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Mnif-Feki M, Safi W, Bougacha-Elleuch N, Abid G, Moalla M, Elleuch M, Ben Salah DH, Rekik N, Belguith N, Abdelhedi F, Kammoun T, Hachicha M, Charfi N, Mnif F, Kammoun H, Hadj Kacem H, Hadj-Kacem F, Abid M. Occurrence of Hypopituitarism in Tunisian Turner Syndrome patients: familial versus sporadic cases. Gynecol Endocrinol 2021; 37:848-852. [PMID: 34124982 DOI: 10.1080/09513590.2021.1939298] [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] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE To explore unusual association between Turner Syndrome (TS) and Hypopituitarism in a Tunisian cohort. METHODS We reported 6 patients with TS associated to Hypopituitarism, including three familial cases except the fourth sister who showed only a TS phenotype. Biochemical analysis, resonance magnetic imaging and cytogenetic analyses were performed. RESULTS The average age of our patients was 17.2 years (11-31 years). They were all referred for short stature and pubertal delay, except for the fourth sister who presented spontaneous puberty with the integrity of the pituitary axis and the presence of an X ring chromosome. Karyotype analysis showed monosomy in 3 cases and a mosaic TS in the 3 remaining cases, including one patient with abnormal X chromosome structure. Somatotropic and corticotropic deficiencies were confirmed in 2 sporadic cases while the gonadotropic and thyrotropic axes were spared. In contrast; familial cases were consistently affected by the integrity of the corticotropic axis. MRI showed pituitary hypoplasia in all familial cases and pituitary stalk interruption syndrome in only one sporadic case. No correlation was found between the chromosome formula and the anterior pituitary involvement. CONCLUSION Co-segregation of congenital Hypopituitarism with pituitary hypoplasia and X chromosome aberrations could imply a molecular anomaly of transcription factors responsible for the differentiation and development of pituitary cells such as PROP1, POUF1, Hesx1, Lhx3, Lhx4. The etiopathogenic link between X chromosome abnormalities and the occurrence of Hypopituitarism remains unclear; however, the progress of molecular biology may clarify the interrelation between transcription factors and sex chromosome segregation abnormalities.
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Affiliation(s)
- M Mnif-Feki
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
| | - W Safi
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
| | - N Bougacha-Elleuch
- Laboratory of Molecular and Functional Genetics, Faculty of Sciences of Sfax, Sfax University, TUNISIA
| | - G Abid
- Department of Medical Imaging, Auxerre Hospital Center, Auxerre, France
| | - M Moalla
- Laboratory of Molecular and Cellular Screening Processes, Center of Biotechnology of Sfax, Sfax, Tunisia
| | - M Elleuch
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
| | - D H Ben Salah
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
| | - N Rekik
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
| | - N Belguith
- Genetic Department, Medicine CHU Hédi Chaker, Sfax, Tunisia
| | - F Abdelhedi
- Genetic Department, Medicine CHU Hédi Chaker, Sfax, Tunisia
| | - T Kammoun
- Pediatric Department, CHU Hédi Chaker, Sfax, Tunisia
| | - M Hachicha
- Pediatric Department, CHU Hédi Chaker, Sfax, Tunisia
| | - N Charfi
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
| | - F Mnif
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
| | - H Kammoun
- Genetic Department, Medicine CHU Hédi Chaker, Sfax, Tunisia
| | - H Hadj Kacem
- Department of Applied Biology, College of Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - F Hadj-Kacem
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
| | - M Abid
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
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