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Kizzee RL, Baker M, Launier K. Hyperbilirubinemia in an Infant with Delayed Eye Tracking. Pediatr Rev 2022; 43:525-528. [PMID: 36045160 DOI: 10.1542/pir.2021-004956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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2
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Kiyokawa M, Ueki S, Hatase T, Hanyu T, Fukuchi T. The Prevalence of Brain Abnormalities in Japanese Patients with Optic Nerve Hypoplasia. Neuroophthalmology 2021; 45:265-270. [PMID: 34366515 DOI: 10.1080/01658107.2020.1844758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
The purpose of this study was to investigate the clinical characteristics of Japanese patients with optic nerve hypoplasia (ONH), with particular attention to the prevalence of brain abnormalities. We retrospectively analysed the medical charts of 16 patients who were diagnosed with ONH and who underwent magnetic resonance imaging (MRI) at Niigata University Medical and Dental Hospital. We recorded the age, sex, laterality, initial eye and visual symptoms, best-corrected visual acuity, and brain abnormalities on MRI (excluding ONH). The median age at the first visit to the Ophthalmology Clinic was 2.4 years old. Four patients were male and 12 were female. ONH was bilateral in 11 patients and unilateral in five. Best-corrected visual acuity ranged from no light perception to 20/20. Seven patients (43.8%) had brain abnormalities including agenesis of the septum pellucidum, pituitary gland hypofunction, cerebral dysplasia, and West syndrome. Five of these seven patients had general manifestations since the neonatal or infantile period. Our study revealed the prevalence of brain abnormalities associated with optic nerve hypoplasia in Japanese patients at a single institute. Because two of 11 patients had no general manifestations since the neonatal or infantile period but demonstrated brain abnormalities, MRI should be performed to investigate all patients with ONH.
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Affiliation(s)
- Megumi Kiyokawa
- Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Satoshi Ueki
- Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.,Center for Integrated Human Brain Science, Brain Research Institute, Niigata University, Niigata, Japan
| | - Tetsuhisa Hatase
- Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.,Imai Eye Clinic, Niigata, Japan
| | - Takako Hanyu
- Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.,Hanyu Clinic, Niigata, Japan
| | - Takeo Fukuchi
- Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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Wadams HD, Gupta N, Novotny P, Tebben PJ. Onset of pituitary hormone deficiencies in optic nerve hypoplasia: a temporal trend analysis of 32 children at Mayo Clinic. J Pediatr Endocrinol Metab 2020; 33:139-145. [PMID: 31811804 DOI: 10.1515/jpem-2019-0269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 11/11/2019] [Indexed: 11/15/2022]
Abstract
Background The objective of this study was to evaluate the age at onset and frequency of individual pituitary hormone deficiencies (PHDs) in optic nerve hypoplasia (ONH). Methods We performed a retrospective chart review of patients ≤21 years of age evaluated between 1996 and 2014. Patients were included if they had: (1) ONH diagnosed by an ophthalmologist and/or magnetic resonance imaging (MRI), (2) documentation of pituitary hormone function on at least two separate occasions and (3) at least one PHD documented or a midline abnormality of the brain on MRI. Results Thirty-two patients (18 females, 14 males) were included (median age, 8 years [range, 1.1-21.0 years]). All patients had ONH (bilateral, n = 31; unilateral, n = 1) and at least one midline abnormality of the brain. At least one PHD was present in 75% of patients (n = 24). The remaining 25% of patients (n = 8) did not develop any PHD at least until the last follow-up (<2-8.6 years of follow-up), despite the presence of ONH and a midline abnormality of the brain. The median age (years) at diagnosis of antidiuretic hormone (ADH), thyroid-stimulating hormone (TSH), adrenocorticotropic hormone (ACTH) and growth hormone (GH) deficiencies was 0.5, 0.6, 0.7 and 1.6, respectively. Twenty-three percent of all PHDs were identified during the neonatal period, 56% by 12 months and 72% by 36 months of age. The latest age at diagnosis of GH, ACTH and TSH deficiencies was 9.6, 9.9 and 12.6 years, respectively. Conclusions The majority of the PHDs in ONH develop within the first 3 years of life. We propose evaluation for endocrinopathies at the time of diagnosis of ONH, with repeat assessment for new deficiencies every 3-4 months until age 3 years and at least semi-annually until growth and puberty are complete.
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Affiliation(s)
- Heather D Wadams
- Division of Pediatric Endocrinology, Department of Pediatrics, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.,Division of Endocrinology and Metabolism, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Nidhi Gupta
- Division of Endocrinology and Metabolism, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA.,Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Paul Novotny
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Peter J Tebben
- Division of Endocrinology and Metabolism, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA.,Division of Endocrinology, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN, USA
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4
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Dahl S, Kristoffersen Wiberg M, Teär Fahnehjelm K, Sävendahl L, Wickström R. High prevalence of pituitary hormone deficiency in both unilateral and bilateral optic nerve hypoplasia. Acta Paediatr 2019; 108:1677-1685. [PMID: 30740788 DOI: 10.1111/apa.14751] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 01/28/2019] [Accepted: 02/07/2019] [Indexed: 12/26/2022]
Abstract
AIM This study examined the prevalence of neurological impairment and pituitary hormone deficiency (PHD) in patients with unilateral and bilateral optic nerve hypoplasia (ONH). METHODS A population-based cross-sectional cohort study of 65 patients (51% female) with ONH was conducted in Stockholm. Of these were 35 bilateral and 30 unilateral. The patients were below 20 years of age, living in Stockholm in December 2009 and found through database searching. The median age at the analysis of the results in January 2018 was 16.1 years (range 8.1-27.5 years). Neurological assessments and blood sampling were conducted, neuroradiology was reviewed and growth curves were analysed. Diagnoses of PHDs were based on clinical and biochemical evidence of hormone deficiency. RESULTS Neurological impairments were identified in 47% of the patients and impairments in gross and fine motor function were more prevalent in bilateral ONH (p < 0.001). In addition, 9% had cerebral palsy and 14% had epilepsy. The prevalence of PHD was 29 and 19% had multiple PHD. CONCLUSION Children with ONH had a high risk of neurological impairment, especially in bilateral disease. Both unilateral and bilateral ONH signified an increased prevalence of PHD and all these children should be endocrinologically followed up until completed puberty.
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Affiliation(s)
- Sara Dahl
- Department of Women's and Children's Health Neuropediatric Unit Karolinska Institutet Stockholm Sweden
| | - Maria Kristoffersen Wiberg
- Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden
- Department of Medical and Health Sciences Division of Radiological Sciences Linköping University Linköping Sweden
- Department of Neuroradiology Karolinska University Hospital Stockholm Sweden
| | - Kristina Teär Fahnehjelm
- Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden
- Department of Paediatric Ophthalmology St Erik Eye Hospital Stockholm Sweden
- Department of Clinical Neuroscience Institute of Neuroscience and Physiology University of Gothenburg Gothenburg Sweden
| | - Lars Sävendahl
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Ronny Wickström
- Department of Women's and Children's Health Neuropediatric Unit Karolinska Institutet Stockholm Sweden
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5
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Altay D, Eren E, Ozkan TB, Ozgur T, Tarım O. Liver Involvement in Congenital Hypopituitarism. Indian J Pediatr 2019; 86:412-416. [PMID: 30666560 DOI: 10.1007/s12098-018-2833-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 11/30/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Cholestatic jaundice in early infancy is a complex diagnostic challenge. Cholestasis caused by endocrine disease is rare and poorly recognized. The aim of this paper is to report patients with liver dysfunctions resulting from hypopituitarism. METHODS Six patients with liver dysfunction diagnosed as hypopituitarism were studied and followed up at Uludag University Faculty of Medicine. RESULTS The median age of the patients at first presentation was 2.5 mo. Three patients were diagnosed with congenital hypopituitarism at the first visit, and the other three were diagnosed during follow-up. Serum aminotransferase levels were very high in two patients and only moderately elevated in the others. Combined adrenal, thyroid, and growth hormone deficiencies were diagnosed in two patients, while remaining 4 patients had various combinations of adrenal, thyroid, and growth hormone deficiencies. Liver function abnormalities resolved between 10 d and 2 mo follow-up after hormone replacement therapy. CONCLUSIONS Abnormal liver biochemical test results due to hormonal deficiencies in infants should be considered in the differential diagnosis by pediatricians. Hormone replacement therapy is the basis of treatment.
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Affiliation(s)
- Derya Altay
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Erciyes University Faculty of Medicine, Kayseri, Turkey.
| | - Erdal Eren
- Department of Pediatric Endocrinology, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Tanju Basarır Ozkan
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Taner Ozgur
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Omer Tarım
- Department of Pediatric Endocrinology, Uludag University Faculty of Medicine, Bursa, Turkey
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6
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ACR Appropriateness Criteria® Neuroendocrine Imaging. J Am Coll Radiol 2019; 16:S161-S173. [DOI: 10.1016/j.jacr.2019.02.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 02/08/2019] [Indexed: 01/06/2023]
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7
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Alyahyawi N, Dheensaw K, Islam N, Aroichane M, Amed S. Pituitary Dysfunction in Pediatric Patients with Optic Nerve Hypoplasia: A Retrospective Cohort Study (1975-2014). Horm Res Paediatr 2018; 89:22-30. [PMID: 29176324 DOI: 10.1159/000484046] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 10/05/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS The risk factors for pituitary hormone dysfunction (PHD) in children with optic nerve hypoplasia (ONH) are not well understood. This study identified the type, timing, and predictors of PHD in children with ONH. METHODS ONH patient charts were reviewed retrospectively. The incidence rate of PHD was calculated assuming a Poisson distribution. Predictors of PHD were identified through a multivariable Cox proportional hazards model. RESULTS Among 144 subjects with ONH, 49.3% (n = 71) developed PHD over 614.7 person-years of follow-up. The incidence was 11.55 (95% confidence interval [CI]: 9.02-14.57/100 person-years). The median time to first PHD was 2.88 (interquartile range: 0.02-18.72) months. Eighty-two percent developed their first PHD by their 5th and 90% by their 10th birthday, and 89% within 5 years of ONH diagnosis. Prematurity (adjusted hazard ratio [aHR]: 0.33; 95% CI: 0.1-1.07), blindness (aHR: 1.72; 95% CI: 1.03-2.86), maternal substance abuse (aHR: 1.51; 95% CI: 0.91-2.48), abnormal posterior pituitary (aHR: 3.8; 95% CI: 2.01-7.18), and hypoplastic/absent anterior pituitary (aHR: 2.52; 95% CI: 1.29-4.91) were significant predictors of PHD. CONCLUSIONS The clinical predictors of PHD included blindness, pituitary gland abnormalities, and maternal substance abuse. These predictors help clinical decision-making related to the need for and frequency of hormone testing in pediatric patients with ONH.
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Affiliation(s)
- Naseem Alyahyawi
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.,Division of Endocrinology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Keira Dheensaw
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nazrul Islam
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Maryam Aroichane
- Pediatric Ophthalmology, Department of Ophthalmology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shazhan Amed
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
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8
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Benvenga S, Klose M, Vita R, Feldt-Rasmussen U. Less known aspects of central hypothyroidism: Part 2 - Congenital etiologies. JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY 2018; 14:5-11. [PMID: 30294553 PMCID: PMC6171088 DOI: 10.1016/j.jcte.2018.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 07/12/2018] [Accepted: 09/25/2018] [Indexed: 12/27/2022]
Abstract
Central hypothyroidism (CH) occurs approximately in 1:50,000, and therefore is expected to be one thousand times rarer compared with primary hypothyroidism. Despite its rarity in the general population, it is much more common in certain disorders, in which it is frequently associated with other pituitary hormone deficiencies. The aim of this paper is to provide an updated review on the frequency of congenital CH, which is <1:50,000, and on its etiology, disregarding CH caused by other genetic defects, such as mutations of transcription factors involved in pituitary organogenesis or mutations of the genes encoding TRH or TRH receptor.
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Key Words
- ACTH, adrenocorticotropin hormone
- ALGS, arteriohepatic dysplasia
- CH, central hypothyroidism
- Central hypothyroidism
- Congenital hypothyroidism
- DWS, Dandy-Walker syndrome
- FT3, free triiodothyronine
- FT4, free thyroxine
- GH, growth hormone
- HCG, human chorionic gonadotropin
- Hypopituitarism
- IGDF1, immunogobulin superfamily member 1
- PC1/3, proprotein convertase 1/3
- PWS, Prader-Willi syndrome
- ROHHAD, rapid-onset obesity with hypoventilation, hypothalamic dysfunction and autonomic dysregulation
- SCD, sickle cell anemia
- SMMCIS, solitary median maxillary central incisor syndrome
- SOD, septo-optic dysplasia
- SWS, Sturge-Weber syndrome
- TRH, TSH-releasing hormone
- TSH, thyrotropin
- TT3, total triiodothyronine
- TT4, total thyroxine
- Thyrotropin deficiency
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Affiliation(s)
- Salvatore Benvenga
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.,Master Program on Childhood, Adolescent and Women's Endocrine Health, University of Messina, Messina, Italy.,Interdepartmental Program of Molecular & Clinical Endocrinology, and Women's Endocrine Health, University Hospital Policlinico G. Martino, Messina, Italy
| | - Marianne Klose
- Department of Medical Endocrinology and Metabolism, Rigshospitalet, National University Hospital, Copenhagen University, Copenhagen, Denmark
| | - Roberto Vita
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Ulla Feldt-Rasmussen
- Department of Medical Endocrinology and Metabolism, Rigshospitalet, National University Hospital, Copenhagen University, Copenhagen, Denmark
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9
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Khaper T, Bunge M, Clark I, Rafay MF, Mhanni A, Kirouac N, Sharma A, Rodd C, Wicklow B. Increasing incidence of optic nerve hypoplasia/septo-optic dysplasia spectrum: Geographic clustering in Northern Canada. Paediatr Child Health 2017; 22:445-453. [PMID: 29479262 DOI: 10.1093/pch/pxx118] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Introduction Owing to the shared embryonic origin, defects in development of optic nerves are often seen in conjunction with defects affecting the surrounding brain and pituitary gland. Optic nerve hypoplasia (ONH) and septo-optic dysplasia (SOD) represent a clinical spectrum associated with visual, pituitary and severe central nervous system structural abnormalities (SODplus). Based on changing clinical patterns, our primary objective was to examine trends in annual incidence of ONH/SOD and geographical clustering in Manitoba. Methods This was a retrospective 1996 to 2015 chart review with extraction of anthropometric measures, radiologic findings, parental characteristics, endocrinopathies and neurologic symptoms from all involved in care. Postal codes were used to assign map co-ordinates and identify relevant census-based deprivation indices. Results Ninety-three children were identified in our catchment area; Poisson regression confirmed a striking 1.11-fold annual increase (95% confidence interval 1.07 to 1.16) or ~800% over two decades. The annual incidence (averaged 2010 to 2014 chart data) reached 53.3 per 100,000, affecting 1 in 1875 live births. Most (~55%) had SODplus. Common presenting features were hypoglycemia, nystagmus, seizures and developmental delay; 40% had hormone deficiencies; 80% had reduced visual acuity, typically bilateral. Many were premature with young, primiparous mothers. Unhealthy maternal lifestyles and severe material deprivation were noted. There was disproportionate clustering in individuals from Northern Manitoba at three times the average provincial rate. Conclusion We noted a dramatic rise in the annual incidence of ONH/SOD, which was strongly associated with poverty and northern communities. The pattern was consistent with environmental or nutritional etiologies. Many children were severely affected with increased morbidity and health care burdens.
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Affiliation(s)
- Tanya Khaper
- Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba
| | - Martin Bunge
- Section of Pediatric Radiology, Children's Hospital of Winnipeg, University of Manitoba, Winnipeg, Manitoba
| | - Ian Clark
- Section of Pediatric Ophthalmology, Children's Hospital of Winnipeg, University of Manitoba, Winnipeg, Manitoba
| | - Mubeen Fatima Rafay
- Section of Pediatric Neurology, Department of Pediatrics and Child Health, Children's Hospital of Winnipeg, University of Manitoba, Winnipeg, Manitoba
| | - Aziz Mhanni
- Department of Biochemistry & Medical Genetics, Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba
| | - Nicole Kirouac
- Section of Pediatric Endocrinology, Children's Hospital Winnipeg, University of Manitoba, Winnipeg, Manitoba
| | - Atul Sharma
- George and Fay Yee Center for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba
| | - Celia Rodd
- Section of Pediatric Endocrinology, Children's Hospital Winnipeg, University of Manitoba, Winnipeg, Manitoba
| | - Brandy Wicklow
- Section of Pediatric Endocrinology, Children's Hospital Winnipeg, University of Manitoba, Winnipeg, Manitoba
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10
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Affiliation(s)
- Irena Hozjan
- Endocrine Program, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.
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11
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Pereira-Gurgel VM, Faro ACN, Salvatori R, Chagas TA, Carvalho-Junior JF, Oliveira CRP, Costa UMM, Melo GB, Hellström A, Aguiar-Oliveira MH. Abnormal vascular and neural retinal morphology in congenital lifetime isolated growth hormone deficiency. Growth Horm IGF Res 2016; 30-31:11-15. [PMID: 27552668 DOI: 10.1016/j.ghir.2016.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 07/10/2016] [Accepted: 07/26/2016] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Experimental models demonstrate an important role of GH in retinal development. However, the interactions between GH and the neuro-vascularization of the human retina are still not clear. A model of untreated congenital isolated GH deficiency (IGHD) may clarify the actions of GH on the retina. The purpose of this work was to assess the retinal neuro-vascularization in untreated congenital IGHD (cIGHD). DESIGN In a cross sectional study, we performed an endocrine and ophthalmological assessment of 25 adult cIGHD subjects, homozygous for a null mutation (c.57+1G>A) in the GHRH receptor gene and 28 matched controls. Intraocular pressure measurement, retinography (to assess the number of retinal vascular branching points and the optic disc and cup size), and optical coherence tomography (to assess the thickness of macula) were performed. RESULTS cIGHD subjects presented a more significant reduction of vascular branching points in comparison to controls (91% vs. 53% [p=0.049]). The percentage of moderate reduction was higher in cIGHD than in controls (p=0.01). The percentage of individuals with increased optic disc was higher in cIGHD subjects in comparison to controls (92.9% vs. 57.1%). The same occurred for cup size (92.9% vs. 66.7%), p<0.0001 in both cases. There was no difference in macula thickness. CONCLUSIONS Most cIGHD individuals present moderate reduction of vascular branching points, increase of optic disc and cup size, but have similar thickness of the macula.
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Affiliation(s)
| | - Augusto C N Faro
- Division of Ophthalmology Federal University of Sergipe, Aracaju, SE 49060-100, Brazil
| | - Roberto Salvatori
- Division of Endocrinology, Diabetes and Metabolism, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
| | - Thiago A Chagas
- Division of Ophthalmology Federal University of Sergipe, Aracaju, SE 49060-100, Brazil
| | | | - Carla R P Oliveira
- Division of Endocrinology, Federal University of Sergipe, Aracaju, SE 49060-100, Brazil
| | - Ursula M M Costa
- Division of Endocrinology, Federal University of Sergipe, Aracaju, SE 49060-100, Brazil
| | | | - Ann Hellström
- Sahlgrenska Academy, The Queen Silvia Children's Hospital, Göteborg, Sweden
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12
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Ryabets-Lienhard A, Stewart C, Borchert M, Geffner ME. The Optic Nerve Hypoplasia Spectrum: Review of the Literature and Clinical Guidelines. Adv Pediatr 2016; 63:127-46. [PMID: 27426898 DOI: 10.1016/j.yapd.2016.04.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Anna Ryabets-Lienhard
- Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Los Angeles, CA 90027, USA.
| | - Carly Stewart
- The Vision Center, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Los Angeles, CA 90027, USA
| | - Mark Borchert
- The Vision Center, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Los Angeles, CA 90027, USA; The Saban Research Institute, Children's Hospital Los Angeles, 4661 Sunset Boulevard, Los Angeles, CA 90027, USA
| | - Mitchell E Geffner
- Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Los Angeles, CA 90027, USA; The Saban Research Institute, Children's Hospital Los Angeles, 4661 Sunset Boulevard, Los Angeles, CA 90027, USA
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13
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Hunter JD, Calikoglu AS. Etiological and clinical characteristics of central diabetes insipidus in children: a single center experience. INTERNATIONAL JOURNAL OF PEDIATRIC ENDOCRINOLOGY 2016; 2016:3. [PMID: 26870137 PMCID: PMC4750251 DOI: 10.1186/s13633-016-0021-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 01/12/2016] [Indexed: 01/27/2023]
Abstract
Background Central diabetes insipidus (CDI) results from a number of conditions affecting the hypothalamic-neurohypophyseal system to cause vasopressin deficiency. Diagnosis of CDI is challenging, and clinical data and guidelines for management are lacking. We aim to characterize clinical and radiological characteristics of a cohort of pediatric patients with CDI. Methods A chart review of 35 patients with CDI followed at North Carolina Children’s Hospital from 2000 to 2015 was undertaken. The frequencies of specific etiologies of CDI and characteristic magnetic resonance imaging (MRI) findings were determined. The presence of additional hormone deficiencies at diagnosis and later in the disease course was ascertained. Patient characteristics and management strategies were evaluated. Results The cohort included 14 female and 21 male patients with a median age of 4.7 years (range, less than 1 month to 16 years) at diagnosis. Median duration of follow-up was 5 years (range, 2 months to 16 years). The cause of CDI was intracranial mass in 13 patients (37.2 %), septo-optic dysplasia in 9 patients (25.7 %), holoprosencephaly in 5 patients (14.2 %), Langerhans cell histiocytosis in 3 patients (8.6 %), isolated pituitary hypoplasia in 2 patients (5.7 %), and encephalocele in 1 patient (2.9 %). Patients were symptomatic for a mean of 6.3 months (range, less than 1 month to 36 months) prior to diagnosis of CDI. Growth hormone (GH), thyrotropin (TSH), adrenocorticotropic hormone (ACTH), and gonadotropin deficiencies were present at diagnosis in 34, 23, 23, and 6 % of patients, respectively. GH, TSH, ACTH, and gonadotropin deficiencies were diagnosed during follow-up in 23, 40, 37, and 14 % of patients, respectively. In patients with structural CNS abnormalities, development of additional hormone deficiencies occurred anywhere from 2 months to 13 years after the time of initial presentation. Conclusions All patients in our cohort had an underlying organic etiology for CDI, with intracranial masses and CNS malformations being most common. Therefore, MRI of the brain is indicated in all pediatric patients with CDI. Other pituitary hormone deficiencies should be investigated at diagnosis as well as during follow-up.
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Affiliation(s)
- Janel D Hunter
- Division of Pediatric Endocrinology, University of North Carolina at Chapel Hill, Campus Box #7039, Medical School Wing E, Chapel Hill, NC 27599 USA
| | - Ali S Calikoglu
- Division of Pediatric Endocrinology, University of North Carolina at Chapel Hill, Campus Box #7039, Medical School Wing E, Chapel Hill, NC 27599 USA
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