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Ertl DA, Mantovani G, de Nanclares GP, Elli FM, Pereda A, Pagnano A, Sanchis A, Cueto-Gonzalez AM, Berrade S, León MC, Rothenbuhler A, Audrain C, Berkenou J, Knight N, Dolman K, Gleiss A, Argente J, Linglart A. Growth patterns and outcomes of growth hormone therapy in patients with acrodysostosis. J Endocrinol Invest 2023:10.1007/s40618-023-02026-2. [PMID: 36749450 DOI: 10.1007/s40618-023-02026-2] [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: 09/08/2022] [Accepted: 01/25/2023] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Severe short stature is a feature of acrodysostosis, but data on growth are sparse. Treatment with recombinant human growth hormone (rhGH) is used in some centers to increase final height, but no studies have been published so far. Our objective was to conduct a multicenter, retrospective, cohort study to investigate growth in individuals with both types of acrodysostosis, treated with rhGH or not; we used the new nomenclature to describe acrodysostosis, as this disease belongs to the large group of inactivating PTH/PTHrP signaling disorders (iPPSD); acrodysostosis refers to iPPSD4 (acrodysostosis type 1 due to PRKAR1A mutations) and iPPSD5 (acrodysostosis type 2, due to PDE4D mutations). METHODS We present auxological data from individuals with genetically characterized iPPSD4, and participants with clinical features of iPPSD5. RESULTS We included 20 and 17 individuals with iPPSD4 and iPPSD5, respectively. The rhGH-treated iPPSD4 patients (n = 9) were smaller at birth than those who did not receive rhGH (median - 2.2 SDS vs. - 1.7 SDS); they showed a trend to catch-up growth during rhGH therapy (median 0.5 SDS in the first year). The rhGH-treated patients (n = 5) reached a better final height compared to those who did not receive rhGH (n = 4) (median - 2.8 SDS vs. - 3.9 SDS), suggesting that rhGH is efficient to increase height in those patients. The difference in target height to final height ranged between 1.6 and 3.0 SDS for iPPSD4 not treated with rhGH (n = 4), 2.1-2.8 SDS for rhGH-treated iPPSD4 (n = 5), 0.6-5.5 SDS for iPPSD5 not treated with rhGH (n = 5) and 2.5-3.1 for rhGH-treated iPPSD5 (n = 2). CONCLUSION Final height may be positively influenced by rhGH in patients with acrodysostosis/iPPSD. Our rhGH-treated cohort started therapy relatively late, which might explain, at least in part, the limited effect of rhGH on height.
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Affiliation(s)
- D-A Ertl
- AP-HP, Department of Endocrinology and Diabetology for Children and Department of Adolescent Medicine, Bicêtre Paris-Saclay University Hospital, 78 Rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France.
- AP-HP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Filière OSCAR and Platform of Expertise for Rare Diseases Paris-Saclay, Bicêtre Paris-Saclay Hospital, 78 Rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France.
- University Paris Saclay, Le Kremlin-Bicêtre, France.
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
- Reference Center for Rare Bone and Growth Disorders: Vienna Bone and Growth Center (ERN-BOND), Vienna, Austria.
| | - G Mantovani
- Endocrinology Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy
| | - G P de Nanclares
- Molecular (Epi) Genetics Laboratory, Bioaraba Health Research Institute, Araba University Hospital, Vitoria-Gasteiz, Spain
| | - F M Elli
- Endocrinology Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy
| | - A Pereda
- Molecular (Epi) Genetics Laboratory, Bioaraba Health Research Institute, Araba University Hospital, Vitoria-Gasteiz, Spain
| | - A Pagnano
- Endocrinology Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy
| | - A Sanchis
- Pediatrics Service, Dysmorphology Consultation, Dr Peset University Hospital, Valencia, Spain
| | - A M Cueto-Gonzalez
- Department of Clinical and Molecular Genetics, Vall d'Hebron Barcelona Campus Hospital, Barcelona, Spain
- Medicine Genetics Group, Vall d'Hebron Barcelona Campus Hospital, Vall d'Hebron Research Institute (VHIR), Autonomous University of Barcelona, Barcelona, Spain
- European Reference Network Craniofacial Anomalies and ENT Disorders (ERN CRANIO and ERN ITHACA), Barcelona, Spain
| | - S Berrade
- Section of Pediatric Endocrinology, Navarra Hospital Complex, Pamplona, Navarra, Spain
| | - M C León
- Pediatric Endocrinology Unit, CIBERER, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - A Rothenbuhler
- AP-HP, Department of Endocrinology and Diabetology for Children and Department of Adolescent Medicine, Bicêtre Paris-Saclay University Hospital, 78 Rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France
- AP-HP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Filière OSCAR and Platform of Expertise for Rare Diseases Paris-Saclay, Bicêtre Paris-Saclay Hospital, 78 Rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France
- University Paris Saclay, Le Kremlin-Bicêtre, France
| | - C Audrain
- AP-HP, Department of Endocrinology and Diabetology for Children and Department of Adolescent Medicine, Bicêtre Paris-Saclay University Hospital, 78 Rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France
- AP-HP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Filière OSCAR and Platform of Expertise for Rare Diseases Paris-Saclay, Bicêtre Paris-Saclay Hospital, 78 Rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France
| | - J Berkenou
- AP-HP, Department of Endocrinology and Diabetology for Children and Department of Adolescent Medicine, Bicêtre Paris-Saclay University Hospital, 78 Rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France
- AP-HP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Filière OSCAR and Platform of Expertise for Rare Diseases Paris-Saclay, Bicêtre Paris-Saclay Hospital, 78 Rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France
| | - N Knight
- Acrodysostosis Support and Research, Reg 1182818, London, UK
| | - K Dolman
- Acrodysostosis Support and Research, Reg 1182818, London, UK
| | - A Gleiss
- Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - J Argente
- Department of Pediatrics and Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación la Princesa, Madrid, Spain
- Department of Pediatrics, Universidad Autónoma de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- IMDEA Food Institute, Madrid, Spain
| | - A Linglart
- AP-HP, Department of Endocrinology and Diabetology for Children and Department of Adolescent Medicine, Bicêtre Paris-Saclay University Hospital, 78 Rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France
- AP-HP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Filière OSCAR and Platform of Expertise for Rare Diseases Paris-Saclay, Bicêtre Paris-Saclay Hospital, 78 Rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France
- University Paris Saclay, Le Kremlin-Bicêtre, France
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Di Rocco F, Rothenbuhler A, Cormier Daire V, Bacchetta J, Adamsbaum C, Baujat G, Rossi M, Lingart A. Craniosynostosis and metabolic bone disorder. A review. Neurochirurgie 2019; 65:258-263. [PMID: 31562881 DOI: 10.1016/j.neuchi.2019.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 07/15/2019] [Revised: 09/12/2019] [Accepted: 09/15/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Some metabolic bone disorders may result in the premature closure of one or more calvarial sutures during childhood, potentially leading to a cranioencephalic disproportion. The aim of this paper is to review the characteristics and consequences of craniosynostosis associated with metabolic disorder. MATERIAL AND METHODS A review of the literature on metabolic forms of craniosynostosis was performed. RESULTS The most common forms of craniosynostosis associated with metabolic bone disorder were isolated sagittal suture fusion with or without scaphocephaly, and sagittal suture fusion associated with coronal suture fusion (oxycephaly) or also with lambdoid suture fusion (pansynostosis). Synostosis may be well-tolerated, but in some subjects results in neurodevelopmental and functional impairment that is sometimes severe. CONCLUSION The impact of metabolic synostosis is very variable, depending on the specific underlying metabolic disease, with a large spectrum of morphological and functional consequences. Diagnosis should be early and management should be carried out by a multidisciplinary team with expertise in both rare skeletal disorders and craniosynostosis. The impact of emergent medical therapies recently developed for some of these diseases will be assessed by systematic coherent follow-up of international registries.
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Affiliation(s)
- F Di Rocco
- Inserm 1033, neurochirurgie pédiatrique, centre de référence pour les craniosténoses, Lyon et université Claude Bernard Lyon 1, hôpital femme-mère-enfant, 69003 Lyon, France.
| | - A Rothenbuhler
- Endocrinologie et diabète de l'enfant, filière OSCAR et plateforme d'expertise Paris Sud maladies rares, centre de référence des maladies rares du calcium et du phosphate, hôpital Bicêtre Paris Sud, AP-HP, 94270 Le Kremlin Bicêtre, France
| | - V Cormier Daire
- Centre de référence maladies osseuses constitutionnelles, institut imagine, 75015 Paris, France
| | - J Bacchetta
- Inserm 1033, centre de référence des maladies rares du calcium et du phosphate, université Claude Bernard Lyon 1, hôpital femme-mère-enfant, 69003 Lyon, France
| | - C Adamsbaum
- Service de radiologie pédiatrique, université Paris-Saclay, hôpital Bicêtre, AP-HP, 94270 Le Kremlin Bicêtre, France
| | - G Baujat
- Centre de référence maladies osseuses constitutionnelles, institut imagine, 75015 Paris, France
| | - M Rossi
- GENDEV Team, CNRS UMR5292, CRNL, UCBL1, Inserm U1028, service de génétique, centre de référence anomalies du développement, centre de compétence maladies osseuses constitutionnelles, hospices civils de Lyon, 69003 Lyon, France
| | - A Lingart
- Endocrinologie et diabète de l'enfant, filière OSCAR et plateforme d'expertise Paris Sud maladies rares, centre de référence des maladies rares du calcium et du phosphate, hôpital Bicêtre Paris Sud, AP-HP, 94270 Le Kremlin Bicêtre, France; Service de radiologie pédiatrique, université Paris-Saclay, hôpital Bicêtre, AP-HP, 94270 Le Kremlin Bicêtre, France; Inserm U1185, université Paris Sud Paris-Saclay, 94270 Le Kremlin Bicêtre, France
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Gizard A, Rothenbuhler A, Pejin Z, Finidori G, Glorion C, de Billy B, Linglart A, Wicart P. Outcomes of orthopedic surgery in a cohort of 49 patients with X-linked hypophosphatemic rickets (XLHR). Endocr Connect 2017; 6:566-573. [PMID: 28954742 PMCID: PMC5633063 DOI: 10.1530/ec-17-0154] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [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] [Received: 09/04/2017] [Accepted: 09/07/2017] [Indexed: 01/18/2023]
Abstract
BACKGROUND X-linked hypophosphatemic rickets (XLHR) is due to mutations in PHEX leading to unregulated production of FGF23 and hypophosphatemia. XLHR is characterized by leg bowing of variable severity. Phosphate supplements and oral vitamin analogs, partially or, in some cases, fully restore the limb straightness. Surgery is the alternative for severe or residual limb deformities. OBJECTIVE To retrospectively assess the results of surgical limb correction in XLHR (osteotomies and bone alignment except for 3 transient hemiepiphysiodesis). METHODS We analyzed the incidence of recurrence and post-surgical complications in 49 XLHR patients (29F, 20M) (mean age at diagnosis 6.0 years (± 7.1)). RESULTS At first surgery, the mean age was 13.4 years (± 5.0). Recurrence was observed in 14/49 (29%) patients. The number of additional operations significantly decreased with age (2.0 (± 0.9), 1.7 (± 1.0) and 1.2 (± 0.4) in children <11 years, between 11 and 15, and >15 years; P < 0.001). Incidence of recurrence seemed to be lower in patients with good metabolic control of the rickets (25% vs 33%). Complications were observed in 57% of patients. CONCLUSION We report a large series of surgical procedures in XLHR. Our results confirm that phosphate supplements and vitamin D analog therapy is the first line of treatment to correct leg bowing. Surgery before puberty is associated with a high risk of recurrence of the limb deformity. Such procedures should only be recommended, following multidisciplinary discussions, in patients with severe distortion leading to mechanical joint and ligament complications, or for residual deformities once growth plates have fused.
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Affiliation(s)
- A Gizard
- Department of Pediatric Orthopedic SurgeryBesançon University Hospital, Paris, France
| | - A Rothenbuhler
- APHPDepartment of Pediatric Endocrinology, Bicêtre Paris Sud, Le Kremlin Bicêtre, France
- Reference Center for Rare Disorders of Calcium and Phosphate MetabolismLe Kremlin Bicêtre, France
- Plateforme d'Expertise Paris Sud Maladies Rares and Filière OSCARBicêtre Paris Sud, Le Kremlin Bicêtre, France
| | - Z Pejin
- APHPDepartment of Pediatric Orthopedic Surgery, Necker Hospital, Paris, France
| | - G Finidori
- APHPDepartment of Pediatric Orthopedic Surgery, Necker Hospital, Paris, France
| | - C Glorion
- APHPDepartment of Pediatric Orthopedic Surgery, Necker Hospital, Paris, France
| | - B de Billy
- Department of Pediatric Orthopedic SurgeryBesançon University Hospital, Paris, France
| | - A Linglart
- APHPDepartment of Pediatric Endocrinology, Bicêtre Paris Sud, Le Kremlin Bicêtre, France
- Reference Center for Rare Disorders of Calcium and Phosphate MetabolismLe Kremlin Bicêtre, France
- Plateforme d'Expertise Paris Sud Maladies Rares and Filière OSCARBicêtre Paris Sud, Le Kremlin Bicêtre, France
- INSERM U1169Hôpital Bicêtre, Le Kremlin Bicêtre, et Université Paris-Saclay, Le Kremlin Bicêtre, France
| | - P Wicart
- Reference Center for Rare Disorders of Calcium and Phosphate MetabolismLe Kremlin Bicêtre, France
- APHPDepartment of Pediatric Orthopedic Surgery, Necker Hospital, Paris, France
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Biosse Duplan M, Coyac BR, Bardet C, Zadikian C, Rothenbuhler A, Kamenicky P, Briot K, Linglart A, Chaussain C. Phosphate and Vitamin D Prevent Periodontitis in X-Linked Hypophosphatemia. J Dent Res 2016; 96:388-395. [PMID: 27821544 DOI: 10.1177/0022034516677528] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
X-linked hypophosphatemia (XLH) is a rare genetic skeletal disease where increased phosphate wasting in the kidney leads to hypophosphatemia and prevents normal mineralization of bone and dentin. Here, we examined the periodontal status of 34 adults with XLH and separated them according to the treatment they received for hypophosphatemia. We observed that periodontitis frequency and severity were increased in adults with XLH and that the severity varied according to the hypophosphatemia treatment. Patients who benefited from an early and continuous vitamin D and phosphate supplementation during their childhood presented less periodontal attachment loss than patients with late or incomplete supplementation. Continued hypophosphatemia treatment during adulthood further improved the periodontal health. Extracted teeth from patients with late or incomplete supplementation showed a strong acellular cementum hypoplasia when compared with age-matched healthy controls. These results show that XLH disturbs not only bone and dentin formation but also cementum and that the constitutional defect of the attachment apparatus is associated with attachment loss.
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Affiliation(s)
- M Biosse Duplan
- 1 Service d'Odontologie, Hôpital Bretonneau, HUPNVS, AP-HP, Paris, France.,2 Faculté de Chirurgie Dentaire, Université Paris Descartes, Montrouge, France.,3 Centre de Référence des Maladies Rares du Métabolisme du Calcium et du Phosphore, Plateforme d'expertise Paris Sud Maladies rares, filière OSCAR, Hôpital Bicêtre-Paris Sud, AP-HP, Le Kremlin Bicêtre, France
| | - B R Coyac
- 4 EA 2496, Faculté de Chirurgie Dentaire, Université Paris Descartes, Montrouge, France
| | - C Bardet
- 4 EA 2496, Faculté de Chirurgie Dentaire, Université Paris Descartes, Montrouge, France
| | - C Zadikian
- 1 Service d'Odontologie, Hôpital Bretonneau, HUPNVS, AP-HP, Paris, France.,2 Faculté de Chirurgie Dentaire, Université Paris Descartes, Montrouge, France
| | - A Rothenbuhler
- 3 Centre de Référence des Maladies Rares du Métabolisme du Calcium et du Phosphore, Plateforme d'expertise Paris Sud Maladies rares, filière OSCAR, Hôpital Bicêtre-Paris Sud, AP-HP, Le Kremlin Bicêtre, France.,5 Service d'endocrinologie, Hôpital Bicêtre, HUPS, AP-HP, Le Kremlin Bicêtre, France
| | - P Kamenicky
- 3 Centre de Référence des Maladies Rares du Métabolisme du Calcium et du Phosphore, Plateforme d'expertise Paris Sud Maladies rares, filière OSCAR, Hôpital Bicêtre-Paris Sud, AP-HP, Le Kremlin Bicêtre, France.,5 Service d'endocrinologie, Hôpital Bicêtre, HUPS, AP-HP, Le Kremlin Bicêtre, France
| | - K Briot
- 3 Centre de Référence des Maladies Rares du Métabolisme du Calcium et du Phosphore, Plateforme d'expertise Paris Sud Maladies rares, filière OSCAR, Hôpital Bicêtre-Paris Sud, AP-HP, Le Kremlin Bicêtre, France.,6 Service de Rhumatologie, Hôpital Cochin, HUPC, AP-HP, Paris, France
| | - A Linglart
- 3 Centre de Référence des Maladies Rares du Métabolisme du Calcium et du Phosphore, Plateforme d'expertise Paris Sud Maladies rares, filière OSCAR, Hôpital Bicêtre-Paris Sud, AP-HP, Le Kremlin Bicêtre, France.,5 Service d'endocrinologie, Hôpital Bicêtre, HUPS, AP-HP, Le Kremlin Bicêtre, France
| | - C Chaussain
- 1 Service d'Odontologie, Hôpital Bretonneau, HUPNVS, AP-HP, Paris, France.,3 Centre de Référence des Maladies Rares du Métabolisme du Calcium et du Phosphore, Plateforme d'expertise Paris Sud Maladies rares, filière OSCAR, Hôpital Bicêtre-Paris Sud, AP-HP, Le Kremlin Bicêtre, France.,4 EA 2496, Faculté de Chirurgie Dentaire, Université Paris Descartes, Montrouge, France
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Petit-Bibal C, Rothenbuhler A, Lucchini P, Aboumrad B, Castell AL, Le Fur S, Bougnères P. Decrease in clinical hypoglycemia in young children with type 1 diabetes treated with free-mixed aspart and detemir insulin: an open labeled randomized trial. Pediatr Diabetes 2015; 16:345-53. [PMID: 24888575 DOI: 10.1111/pedi.12156] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 01/24/2014] [Revised: 03/28/2014] [Accepted: 04/24/2014] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To compare the effectiveness of a free-mix of aspart (A) and detemir (D) insulins (ADIM) with a commonly used premixed fixed-ratio aspart and neutral protamine Hagedorn (NPH) insulin mixture (ANIM) in young children with type 1 diabetes (T1D) treated with twice-daily injections. The trial thus compares not only D vs. NPH, but also flexible, personalized insulin preparations vs. a fixed premixed preparation. RESEARCH DESIGN AND METHODS This single-center, open-label, randomized trial included 82 children with T1D. Patients stayed on ANIM for 1 yr of optimization of disease management, then were randomized to either ANIM (N = 41) or ADIM (N = 41) for another year. OUTCOMES Frequency of severe or symptomatic episodes, glycated hemoglobin A1c (HbA1c), and blood glucose (BG) values. RESULTS Compared with ANIM, ADIM decreases symptomatic hypoglycemia by approximately 2 fold (p < 0.001) and severe hypoglycemia by 7-10 fold (p = 0.04). ADIM somewhat reduced BG variation. Mean HbA1c was comparable on ADIM (7.9 ± 0.8 %; 63 ± 9 mmol/mol) and ANIM (8.2 ± 0.7 %; 66 ± 8 mmol/mol). CONCLUSIONS Using a free-mixing preparation of aspart and detemir insulin decreases hypoglycemia in young children with type 1 diabetes.
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Affiliation(s)
- C Petit-Bibal
- AP-HP, Department of Pediatric Endocrinology, Bicêtre Hospital, Paris Sud University, Pôle I3E, 94275, Le Kremlin Bicetre, France
| | - A Rothenbuhler
- AP-HP, Department of Pediatric Endocrinology, Bicêtre Hospital, Paris Sud University, Pôle I3E, 94275, Le Kremlin Bicetre, France
| | - P Lucchini
- AP-HP, Department of Pediatric Endocrinology, Bicêtre Hospital, Paris Sud University, Pôle I3E, 94275, Le Kremlin Bicetre, France
| | - B Aboumrad
- AP-HP, Department of Pediatric Endocrinology, Bicêtre Hospital, Paris Sud University, Pôle I3E, 94275, Le Kremlin Bicetre, France
| | - A L Castell
- AP-HP, Department of Pediatric Endocrinology, Bicêtre Hospital, Paris Sud University, Pôle I3E, 94275, Le Kremlin Bicetre, France
| | - S Le Fur
- AP-HP, Department of Pediatric Endocrinology, Bicêtre Hospital, Paris Sud University, Pôle I3E, 94275, Le Kremlin Bicetre, France
| | - P Bougnères
- AP-HP, Department of Pediatric Endocrinology, Bicêtre Hospital, Paris Sud University, Pôle I3E, 94275, Le Kremlin Bicetre, France
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Che H, Roux C, Etcheto A, Rothenbuhler A, Kamenicky P, Linglart A, Briot K. THU0551 Quality of Life of Adults with X-Linked Hypophosphatemic Rickets. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Rothenbuhler A, Esterle L, Lahlou N, Bienvenu T, Bahi-Buisson N, Linglart A. CO-62 – Syndrome de Rett et déterminants de la fragilité osseuse. Arch Pediatr 2015. [DOI: 10.1016/s0929-693x(15)30162-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Gueorguieva I, Linglart A, Rothenbuhler A, Piquard C, Bougneres P. P111 - Le syndrome de ROHHADNET (Rapid-Onset Obesity Hypoventilation Hypothalamic Autonomic Dysregulation NEural Tumors), une obésité hypothalamique mal connue. Arch Pediatr 2010. [DOI: 10.1016/s0929-693x(10)70512-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Linglart A, Marchand I, Djavidi A, Senez C, Benigni I, Rothenbuhler A, Forin V. Ostéoporose et handicap moteur central. Arch Pediatr 2009; 16:614-5. [DOI: 10.1016/s0929-693x(09)74087-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
Our objective was to test the ventricular repolarization response to a controlled hypoglycaemia test in Type 1 diabetic adolescents, an age group at risk for 'dead in bed syndrome'. We measured QTc, blood glucose level, potassium, heart rate, blood pressure and urinary metanephrine levels in 16 Type 1 diabetic adolescents during an insulin clamp mimicking the transition from mild hyperglycaemia to hypoglycaemia. QTc increased in all patients by 146 +/- 44 ms (mean +/-sd) ranging from 70 to 230 ms. The longest QTc (630 ms) was recorded in the sibling of a diabetic patient found 'dead in bed'. Heart rate and urinary metanephrine levels correlated with QTc (r = 0.60 and 0.79, respectively; P = 0.02 and 0.003). QTc in euglycaemia showed no correlation with hypoglycaemia associated QTc prolongation. The prognostic value of the hypoglycaemia test for the risk of recurrent episodes of QTc prolongation should be evaluated in real-life conditions in large-scale studies of diabetic adolescents.
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Affiliation(s)
- A Rothenbuhler
- Department of Paediatric Endocrinology, University Paris Descartes, Hôpital Saint Vincent de Paul, AP-HP, Paris, France
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