1
|
Lack of Catch-Up Growth with Growth Hormone Treatment in a Child Born Small for Gestational Age Leading to a Diagnosis of Noonan Syndrome with a Pathogenic PTPN11 Variant. Case Rep Endocrinol 2021; 2021:5571524. [PMID: 34194850 PMCID: PMC8203378 DOI: 10.1155/2021/5571524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/27/2021] [Indexed: 11/30/2022] Open
Abstract
Background Growth hormone (GH) treatment increases the adult height of short children born small for gestational age (SGA). Catch-up growth is associated with a younger age, shorter height, and prepubertal status at the onset of GH treatment. We report a 12 11/12-year-old girl born SGA who received GH for 5 years without catch-up growth and was diagnosed with Noonan Syndrome (NS). Results A 5-year-and-9-month-old 46, XX girl born SGA was started on GH treatment at a dose of 0.32 mg/kg/week. Her midparental target height is 158.6 cm. Endocrine work up showed an IGF-1 level 69 ng/ml (Normal (N): 55–238 ng/ml), IGFBP3 2.6 mg/L (N: 1.9–5.2 mg/L), TSH 3.2 mIU/L (N: 0.35–5.5 mIU/L), and a normal skeletal survey. Height was 96 cm (0.1%; Ht SDS −2.9), weight 14 kgs (1%; Wt SDS −2.3), and Tanner 1 breast and pubic hair were observed. Due to the poor catch-up growth on GH treatment, she was referred to Genetics to elucidate genetic or syndromic causes of short stature. She was noted to have posteriorly rotated ears and slight down slanting of the palpebral fissures. Genetic findings showed a heterozygous pathogenic variant in PTPN11 (c.922A > G (p.Asn308Asp)) diagnostic for NS. This finding is de novo given negative parental testing. She was noted to have a heterozygous missense variant of unknown significance (VUS) in FGFR3: c.746C > A (p.Ser249Tyr). FGFR3 is associated with multiple skeletal dysplasias including thanatophoric dysplasia, achondroplasia, and Crouzon syndrome and hypochondroplasia. Clinical correlation is poor for these syndromes. Conclusion Diminished catch-up growth and response to GH treatment in a child born SGA led to the diagnosis of NS. The concomitant diagnosis of SGA and NS may have affected the responsiveness of this child to the growth promoting effect of GH treatment.
Collapse
|
2
|
Lee H, Hwangbo H, Ji SY, Kim MY, Kim SY, Kim DH, Hong SH, Lee SJ, Assefa F, Kim GY, Park EK, Park JH, Lee BJ, Jeon YJ, Choi YH. Gamma Aminobutyric Acid-Enriched Fermented Oyster ( Crassostrea gigas) Increases the Length of the Growth Plate on the Proximal Tibia Bone in Sprague-Dawley Rats. Molecules 2020; 25:molecules25194375. [PMID: 32977643 PMCID: PMC7582314 DOI: 10.3390/molecules25194375] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/21/2020] [Accepted: 09/22/2020] [Indexed: 11/16/2022] Open
Abstract
Bone growth during childhood and puberty determines an adult’s final stature. Although several prior studies have reported that fermented oyster (FO) consisting of a high amount of gamma aminobutyric acid can be attributed to bone health, there is no research on the efficacy of FO on growth regulation and the proximal tibial growth plate. Therefore, in this study, we investigated the effect of FO oral administration on hepatic and serum growth regulator levels and the development of the proximal tibial growth plate in young Sprague-Dawley rats. Both oral administration of FO (FO 100, 100 mg/kg FO and FO 200, 200 mg/kg FO) and subcutaneous injection of recombinant human growth hormone (rhGH, 200 μg/kg of rhGH) for two weeks showed no toxicity. Circulating levels of growth hormone (GH) significantly increased in the FO 200 group. The expression and secretion of insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) were enhanced by FO administration. FO administration promoted the expression of bone morphogenic proteins IGF-1 and IGFBP-3 in the proximal tibial growth plate. This positive effect of FO resulted in incremental growth of the entire plate length by expanding the proliferating and hypertrophic zones in the proximal tibial growth plate. Collectively, our results suggested that oral administration of FO is beneficial for bone health, which may ultimately result in increased height.
Collapse
Affiliation(s)
- Hyesook Lee
- Anti-Aging Research Center, Dong-eui University, Busan 47340, Korea; (H.L.); (H.H.); (S.Y.J.); (M.Y.K.); (S.Y.K.); (D.H.K.); (S.H.H.)
- Department of Biochemistry, Dong-eui University College of Korean Medicine, Busan 47227, Korea
| | - Hyun Hwangbo
- Anti-Aging Research Center, Dong-eui University, Busan 47340, Korea; (H.L.); (H.H.); (S.Y.J.); (M.Y.K.); (S.Y.K.); (D.H.K.); (S.H.H.)
- Department of Molecular Biology, Pusan National University, Busan 46241, Korea
| | - Seon Yeong Ji
- Anti-Aging Research Center, Dong-eui University, Busan 47340, Korea; (H.L.); (H.H.); (S.Y.J.); (M.Y.K.); (S.Y.K.); (D.H.K.); (S.H.H.)
- Department of Biochemistry, Dong-eui University College of Korean Medicine, Busan 47227, Korea
| | - Min Yeong Kim
- Anti-Aging Research Center, Dong-eui University, Busan 47340, Korea; (H.L.); (H.H.); (S.Y.J.); (M.Y.K.); (S.Y.K.); (D.H.K.); (S.H.H.)
- Department of Biochemistry, Dong-eui University College of Korean Medicine, Busan 47227, Korea
| | - So Young Kim
- Anti-Aging Research Center, Dong-eui University, Busan 47340, Korea; (H.L.); (H.H.); (S.Y.J.); (M.Y.K.); (S.Y.K.); (D.H.K.); (S.H.H.)
- Department of Molecular Biology, Pusan National University, Busan 46241, Korea
| | - Da Hye Kim
- Anti-Aging Research Center, Dong-eui University, Busan 47340, Korea; (H.L.); (H.H.); (S.Y.J.); (M.Y.K.); (S.Y.K.); (D.H.K.); (S.H.H.)
- Department of Smart Bio-Health, Dong-eui University, Busan 47340, Korea
| | - Su Hyun Hong
- Anti-Aging Research Center, Dong-eui University, Busan 47340, Korea; (H.L.); (H.H.); (S.Y.J.); (M.Y.K.); (S.Y.K.); (D.H.K.); (S.H.H.)
- Department of Biochemistry, Dong-eui University College of Korean Medicine, Busan 47227, Korea
| | - Su Jeong Lee
- Department of Pathology and Regenerative Medicine, School of Dentistry, Kyungpook National University, Daegu 41940, Korea; (S.J.L.); (F.A.); (E.K.P.)
| | - Freshet Assefa
- Department of Pathology and Regenerative Medicine, School of Dentistry, Kyungpook National University, Daegu 41940, Korea; (S.J.L.); (F.A.); (E.K.P.)
| | - Gi-Young Kim
- Department of Marine Life Science, Jeju National University, Jeju 63243, Korea; (G.-Y.K.); (Y.-J.J.)
| | - Eui Kyun Park
- Department of Pathology and Regenerative Medicine, School of Dentistry, Kyungpook National University, Daegu 41940, Korea; (S.J.L.); (F.A.); (E.K.P.)
| | - Joung-Hyun Park
- Ocean Fisheries & Biology Center, Marine Bioprocess Co., Ltd., Busan 46048, Korea; (J.-H.P.); (B.-J.L.)
| | - Bae-Jin Lee
- Ocean Fisheries & Biology Center, Marine Bioprocess Co., Ltd., Busan 46048, Korea; (J.-H.P.); (B.-J.L.)
| | - You-Jin Jeon
- Department of Marine Life Science, Jeju National University, Jeju 63243, Korea; (G.-Y.K.); (Y.-J.J.)
| | - Yung Hyun Choi
- Anti-Aging Research Center, Dong-eui University, Busan 47340, Korea; (H.L.); (H.H.); (S.Y.J.); (M.Y.K.); (S.Y.K.); (D.H.K.); (S.H.H.)
- Department of Biochemistry, Dong-eui University College of Korean Medicine, Busan 47227, Korea
- Correspondence: ; Tel.: +82-51-890-3319
| |
Collapse
|
3
|
Chae HW, Kim DH, Kim HS. Growth hormone treatment and risk of malignancy. KOREAN JOURNAL OF PEDIATRICS 2015; 58:41-6. [PMID: 25774194 PMCID: PMC4357770 DOI: 10.3345/kjp.2015.58.2.41] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 11/06/2014] [Indexed: 11/27/2022]
Abstract
Growth hormone (GH) treatment has been increasingly widely used for children with GH deficiencies as the survival rate of pediatric patients with malignancies has increased. Both GH and insulin-like growth factor-I have mitogenic and antiapoptotic activity, prompting concern that GH treatment may be associated with tumor development. In this review, the authors examined the relationship between GH treatment and cancer risk in terms of de novo malignancy, recurrence, and secondary neoplasm. Although the results from numerous studies were not entirely consistent, this review of various clinical and epidemiological studies demonstrated that there is no clear evidence of a causal relationship between GH treatment and tumor development. Nonetheless, a small number of studies reported that childhood cancer survivors who receive GH treatment have a small increased risk of developing de novo cancer and secondary malignant neoplasm. Therefore, regular follow-ups and careful examination for development of cancer should be required in children who receive GH treatment. Continued surveillance for an extended period is essential for monitoring long-term safety.
Collapse
Affiliation(s)
- Hyun-Wook Chae
- Department of Pediatrics, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | | | - Ho-Seong Kim
- Department of Pediatrics, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
5
|
Abstract
Since 1958 growth hormone (GH) has been used as substitution treatment for children with GH deficiency. At present, it is clear that a dose of 0.23 mg/kg/week can lead to a final height close to target height, but in view of the wide inter-individual variation, alternative regimens based on invidualizing the dosage with the help of prediction models are being investigated. The best strategy during puberty (increase the dosage, delay puberty) is still uncertain. The value of GH in idiopathic short stature is still heavily debated, although the average final height gain on 0.33 mg/kg/week is 5-7 cm. GH is efficacious in short stature due to chronic renal failure and Prader-Willi syndrome. In other conditions insufficient data are available. There are few side-effects.
Collapse
Affiliation(s)
- J M Wit
- Department of Paediatrics, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands
| |
Collapse
|