany; Helmholtz Institute for RNA-based Infection Research, Helmholtz Centre for Infection Research, Würzburg, Germany
| | - Christoph-Thomas Germer
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital, University of Würzburg, Germany
| | - Martin Fassnacht
- Department of Internal Medicine, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Germany
| | - Martin J Herrmann
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital, University of Würzburg, Germany
| | - Florian Seyfried
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital, University of Würzburg, Germany
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Nakamura-Utsunomiya A, Goda S, Hayakawa S, Sonoko S, Hoorn EJ, Blanchard A, Saito-Hakoda A, Kakimoto H, Hachiya R, Kamimura M, Kawakita R, Higuchi S, Fujimaru R, Shirai Y, Miyaoka D, Nagata Y, Kishi Y, Wada A, Mitsuboshi A, Ozaki K, Komatsu N, Niizuma H, Kanno J, Fujiwara I, Hasegawa Y, Yorifuji T, Brickman W, Vantyghem MC, Yamaguchi K, Goshima N, Hiyama TY. Identification of clinical factors related to antibody-mediated immune response to the subfornical organ. Clin Endocrinol (Oxf) 2022; 97:72-80. [PMID: 35419873 DOI: 10.1111/cen.14737] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 05/15/2021] [Revised: 02/28/2022] [Accepted: 04/06/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE We recently reported cases of adipsic hypernatremia caused by autoantibodies against the subfornical organ in patients with hypothalamic-pituitary lesions. This study aimed to clarify the clinical features of newly identified patients with adipsic hypernatremia whose sera displayed immunoreactivity to the mouse subfornical organ. DESIGN Observational cohort study of patients diagnosed with adipsic hypernatremia in Japan, United States, and Europe. METHODS The study included 22 patients with adipsic hypernatremia but without overt structural changes in the hypothalamic-pituitary region and congenital disease. Antibody response to the mouse subfornical organ was determined using immunohistochemistry. The clinical characteristics were compared between the patients with positive and negative antibody responses. RESULTS Antibody response to the mouse subfornical organ was detected in the sera of 16 patients (72.7%, female/male ratio, 1:1, 12 pediatric and 4 adult patients). The prolactin levels at the time of diagnosis were significantly higher in patients with positive subfornical organ (SFO) immunoreactivity than in those with negative SFO immunoreactivity (58.9 ± 33.5 vs. 22.9 ± 13.9 ng/ml, p < .05). Hypothalamic disorders were found in 37.5% of the patients with positive SFO immunoreactivity. Moreover, six patients were diagnosed with rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation/neural tumor syndrome after the diagnosis of adipsic hypernatremia. Plasma renin activity levels were significantly higher in patients with serum immunoreactivity to the Nax channel. CONCLUSIONS The patients with serum immunoreactivity to the SFO had higher prolactin levels and hypothalamic disorders compared to those without the immunoreactivity. The clinical characteristics of patients with serum immunoreactivity to the subfornical organ included higher prolactin levels and hypothalamic disorders, which were frequently associated with central hypothyroidism and the presence of retroperitoneal tumors.
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Affiliation(s)
- Akari Nakamura-Utsunomiya
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- Department of Pediatrics, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Satoshi Goda
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Seiichi Hayakawa
- Department of Pediatrics, Hiroshima University Hospital, Hiroshima, Japan
| | - Sakata Sonoko
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Ewout J Hoorn
- Division of Nephrology and Transplantation, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Anne Blanchard
- Center of Clinical investigation, Faculty of Medicine, Hospital European George Pompidou Paris, Paris, France
| | | | - Haruna Kakimoto
- Department of Pediatrics, Kagoshima University Hospital, Kagoshima, Japan
| | - Rumi Hachiya
- Division of Endocrinology and Metabolism, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Miki Kamimura
- Department of Pediatrics, Tohoku University Hospital, Sendai, Japan
| | - Rie Kawakita
- Division of Pediatric Endocrinology and Metabolism, Children's Medical Center, Osaka City General Hospital, Osaka, Japan
| | - Shinji Higuchi
- Division of Pediatric Endocrinology and Metabolism, Children's Medical Center, Osaka City General Hospital, Osaka, Japan
| | - Rika Fujimaru
- Department of Pediatrics, Osaka City General Hospital, Osaka, Japan
| | - Yoko Shirai
- Department of Pediatric Nephrology, Tokyo Women's Medical University, Tokyo, Japan
| | - Daichi Miyaoka
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yuki Nagata
- Department of Vascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
- Department of vascular medicine, Vascular Science Center for Translational Research, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yutaro Kishi
- Department of Endocrinology and Metabolism, Niigata University Medical and Dentist Hospital, Niigata, Japan
| | - Aya Wada
- Department of Pediatrics, Gunma University Hospital, Tochigi, Japan
| | - Akari Mitsuboshi
- Division of Endocrinology and Metabolism, Hyogo Prefectural Kobe children's Hospital, Kobe, Japan
| | - Kayo Ozaki
- Division of Endocrinology and Metabolism, Hyogo Prefectural Kobe children's Hospital, Kobe, Japan
| | - Nagisa Komatsu
- Department of Pediatrics, Kumamoto Chuo Hospital, Kumamoto, Japan
| | - Hidetaka Niizuma
- Department of Pediatrics, Tohoku University Hospital, Sendai, Japan
| | - Junko Kanno
- Department of Pediatrics, Tohoku University Hospital, Sendai, Japan
| | - Ikuma Fujiwara
- Department of Pediatrics, Tohoku University Hospital, Sendai, Japan
| | - Yukihiro Hasegawa
- Division of Endocrinology and Metabolism, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Tohru Yorifuji
- Division of Pediatric Endocrinology and Metabolism, Children's Medical Center, Osaka City General Hospital, Osaka, Japan
| | - Wendy Brickman
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Division of Endocrinology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Marie-Christine Vantyghem
- Department of Endocrinology, Diabetology, Metabolism and Nutrition, Lille University Hospital, Lille, France
| | - Kei Yamaguchi
- Molecular Profiling Research Center for Drug Discovery, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
- ProteoBridge Corporation, Tokyo, Japan
| | - Naoki Goshima
- Molecular Profiling Research Center for Drug Discovery, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
- ProteoBridge Corporation, Tokyo, Japan
| | - Takeshi Y Hiyama
- Department of Cellular Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
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Nakamura-Utsunomiya A. Autoimmunity Related to Adipsic Hypernatremia and ROHHAD Syndrome. Int J Mol Sci 2022; 23:ijms23136899. [PMID: 35805903 PMCID: PMC9266522 DOI: 10.3390/ijms23136899] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/18/2022] [Accepted: 06/20/2022] [Indexed: 11/16/2022] Open
Abstract
Specific antibody responses to subfornical organs, including Nax antibody, have been reported in patients with adipsic hypernatremia of unknown etiology who do not have structural lesions in the hypothalamic–pituitary gland. The subfornical organ, also referred to as the window of the brain, is a sensing site that monitors sodium and osmotic pressure levels. On the other hand, ROHHAD syndrome is a rare disease for which the etiology of the hypothalamic disorder is unknown, and there have been some reports in recent years describing its association with autoimmune mechanisms. In addition, abnormal Na levels, including hypernatremia, are likely to occur in this syndrome. When comparing the clinical features of adipsic hypernatremia due to autoimmune mechanisms and ROHHAD syndrome, there are similar hypothalamic–pituitary dysfunction symptoms in addition to abnormal Na levels. Since clinical diagnoses of autoimmunological adipsic hypernatremia and ROHAD syndrome might overlap, we need to understand the essential etiology and carry out precise assessments to accurately diagnose patients and provide effective treatment. In this review, I review the literature on the autoimmune mechanism reported in recent years and describe the findings obtained so far and future directions.
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Affiliation(s)
- Akari Nakamura-Utsunomiya
- Department of Genetic Medicine, Hiroshima University Graduate School, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8511, Japan;
- Department of Pediatrics, Hiroshima University Graduate School, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8511, Japan
- Division of Neonatal Screening, National Center for Child Health and Development, 2 Chome-10-1 Okura, Setagaya, Tokyo 157-8535, Japan
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12
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Tuleasca C, Hamdi H, Daquin G, Villeneuve N, Chauvel P, Lepine A, Bartolomei F, Régis J. Increased Gray Matter Density in the Right Mesencephalic Tegmentum Is Associated With Better Engel Classes I and II After Radiosurgery for Hypothalamic Hamartomas. Neurosurgery 2022; 90:180-185. [PMID: 34995238 DOI: 10.1227/neu.0000000000001738] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 08/21/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Hypothalamic hamartomas (HHs) are disabling congenital lesions, responsible for gelastic seizures frequently associated with catastrophic epilepsies, epileptogenic encephalopathy, and cognitive and psychiatric severe comorbidities. Stereotactic radiosurgery (SRS) is a well-established minimally invasive therapeutic approach. OBJECTIVE To assess whether pretherapeutic gray matter density (GMD) correlates with seizure outcome. METHODS We used voxel-based morphometry at whole-brain level, as depicted on pretherapeutic standard structural magnetic resonance neuroimaging. We examined 24 patients (10 male patients, 14 female patients; mean age, 12.7 yr; median, 9; range, 5.9-50) treated in Marseille University Hospital, France, between May 2001 and August 2018. RESULTS Most relevant anatomic area predicting postoperative Engel classes I and II vs III and IV after SRS for HHs was mesencephalic tegmentum. Higher pretherapeutic GMD in this area was associated with better outcomes for seizure cessation. The only other statistically significant clusters were right cerebellar lobule VIIIb and VIIIa. Lower pretherapeutic GMD in both clusters correlated with better Engel class outcomes. GMD decreased with age in the left mediodorsal thalamus. CONCLUSION Seizure cessation after SRS for HHs was associated with higher GMD in mesencephalic tegmental area, acknowledged to be involved in the neural control of explosive vocal behavior in animals. This area is connected by the mamillotegmental bundle to the lateral tuberal nucleus area of the hypothalamus, where HHs are known to rise. In the future, the detection of more gray matter in this "laugh" tegmental area based on pretherapeutic routine structural neuroimaging might help in patient selection for minimally invasive radiosurgery for HH.
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Affiliation(s)
- Constantin Tuleasca
- Neurosurgery Service and Gamma Knife Center, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Faculty of Biology and Medicine (FBM), University of Lausanne (Unil), Lausanne, Switzerland
- Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Hussein Hamdi
- Aix-Marseille University, INSERM, UMR 1106, Marseille, France
- Functional and Stereotactic Neurosurgery and Gamma Knife Unit, Timone University Hospital, Marseille, France
- Functional Neurosurgery and Stereotaxy Unit, Neurological Surgery Department, Tanta University, Tanta, Egypt
| | - Géraldine Daquin
- Aix-Marseille University, INSERM, UMR 1106, Marseille, France
- Clinical Physiology Department, Timone University Hospital, Marseille, France
| | - Nathalie Villeneuve
- Clinical Physiology Department, Timone University Hospital, Marseille, France
| | - Patrick Chauvel
- Aix-Marseille University, INSERM, UMR 1106, Marseille, France
- Clinical Physiology Department, Timone University Hospital, Marseille, France
| | - Anne Lepine
- Clinical Physiology Department, Timone University Hospital, Marseille, France
| | - Fabrice Bartolomei
- Aix-Marseille University, INSERM, UMR 1106, Marseille, France
- Clinical Physiology Department, Timone University Hospital, Marseille, France
| | - Jean Régis
- Aix-Marseille University, INSERM, UMR 1106, Marseille, France
- Functional and Stereotactic Neurosurgery and Gamma Knife Unit, Timone University Hospital, Marseille, France
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Savateev AN, Golanov AV, Saushev DA, Osinov IK, Kostyuchenko VV, Dalechina AV, Melikian AG, Vlasov PA, Mazerkina NA, Makashova ES. [Stereotactic radiosurgery for epilepsy related to hypothalamic hamartoma]. Zh Vopr Neirokhir Im N N Burdenko 2022; 86:14-24. [PMID: 35942833 DOI: 10.17116/neiro20228604114] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
UNLABELLED Hypothalamic hamartoma (HH) is a dysplastic lesion fused with hypothalamus and followed by epilepsy, precocious puberty and behavioral disorders. Up to 50% of patients become free of seizures after surgery, but various complications occur in 1/4 of cases. Radiofrequency thermocoagulation, laser interstitial thermal therapy and stereotactic radiosurgery (SRS) are alternative treatment options. OBJECTIVE To define the indications for SRS in patients with HH and to clarify the irradiation parameters. MATERIAL AND METHODS Twenty-two patients with HH and epilepsy underwent SRS at the Moscow Gamma-knife Center. A retrospective analysis included 19 patients with sufficient follow-up data. Median age of patients was 11.5 years (range 1.3-25.8). The diameter of irradiated HHs ranged between 5.5 and 40.9 mm. In 8 (36%) cases, the volume of hamartoma exceeded 3 cm3. Mean prescribed dose was 18±2.0 Gy, mean prescribed isodose - 48±4.2%. Median follow-up period was 14.8 months (range 3.4 - 96.1). RESULTS Three (15.8%) patients were free of seizures. One patient (5.3%) improved dramatically after treatment with compete resolution of generalized seizures and experienced only rare emotional seizures (Engel IB). Eleven (57.8%) patients reported lower incidence of seizures. Severity and incidence of seizures were the same in 4 patients (21.1%). The best results were achieved in mean target dose over 20-22 Gy, minimal target dose over 7-10 Gy, covering by the prescribed dose of at least 70-80% of hamartoma volume, as well as in patients with the prescribed dose of 12 Gy delivered to almost entire volume of tumor. None patient had any complications after SRS. CONCLUSION SRS is safe regarding neurological, endocrine or visual disturbances. Careful patient selection for SRS makes it an effective option for HH-related epilepsy. The best candidates for SRS are children with seizures aged over 1 year, hamartoma <3 cm3 and area of fusion with hypothalamus <150 mm2.
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Affiliation(s)
| | - A V Golanov
- Burdenko Neurosurgical Center, Moscow, Russia
| | | | - I K Osinov
- Moscow Gamma-knife Center, Moscow, Russia
| | | | | | | | - P A Vlasov
- Burdenko Neurosurgical Center, Moscow, Russia
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14
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Fontana L, Garzia E, Marfia G, Galiano V, Miozzo M. Epigenetics of functional hypothalamic amenorrhea. Front Endocrinol (Lausanne) 2022; 13:953431. [PMID: 36034425 PMCID: PMC9415998 DOI: 10.3389/fendo.2022.953431] [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: 05/26/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Functional hypothalamic amenorrhea (FHA) is a temporary infertility characterized by the suppression of the hypothalamic-pituitary-gonadal (HPG) axis, induced by the inhibition of the hypothalamic pulsatile secretion of the gonadotropin-releasing hormone (GnRH), in the presence of stressors, including eating disorders, excessive exercise, and psychological distress. Although the stressful factors that may lead to FHA are well-established, little is known about the inter-individual variability in response to stress and the consequent inhibition of the HPG axis. Not all women, indeed, manifest FHA in presence of stressful conditions. Recent studies highlighted a genetic contribution to FHA. Rare or polymorphic variants in genes that control the development and/or function of GnRH neurons may contribute, indeed, to the adaptability of the reproductive axis to stress factors. Also epigenetic changes have been associated with different pathways involved in the HPG axis and therefore, take part in FHA and confer a personal predisposition to anovulation consequent to a stressful event, or represent biological markers of response to stress. This review summarizes recent advances in the identification of the contribution of (epi)genetics to FHA and to long-term complications of functional amenorrhea, and reports insights into the involvement of additional genetic loci in FHA development on the bases of the clinical and molecular overlap with other gynecological and/or psychological conditions. Finally, we describe the promising application of induced pluripotent stem cells (iPSCs) as a new approach to investigate the molecular pathways involved in FHA.
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Affiliation(s)
- L. Fontana
- Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Unit of Medical Genetics, ASST Santi Paolo e Carlo, Milan, Italy
| | - E. Garzia
- Reproductive Medicine Unit, Department of Mother and Child, San Paolo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
- Aerospace Medicine Institute “A. Mosso”, Italian Air Force, Milan, Italy
| | - G. Marfia
- Aerospace Medicine Institute “A. Mosso”, Italian Air Force, Milan, Italy
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - V. Galiano
- Reproductive Medicine Unit, Department of Mother and Child, San Paolo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - M. Miozzo
- Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Unit of Medical Genetics, ASST Santi Paolo e Carlo, Milan, Italy
- *Correspondence: M. Miozzo,
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15
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Prieto R, Barrios L, Pascual JM. Papillary Craniopharyngioma: A Type of Tumor Primarily Impairing the Hypothalamus - A Comprehensive Anatomo-Clinical Characterization of 350 Well-Described Cases. Neuroendocrinology 2022; 112:941-965. [PMID: 35108706 DOI: 10.1159/000521652] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 09/21/2021] [Accepted: 12/22/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Papillary craniopharyngiomas (PCPs) represent a rare histological type of craniopharyngiomas (CPs) usually involving the hypothalamus. This study systematically analyzes the clinical-anatomical correlation between tumor topography and symptoms related to hypothalamic dysfunction in the largest series of PCPs ever gathered. METHODS From 5,346 CP reports published from 1856 to 2021, we selected 350 well-described cases of the squamous-papillary type. Clinical presentation, tumor topography, severity of hypothalamic adhesion, patient outcome, and tumor recurrence were thoroughly analyzed. RESULTS PCPs predominantly occur in adult (96.3%), male (61.7%) patients presenting with headache (63.4%), visual alterations (56.2%), and psychiatric disturbances (50.4%). Most PCPs are solid (50%), round (72%) lesions that occupy the third ventricle (3V, 94.8%) and show low-risk severity adhesions to the hypothalamus (66.8%). Two major topographical categories can be found: strictly 3V (57.5%), growing above an intact 3V floor, and not-strictly or infundibulo-tuberal (32.9%), expanding at the infundibulum and/or tuber cinereum. The hypothalamic syndrome predominated among strictly 3V PCPs (p < 0.001). Psychiatric symptoms (p < 0.001) and high-risk hypothalamic attachments (p = 0.031) related to unfavorable postoperative outcomes among patients treated from 2006 onwards. The not-strictly 3V topography was identified as the major predictor of high-risk hypothalamic attachments (71.2% correctly predicted), which, along with incomplete tumor removal (p = 0.018), underlies the higher tumor recurrence of this topography (p = 0.001). CONCLUSIONS This systematic review evidences that PCP topography is a major determinant of hypothalamic-related symptoms, type of hypothalamic attachments, and tumor recurrence rate. Accurate preoperative definition of PCP-hypothalamus relationships is essential for the judicious, safe management of these complex lesions.
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Affiliation(s)
- Ruth Prieto
- Department of Neurosurgery, Puerta de Hierro University Hospital, Madrid, Spain
| | - Laura Barrios
- Department of Statistics, Computing Center, CSIC, Madrid, Spain
| | - José M Pascual
- Department of Neurosurgery, La Princesa University Hospital, Madrid, Spain
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16
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Müller HL. Bariatric Interventions in Craniopharyngioma Patients-Best Choice or Last Option for Treatment of Hypothalamic Obesity? J Clin Endocrinol Metab 2022; 107:e426-e428. [PMID: 34331765 DOI: 10.1210/clinem/dgab567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 07/26/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Hermann L Müller
- University Children's Hospital, Department of Pediatrics and Pediatric Hematology/Oncology, Klinikum Oldenburg AöR, Carl von Ossietzky University, 26133 Oldenburg, Germany
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17
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Abstract
Rapid-onset Obesity with Hypothalamic dysfunction, Hypoventilation, and Autonomic Dysregulation (ROHHAD) and Congenital Central Hypoventilation Syndrome (CCHS) are ultra-rare distinct clinical disorders with overlapping symptoms including altered respiratory control and autonomic regulation. Although both disorders have been considered for decades to be on the same spectrum with necessity of artificial ventilation as life-support, recent acquisition of specific knowledge concerning the genetic basis of CCHS coupled with an elusive etiology for ROHHAD have definitely established that the two disorders are different. CCHS is an autosomal dominant neurocristopathy characterized by alveolar hypoventilation resulting in hypoxemia/hypercarbia and features of autonomic nervous system dysregulation (ANSD), with presentation typically in the newborn period. It is caused by paired-like homeobox 2B (PHOX2B) variants, with known genotype-phenotype correlation but pathogenic mechanism(s) are yet unknown. ROHHAD is characterized by rapid weight gain, followed by hypothalamic dysfunction, then hypoventilation followed by ANSD, in seemingly normal children ages 1.5-7 years. Postmortem neuroanatomical studies, thorough clinical characterization, pathophysiological assessment, and extensive genetic inquiry have failed to identify a cause attributable to a traditional genetic basis, somatic mosaicism, epigenetic mechanism, environmental trigger, or other. To find the key to the ROHHAD pathogenesis and to improve its clinical management, in the present chapter, we have carefully compared CCHS and ROHHAD.
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Affiliation(s)
- Isabella Ceccherini
- Laboratory of Genetics and Genomics of Rare Diseases, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Kyle C Kurek
- Department of Pathology & Laboratory Medicine, University of Calgary, Calgary, AB, Canada
| | - Debra E Weese-Mayer
- Division of Autonomic Medicine, Department of Pediatrics, Ann & Robert H Lurie Children's Hospital of Chicago and Stanley Manne Children's Research Institute; and Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
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18
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Basiratnia M, Derakhshan D, Fouladi D, Ranjbar K, Shahriarirad R. ROHHAD Syndrome an Inconspicuous Cause of Hypernatremia, A Case Report. Iran J Kidney Dis 2021; 15:319-321. [PMID: 34279004] [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] [Received: 01/20/2021] [Revised: 02/25/2021] [Accepted: 03/08/2021] [Indexed: 06/13/2023]
Abstract
Rapid-onset obesity with hypoventilation, hypothalamic dysfunction, and autonomic dysregulation (ROHHAD) syndrome is a rare, life threatening disease with unknown etiology. Dysnatremia is a common finding in these patients. Here we present a 12-year-old boy with multiple admissions due to hypernatremia and was repeatedly misdiagnosed. An eventual diagnosis of ROHHAD syndrome was made by integration of the previous ignored findings of sleep apnea and obesity. The diagnosis of this rare but potentially fatal syndrome should be considered in patients with dysnatremia associated with obesity and sleep apnea disorders.
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Affiliation(s)
| | - Dorna Derakhshan
- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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田 茂, 雷 文, 郎 长, 李 娟, 谭 君, 束 晓. [Fever for 2 months and disturbance of consciousness for 1 week in a preschool-aged girl]. Zhongguo Dang Dai Er Ke Za Zhi 2021; 23:519-523. [PMID: 34020744 PMCID: PMC8140330 DOI: 10.7499/j.issn.1008-8830.2101101] [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] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/10/2021] [Indexed: 06/12/2023]
Abstract
Rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation syndrome (ROHHADS) is a rare multi-system disease, and delayed diagnosis and treatment may lead to catastrophic cardiopulmonary complications. As far as we know, no patient with ROHHADS has been reported in China, and this article reports a child with ROHHADS to improve the awareness of this disease among clinicians. A girl, aged 3 years, had the clinical manifestations of rapid weight gain, fever, disturbance of consciousness, and convulsion. The physical examination showed a body weight of 20 kg, somnolence, irregular breathing, and stiff neck. She had increased blood levels of prolactin and follicle-stimulating hormone and hyponatremia. The lumbar puncture showed an increased intracranial pressure. The brain MRI and magnetic resonance venography showed symmetrical lesions in the periventricular region and venous thrombosis in the right transverse sinus and the superior sagittal sinus. The sleep monitoring showed hypopnea. The girl was finally diagnosed with ROHHADS and intracranial venous thrombosis. She recovered after symptomatic treatment including decreasing intracranial pressure, anticoagulation, and respiratory support. The possibility of ROHHADS should be considered for patients with unexplained obesity, fever, and hypoventilation, with or without central nervous system symptoms. Early diagnosis and standardized follow-up can improve the prognosis of children with ROHHADS.
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Affiliation(s)
- 茂强 田
- />遵义医大学附属医院小儿内科, 贵州遵义 563003Department of Pediatric, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563003, China
| | - 文婷 雷
- />遵义医大学附属医院小儿内科, 贵州遵义 563003Department of Pediatric, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563003, China
| | - 长会 郎
- />遵义医大学附属医院小儿内科, 贵州遵义 563003Department of Pediatric, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563003, China
| | - 娟 李
- />遵义医大学附属医院小儿内科, 贵州遵义 563003Department of Pediatric, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563003, China
| | - 君梅 谭
- />遵义医大学附属医院小儿内科, 贵州遵义 563003Department of Pediatric, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563003, China
| | - 晓梅 束
- />遵义医大学附属医院小儿内科, 贵州遵义 563003Department of Pediatric, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563003, China
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Emet DC, Ozon A, Alikasifoglu A, Kandemir N, Gonc N. Alpha-Melanocyte-Stimulating Hormone is Elevated in Hypothalamic Obesity Associated with Childhood Craniopharyngioma. Obesity (Silver Spring) 2021; 29:402-408. [PMID: 33491320 DOI: 10.1002/oby.23087] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 07/01/2020] [Revised: 09/24/2020] [Accepted: 11/05/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the peripheral concentrations of leptin and neuropeptides taking part in the melanocortin pathway in hypothalamic obesity (HO) associated with craniopharyngioma (CP) and to find a peripheral marker for diagnosis. METHODS Thirty-one patients (52% girls; median age 16 years) with CP were enrolled in the study group. They were grouped as CP with obesity (CPobesity , n = 17) and CP without obesity (CPnonobesity , n = 14). Two control groups without CP consisted of 27 children with obesity (OC) (55% girls; median age 13.8 years) and 25 children without obesity (normal control [NC]) (72% girls; median age 14.5 years). Obesity was defined as BMI percentile ≥ 95%. Fasting serum concentrations of leptin, brain-derived neurotrophic factor (BDNF), and alpha-melanocyte-stimulating hormone (α-MSH) were measured in the groups. RESULTS Leptin and BDNF concentrations were correlated with BMI SD score (SDS) in controls (OC + NC) and CP. However, there was no correlation between α-MSH and BMI-SDS in CP or control groups. After adjusting for age, sex, and BMI-SDS, α-MSH was found to be significantly higher in CPobesity than in other groups, whereas leptin and BDNF were comparable among the four groups. CONCLUSIONS Serum BDNF, just like leptin, increased with BMI, regardless of hypothalamic damage. On the contrary, α-MSH concentration was significantly high in HO, designating a potential biomarker for HO in CP.
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Affiliation(s)
- Dicle Canoruc Emet
- Department of Pediatric Endocrinology, Hacettepe University, Ankara, Turkey
| | - Alev Ozon
- Department of Pediatric Endocrinology, Hacettepe University, Ankara, Turkey
| | - Ayfer Alikasifoglu
- Department of Pediatric Endocrinology, Hacettepe University, Ankara, Turkey
| | - Nurgun Kandemir
- Department of Pediatric Endocrinology, Hacettepe University, Ankara, Turkey
| | - Nazlı Gonc
- Department of Pediatric Endocrinology, Hacettepe University, Ankara, Turkey
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21
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Zhang K, Zhu HJ, Lu L, Yao Y, Pan H, Wang RZ. [The mode of multidisciplinary team contributes a crucial role to improve the diagnosis and treatment of complicated hypothalamic-pituitary diseases]. Zhonghua Yi Xue Za Zhi 2020; 100:1521-1525. [PMID: 32450638 DOI: 10.3760/cma.j.cn112137-20200224-00428] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- K Zhang
- Hypothalumus-pituitary Disease Multidisplinary Team, Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy and Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - H J Zhu
- Hypothalumus-pituitary Disease Multidisplinary Team, Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy and Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - L Lu
- Hypothalumus-pituitary Disease Multidisplinary Team, Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy and Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Y Yao
- Hypothalumus-pituitary Disease Multidisplinary Team, Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy and Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - H Pan
- Hypothalumus-pituitary Disease Multidisplinary Team, Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy and Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - R Z Wang
- Hypothalumus-pituitary Disease Multidisplinary Team, Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy and Medical Sciences & Peking Union Medical College, Beijing 100730, China
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22
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Abstract
INTRODUCTION Treatment of childhood brain tumors, including surgical resection and especially external beam radiation, often results in endocrine complications manifested by hypopituitarism, which can involve growth hormone deficiency, hypothyroidism, adrenal insufficiency, disorders of puberty, diabetes insipidus, and hypothalamic obesity. AREAS COVERED A comprehensive literature search was conducted on Medline (publications from the 1990s to 01/2019) including systematic reviews, meta-analyses, longitudinal controlled studies, retrospective cohort studies, and case reports. Herein, we present an up-to-date review of the current literature regarding endocrine sequellae of childhood brain tumor survivors. EXPERT OPINION Late endocrine sequellae can arise many years after the initial treatment of tumor, so at least annual surveillance of growth, puberty, weight, development, and endocrine status is recommended for at least 10 years after tumor therapy. This follow up should encompass childhood and adulthood among survivors. If found early, outcomes of endocrinopathies are favorable when treated appropriately. Newer tumor therapy modalities, such as proton beam radiation, offer the potential for fewer endocrine complications, but such benefit has yet to be demonstrated, and more research into short- and long-term outcomes is needed.
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Affiliation(s)
- Jonathan C Howell
- a Division of Pediatric Endocrinology , Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine , Cincinnati , OH , USA
| | - Susan R Rose
- a Division of Pediatric Endocrinology , Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine , Cincinnati , OH , USA
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23
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Bodensteiner JB. Editorial Comment: Case #26 Hypothalamic Hamartoma and Infantile Spasms. Semin Pediatr Neurol 2018; 26:119. [PMID: 29961500 DOI: 10.1016/j.spen.2017.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Affiliation(s)
- Inés Castro-Dufourny
- Department of Endocrinology, Sureste University Hospital, Ronda del Sur S/N, 28500, Arganda del Rey, Madrid, Spain.
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Colombo O, Pinelli G, Comelli M, Marchetti P, Sieri S, Brighenti F, Nappi RE, Tagliabue A. Dietary intakes in infertile women a pilot study. Nutr J 2009; 8:53. [PMID: 19903344 PMCID: PMC2780458 DOI: 10.1186/1475-2891-8-53] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [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: 05/14/2009] [Accepted: 11/10/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The reproductive axis is closely linked to nutritional status. The purpose of this study was to compare the nutritional status in two groups of young infertile women, without clinically overt eating disorders: hypothalamic amenorrhea (HA) and polycystic ovary syndrome (PCOS). METHODS Eighteen young infertile women (10 HA, 8 PCOS) attending an outpatient gynecological endocrinology unit, underwent evaluation of anthropometry, body composition, dietary intakes by means of a food frequency questionnaire (FFQ) and a seven-day food diary (7DD), and psychological characteristics by means of EDI2 and SCL90 tests. RESULTS HA women had lower BMI and body fat compared to PCOS women. Habitual intake derived from FFQs showed a similar macronutrient distribution between groups (about 16% protein, 33% fat, 52% carbohydrates). The psychometric profiles of the two groups did not differ significantly. The underreporting of dietary intakes (measured as habitual energy intake by FFQs/basal metabolic rate) was found to be negatively correlated with the interpersonal sensitivity SCL-90 subscale scores (r = -0.54, p = 0.02). CONCLUSION Our study identified differences in body composition but not in dietary habits between HA and PCOS infertile women. We documented, for the first time, a relationship between the accuracy of dietary surveys and the psychological characteristics of subjects with anovulation. This finding suggests that it may be important to be aware of the psychological terrain when planning a dietary survey in infertile women.
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Affiliation(s)
- Ottavia Colombo
- Department of Applied Health Sciences, University of Pavia, via Bassi 21, 27100 Pavia, Italy
| | - Giovanna Pinelli
- Department of Applied Health Sciences, University of Pavia, via Bassi 21, 27100 Pavia, Italy
| | - Mario Comelli
- Department of Applied Health Sciences, University of Pavia, via Bassi 21, 27100 Pavia, Italy
| | - Pierpaolo Marchetti
- Department of Applied Health Sciences, University of Pavia, via Bassi 21, 27100 Pavia, Italy
| | - Sabina Sieri
- Nutritional Epidemiology Unit, National Cancer Institute, Via Venezian 1, 20133 Milan, Italy
| | - Furio Brighenti
- Department of Public Health, University of Parma, via Volturno 39, 43100 Parma, Italy
| | - Rossella E Nappi
- Research Centre for Reproductive Medicine, Dept of Morphological, Eidological and Clinical Sciences & Gynecological Endocrinology Unit, Dept of Internal Medicine & Endocrinology, IRCCS S. Maugeri Foundation, University of Pavia, Via Ferrata 8 - 27100 Pavia, Italy
| | - Anna Tagliabue
- Department of Applied Health Sciences, University of Pavia, via Bassi 21, 27100 Pavia, Italy
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Zárate A, Saucedo R. [The adiposogenital distrophy or Frohlich syndrome and the beginning of the concept of neuroendocrinology]. GAC MED MEX 2007; 143:349-350. [PMID: 17969845] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
A century has passed since Harvey Cushing presented a syndrome characterized by obesity and sexual infantilism, caused by a tumour located in the base of the brain, and named it as Adiposogenital dystrophy or Frohlich's syndrome, on the name of its discoverer. Further study of this syndrome contributed to establish the hormonal connection between the brain and the anterior pituitary, and then the concept of neuroendocrinology.
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Affiliation(s)
- Arturo Zárate
- Unidad de Investigación de Endocrinología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México DF, México.
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Abstract
Childhood craniopharyngiomas are histologically benign tumours arising from remnants of Rathke's pouch in the hypothalamic-pituitary region. The two common treatment approaches are primary total resection or limited resection followed by radiotherapy. To study the outcome after a primary surgical approach, we followed 25 consecutive patients (10 females, 15 males) under 16 years of age who were treated in a single institution with a management policy of radical tumour excision (mean age at diagnosis 9 years 2 months, SD 4 years 3 months; range 2 years 9 months to 15 years 11 months). Mean follow-up after primary surgery was 11 years 3 months (SD 7 years 7 months). Tumour control, and neurological, endocrine, and hypothalamic complications and their impact on health-related quality of life were assessed (medical follow-up, semi-structured interview, and questionnaires). Results of tumour control were generally good, however, local failure was observed in 6 of 25 patients, and severe late-treatment complications decreased quality of life for many long-time survivors. Endocrine deficiency occurred in 24/25, visual complications in 16/24, neurological complications in 8/24, obesity in 14/23, increased daytime sleepiness in 6/21, and significant school problems in 10/20. Patients with craniopharyngioma rated their health-related quality of life as considerably lower than healthy controls; the domains of social and emotional functioning were particularly affected. Parents' ratings were considerably lower than those of the patients. Poor functional outcome was associated with large tumours infiltrating or displacing the hypothalamus, the occurrence of hydrocephalus, and young age at diagnosis, but also with multiple operations due to tumour recurrence. Alternative treatment strategies should be considered, especially in very young patients with large tumours.
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Affiliation(s)
- Andrea Poretti
- Division of Neurology, University Children's Hospital of Zurich, Switzerland
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[Advances in endocrinology in the recent decade in China. Writing Group on Endocrinology, Editorial Board, Chinese Journal of Internal Medicine]. Zhonghua Nei Ke Za Zhi 1999; 38:587-91. [PMID: 12797323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
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Palermo R, Albano C, Mangione D, Napoli P. Chronic anovulation due to prolactin hypersecretion. Acta Eur Fertil 1994; 25:161-172. [PMID: 7900499] [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] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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31
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Talyzina NK. [Congenital hypotrophy in children]. Feldsher Akush 1972; 37:23-7. [PMID: 4484409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Herdegen L. [Laurence-Moon-Biedl-Bardet syndrome in a 14-year-old boy]. Cesk Pediatr 1969; 24:797-800. [PMID: 5811259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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34
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Kito S, Muro T, Tomonaga M. [Notes on clinical application of electromyography]. Naika 1969; 24:315-23. [PMID: 5352890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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35
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Freire de Oliveira CM. [Chronic dystrophic injuries of the vulva. Their study using the radioactive phosphorus fixation test]. Acta Obstet Ginecol Hisp Lusit 1969; 17:165-90. [PMID: 5792205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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36
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László FA, Durszt F, Kovács K. [Evaluation of the simple water loading method in various endocrine diseases]. Med Welt 1968; 19:1239-44. [PMID: 5728825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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37
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Drukker J. [Fröhlich's syndrome, adipose-genital dystrophy, and pseudo-Fröhlich]. Ned Tijdschr Geneeskd 1967; 111:405-7. [PMID: 6042301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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38
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Otradovec J. [Indirect injuries of the chiasma]. Sb Lek 1966; 68:252-63. [PMID: 5975495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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NATU NK, GUPTA NN, TANDON PN. FROEHLICH'S SYNDROME. J Indian Med Assoc 1965; 44:439-40. [PMID: 14298479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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FRIDBERG DI. [THE CLINICAL CHARACTERISTICS OF ADIPOSITY OF CEREBRAL GENESIS]. Probl Endokrinol Gormonoter 1965; 11:3-8. [PMID: 14288783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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Romero E. [Study of the adiposo-hypogonadal syndrome]. Rev Iber Endocrinol 1965; 12:123-46. [PMID: 5828666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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QUERCI M, TROMPEO MA. [JUVENILE OBESITY. ADIPOSO-GENITAL SYNDROMES AND ANESTHESIA]. Minerva Anestesiol 1964; 30:489-93. [PMID: 14228782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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LEMARIEY A, PAQUELIN F, HAMON L. [HAZARDS DEVELOPING IN THE COURSE OF TREATMENT OF A NASOPHARYNGEAL FIBROMA]. Ann Otolaryngol Chir Cervicofac 1964; 81:723-30. [PMID: 14237553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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JULESZ M, CZEIZEL E, BOGNAR Z, HANCSOK M, ZOLTAI N, ZOLTAI L, JANKO M. [TOXOPLASMOSIS AS A CAUSE OF ADIPOSOGENITAL DYSTROPHY]. Orv Hetil 1964; 105:1723. [PMID: 14195773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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CATALANO F. [FAMILIAL ASPECTS OF SCHIZOPHRENIC DISORDERS AND DYSTROPHIC (ADIPOSE OR ADIPOSO-GENITAL) DISORDERS]. Acta Neurol (Napoli) 1964; 19:807-14. [PMID: 14225874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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48
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TONDI IV. [HEAVY AND STRIKING FAMILY HISTORY DUE TO PROBABLE CONJUGAL TOXOPLASMOSIS]. Riforma Med 1964; 78:942-4. [PMID: 14222309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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GEDDA L, DIRAIMONDO F. THE CONTRIBUTION OF THE "CLINICAL TWIN METHOD" TO THE STUDY OF SEX ANOMALIES IN CHILDHOOD. Acta Genet Med Gemellol (Roma) 1964; 13:217-37. [PMID: 14198921 DOI: 10.1017/s1120962300015559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
SUMMARYFirst of all the Authors stress the importance of twin studies as a method of analysis of the pathological phenomena from a hereditary standpoint: to this aim, the Interzygotic Twin Method may be used in statistical studies, and the Clinical Twin Method in clinical ones. On this basis, the Authors report their observations, on a remarkable number of male twin pairs, affected by anomalies or syndromes including one or more genital dysfunctions, either in infancy or adolescence. Numerous cases of phimosis are thus presented, where the higher concordance in pairs of MZ twins stands for a hereditary conditioning; cases of hypospadias, showing a perfect symmetry of the malformation in the cotwins; cryptorchism, with various possibilities of presentation of the anomaly in the intrageminal comparison. The Authors also describe in detail, making an analytical intra-pair comparison of the symptoms and laboratory data, some cases of complex adiposogenital dystrophy, as well as one case of Laurence-Moon-Bardet-Biedl syndrome with different clinical manifestation in a DZ pair. The longitudinal study carried out over many years on some of the pairs affected by the above mentioned clinical pictures, and the clinico-statistical analysis of the cases under consideration allow the Authors to draw a number of positive conclusions concerning the variable, genotypic conditioning of the sex anomalies considered: in this field, as well as in many others of nosography, the Clinical Twin Method appears to be highly useful in practice, and unique by reason of its peculiarity.
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BENKOVICH IL. [ADIPOSOGENITAL DYSTROPHY AND DIABETES INSIPIDUS FOLLOWING CEREBROCRANIAL INJURY]. Probl Endokrinol Gormonoter 1964; 10:70-1. [PMID: 14241324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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