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Fiot E, Alauze B, Donadille B, Samara-Boustani D, Houang M, De Filippo G, Bachelot A, Delcour C, Beyler C, Bois E, Bourrat E, Bui Quoc E, Bourcigaux N, Chaussain C, Cohen A, Cohen-Solal M, Da Costa S, Dossier C, Ederhy S, Elmaleh M, Iserin L, Lengliné H, Poujol-Robert A, Roulot D, Viala J, Albarel F, Bismuth E, Bernard V, Bouvattier C, Brac A, Bretones P, Chabbert-Buffet N, Chanson P, Coutant R, de Warren M, Demaret B, Duranteau L, Eustache F, Gautheret L, Gelwane G, Gourbesville C, Grynberg M, Gueniche K, Jorgensen C, Kerlan V, Lebrun C, Lefevre C, Lorenzini F, Manouvrier S, Pienkowski C, Reynaud R, Reznik Y, Siffroi JP, Tabet AC, Tauber M, Vautier V, Tauveron I, Wambre S, Zenaty D, Netchine I, Polak M, Touraine P, Carel JC, Christin-Maitre S, Léger J. Turner syndrome: French National Diagnosis and Care Protocol (NDCP; National Diagnosis and Care Protocol). Orphanet J Rare Dis 2022; 17:261. [PMID: 35821070 PMCID: PMC9277788 DOI: 10.1186/s13023-022-02423-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 06/30/2022] [Indexed: 12/03/2022] Open
Abstract
Turner syndrome (TS; ORPHA 881) is a rare condition in which all or part of one X chromosome is absent from some or all cells. It affects approximately one in every 1/2500 liveborn girls. The most frequently observed karyotypes are 45,X (40–50%) and the 45,X/46,XX mosaic karyotype (15–25%). Karyotypes with an X isochromosome (45,X/46,isoXq or 45,X/46,isoXp), a Y chromosome, X ring chromosome or deletions of the X chromosome are less frequent. The objective of the French National Diagnosis and Care Protocol (PNDS; Protocole National de Diagnostic et de Soins) is to provide health professionals with information about the optimal management and care for patients, based on a critical literature review and multidisciplinary expert consensus. The PNDS, written by members of the French National Reference Center for Rare Growth and Developmental Endocrine disorders, is available from the French Health Authority website. Turner Syndrome is associated with several phenotypic conditions and a higher risk of comorbidity. The most frequently reported features are growth retardation with short adult stature and gonadal dysgenesis. TS may be associated with various congenital (heart and kidney) or acquired diseases (autoimmune thyroid disease, celiac disease, hearing loss, overweight/obesity, glucose intolerance/type 2 diabetes, dyslipidemia, cardiovascular complications and liver dysfunction). Most of the clinical traits of TS are due to the haploinsufficiency of various genes on the X chromosome, particularly those in the pseudoautosomal regions (PAR 1 and PAR 2), which normally escape the physiological process of X inactivation, although other regions may also be implicated. The management of patients with TS requires collaboration between several healthcare providers. The attending physician, in collaboration with the national care network, will ensure that the patient receives optimal care through regular follow-up and screening. The various elements of this PNDS are designed to provide such support.
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Affiliation(s)
- Elodie Fiot
- Pediatric Endocrinology-Diabetology Department, Reference Center for Rare Growth and Development Endocrine Diseases, INSERM NeuroDiderot, Assistance Publique-Hôpitaux de Paris, Université de Paris, Robert Debré University Hospital, 48 Bd Sérurier, 75019, Paris, France
| | - Bertille Alauze
- Pediatric Endocrinology-Diabetology Department, Reference Center for Rare Growth and Development Endocrine Diseases, INSERM NeuroDiderot, Assistance Publique-Hôpitaux de Paris, Université de Paris, Robert Debré University Hospital, 48 Bd Sérurier, 75019, Paris, France
| | - Bruno Donadille
- Department of Reproductive Endocrinology, Reference Center for Rare Growth and Development Endocrine Diseases, Assistance Publique-Hôpitaux de Paris, Sorbonne University, Saint Antoine Hospital, 75012, Paris, France
| | - Dinane Samara-Boustani
- Pediatric Endocrinology-Diabetology Department, Reference Center for Rare Growth and Development Endocrine Diseases, Assistance Publique-Hôpitaux de Paris, Université de Paris, Necker Enfants Malades University Hospital, 75015, Paris, France
| | - Muriel Houang
- Explorations Fonctionnelles Endocriniennes, Reference Center for Rare Growth and Development Endocrine Diseases, Assistance Publique-Hôpitaux de Paris, Sorbonne University, Armand-Trousseau Hospital, 75012, Paris, France
| | - Gianpaolo De Filippo
- Pediatric Endocrinology-Diabetology Department, Reference Center for Rare Growth and Development Endocrine Diseases, INSERM NeuroDiderot, Assistance Publique-Hôpitaux de Paris, Université de Paris, Robert Debré University Hospital, 48 Bd Sérurier, 75019, Paris, France
| | - Anne Bachelot
- Endocrinology and Reproductive Medicine Department, Reference Center for Rare Growth and Development Endocrine Diseases, Assistance Publique-Hôpitaux de Paris, Sorbonne University, Pitié Salpétrière University Hospital, 75013, Paris, France
| | - Clemence Delcour
- Department of Obstetrics and Gynecology, Assistance Publique-Hôpitaux de Paris, Université de Paris, Robert Debré University Hospital, 75019, Paris, France
| | - Constance Beyler
- Cardiopaediatric Unit, Assistance Publique-Hôpitaux de Paris, Université de Paris, Robert Debré University Hospital, 75019, Paris, France
| | - Emilie Bois
- Pediatric Otorhinolaryngology Department, Assistance Publique-Hôpitaux de Paris, Université de Paris, Robert Debré University Hospital, 75019, Paris, France
| | - Emmanuelle Bourrat
- Dermatology Unit, Assistance Publique-Hôpitaux de Paris, Université de Paris, Robert Debré University Hospital, 75019, Paris, France
| | - Emmanuel Bui Quoc
- Ophthalmology Department, Assistance Publique-Hôpitaux de Paris, Université de Paris, Robert Debré University Hospital, 75019, Paris, France
| | - Nathalie Bourcigaux
- Department of Reproductive Endocrinology, Reference Center for Rare Growth and Development Endocrine Diseases, Assistance Publique-Hôpitaux de Paris, Sorbonne University, Saint Antoine Hospital, 75012, Paris, France
| | - Catherine Chaussain
- Odontology Department, Assistance Publique-Hôpitaux de Paris, University Hospitals Charles Foix, PNVS, and Henri Mondor, 94000, Créteil, France
| | - Ariel Cohen
- Department of Cardiology, GRC n°27, GRECO, AP-HP, Assistance Publique-Hôpitaux de Paris, Sorbonne University, Saint Antoine Hospital, 75012, Paris, France
| | - Martine Cohen-Solal
- Department of Rheumatology, Assistance Publique-Hôpitaux de Paris, Université de Paris, Lariboisière Hospital, 75010, Paris, France
| | - Sabrina Da Costa
- Reference Center for Rare Gynecological Pathologies, Pediatric Endocrinology Department, Assistance Publique-Hôpitaux de Paris, Université de Paris, Necker Enfants Malades University Hospital, 75015, Paris, France
| | - Claire Dossier
- Department of Paediatric Nephrology, Assistance Publique-Hôpitaux de Paris, Université de Paris, Robert Debré University Hospital, 75019, Paris, France
| | - Stephane Ederhy
- Department of Cardiology, GRC n°27, GRECO, AP-HP, Assistance Publique-Hôpitaux de Paris, Sorbonne University, Saint Antoine Hospital, 75012, Paris, France
| | - Monique Elmaleh
- Department of Radiology, Assistance Publique-Hôpitaux de Paris, Université de Paris, Robert Debré University Hospital, 75019, Paris, France
| | - Laurence Iserin
- Adult Congenital Heart Disease Unit, Cardiology Department, Assistance Publique-Hôpitaux de Paris, Université de Paris, Georges Pompidou University Hospital, 75015, Paris, France
| | - Hélène Lengliné
- Department of Pediatric Gastroenterology and Nutrition, Assistance Publique-Hôpitaux de Paris, Université de Paris, Robert Debré University Hospital, 75019, Paris, France
| | - Armelle Poujol-Robert
- Hepatology Department, Assistance Publique-Hôpitaux de Paris, Sorbonne University, Saint Antoine Hospital, 75012, Paris, France
| | - Dominique Roulot
- Hepatology Department, Assistance Publique-Hopitaux de Paris, Université Sorbonne Paris Nord, Avicenne Hospital, 93009, Bobigny, France
| | - Jerome Viala
- Department of Pediatric Gastroenterology and Nutrition, Assistance Publique-Hôpitaux de Paris, Université de Paris, Robert Debré University Hospital, 75019, Paris, France
| | - Frederique Albarel
- Department of Endocrinology, Assistance Publique-Hôpitaux de Marseille. Hospital La Conception, 13005, Marseille, France
| | - Elise Bismuth
- Department of Pediatric Endocrinology and Diabetology, Competence Center for Rare Diseases of Insulin Secretion and Insulin Sensitivity, Assistance Publique-Hôpitaux de Paris, Université de Paris, Robert Debré University Hospital, 75019, Paris, France
| | - Valérie Bernard
- CHU Pellegrin, Department of Gynecological Surgery, Medical Gynecology and Reproductive Medicine, Centre Aliénor d'aquitaine, Bordeaux University Hospitals, 33000, Bordeaux, France
| | - Claire Bouvattier
- Paediatric Endocrinology Department, Reference Center for Rare Genital Development Disorders, Assistance Publique-Hôpitaux de Paris, Kremlin-Bicêtre University Hospital, Paris-Sud University, 94270, Le Kremlin-Bicêtre, France
| | - Aude Brac
- Department of Endocrinology Pediatric and Adult, Reference Center for Rare Genital Development Disorders, Lyon Hospices Civils, Est Hospital Group, 69677, Bron, France
| | - Patricia Bretones
- Department of Endocrinology Pediatric and Adult, Reference Center for Rare Genital Development Disorders, Lyon Hospices Civils, Est Hospital Group, 69677, Bron, France
| | - Nathalie Chabbert-Buffet
- Gynecology-Obstetrics and Reproductive Medicine Department, Assistance Publique-Hôpitaux de Paris, Tenon University Hospital, 75020, Paris, France
| | - Philippe Chanson
- Department of Endocrinology and Reproductive Diseases, Assistance Publique-Hôpitaux de Paris, Kremlin-Bicêtre University Hospital, Paris-Sud University, 94270, Le Kremlin-Bicêtre, France
| | - Regis Coutant
- Department of Pediatric Endocrinology and Diabetology and Reference Center for Rare Diseases of Thyroid and Hormone Receptivity, Angers University Hospital, 49100, Angers, France
| | - Marguerite de Warren
- AGAT, French Turner Syndrome Association (AGAT; Association Des Groupes Amitié Turner), 75011, Paris, France
| | - Béatrice Demaret
- Grandir Association (French Growth Disorders Association), 92600, Asnières-sur-Seine, France
| | - Lise Duranteau
- Adolescent and Young Adult Gynecology Unit, Reference Center for Rare Genital Development Disorders, Assistance Publique-Hôpitaux de Paris, Kremlin-Bicêtre University Hospital, Paris-Sud University, 94270, Le Kremlin-Bicêtre, France
| | - Florence Eustache
- Reproductive Biology Department, Assistance Publique-Hôpitaux de Paris, Jean Verdier University Hospital, 93140, Bondy, France
| | - Lydie Gautheret
- Pediatric Endocrinology-Diabetology Department, Reference Center for Rare Growth and Development Endocrine Diseases, INSERM NeuroDiderot, Assistance Publique-Hôpitaux de Paris, Université de Paris, Robert Debré University Hospital, 48 Bd Sérurier, 75019, Paris, France
| | - Georges Gelwane
- Pediatric Endocrinology-Diabetology Department, Reference Center for Rare Growth and Development Endocrine Diseases, INSERM NeuroDiderot, Assistance Publique-Hôpitaux de Paris, Université de Paris, Robert Debré University Hospital, 48 Bd Sérurier, 75019, Paris, France
| | - Claire Gourbesville
- Department of Endocrinology and Metabolic Diseases, Caen University Hospital, 14000, Caen, France
| | - Mickaël Grynberg
- Department of Reproductive Medicine and Fertility Preservation, Assistance Publique-Hôpitaux de Paris, Antoine Béclère University Hospital, 92140, Clamart, France
| | - Karinne Gueniche
- Reference Center for Rare Gynecological Pathologies, Pediatric Endocrinology Department, Assistance Publique-Hôpitaux de Paris, Université de Paris, Necker Enfants Malades University Hospital, 75015, Paris, France
| | - Carina Jorgensen
- Endocrinology and Metabolism Department, Assistance Publique-Hôpitaux de Paris, Sorbonne University, Saint Antoine Hospital, 75012, Paris, France
| | - Veronique Kerlan
- Endocrinology and Metabolism Department, Brest University Hospital Centre, 29200, Brest, France
| | - Charlotte Lebrun
- Pediatric Endocrinology-Diabetology Department, Reference Center for Rare Growth and Development Endocrine Diseases, INSERM NeuroDiderot, Assistance Publique-Hôpitaux de Paris, Université de Paris, Robert Debré University Hospital, 48 Bd Sérurier, 75019, Paris, France
| | - Christine Lefevre
- Pediatric Endocrinology, Lille University Jeanne de Flandre Hospital, 59000, Lille, France
| | - Françoise Lorenzini
- Department of Endocrinology, Toulouse University Paule Viguier Hospital, 31300, Toulouse, France
| | - Sylvie Manouvrier
- Clinical Genetics Department, DEV GEN Genital Development Reference Center, Lille University Jeanne de Flandre Hospital, 59000, Lille, France
| | - Catherine Pienkowski
- Genetics and Medical Gynecology Department, Reference Center for Rare Gynecological Pathologies, Toulouse University Hospitals - Hôpital Des Enfants, Pediatrics - Endocrinology, 31059, Toulouse, France
| | - Rachel Reynaud
- Department of Multidisciplinary Pediatrics, Reference Center for Pituitary Rare Diseases Aix Marseille University, Assistance Publique-Hôpitaux de Marseille, Hôpital de La Timone Enfants, 13005, Marseille, France
| | - Yves Reznik
- Department of Endocrinology and Metabolic Diseases, Caen University Hospital, 14000, Caen, France
| | - Jean-Pierre Siffroi
- Genetics and Embryology Department, Sorbonne Université; INSERM UMRS-933, Assistance Publique-Hôpitaux de Paris, Hôpital d'Enfants Armand-Trousseau, Paris, France
| | - Anne-Claude Tabet
- Genetics Department, Assistance Publique-Hôpitaux de Paris, Université de Paris, Robert Debré University Hospital, 75019, Paris, France
| | - Maithé Tauber
- Genetics and Medical Gynecology Department, Toulouse University Hospital - Hôpital Des Enfants, Pediatrics - Endocrinology, 31059, Toulouse, France
| | - Vanessa Vautier
- Pediatric Diabetology Department, Bordeaux University Hospitals, 33000, Bordeaux, France
| | - Igor Tauveron
- Clermont-Ferrand University Hospital, Endocrinology Department, Clermont Auvergne University, 63000, Clermont-Ferrand, France
| | - Sebastien Wambre
- French Turner Syndrome Association (Turner Et Vous Association), 59155, Faches-Thumesnil, France
| | - Delphine Zenaty
- Pediatric Endocrinology-Diabetology Department, Reference Center for Rare Growth and Development Endocrine Diseases, INSERM NeuroDiderot, Assistance Publique-Hôpitaux de Paris, Université de Paris, Robert Debré University Hospital, 48 Bd Sérurier, 75019, Paris, France
| | - Irène Netchine
- Explorations Fonctionnelles Endocriniennes, Reference Center for Rare Growth and Development Endocrine Diseases, Assistance Publique-Hôpitaux de Paris, Sorbonne University, Armand-Trousseau Hospital, 75012, Paris, France
| | - Michel Polak
- Pediatric Endocrinology-Diabetology Department, Reference Center for Rare Growth and Development Endocrine Diseases, Assistance Publique-Hôpitaux de Paris, Université de Paris, Necker Enfants Malades University Hospital, 75015, Paris, France
| | - Philippe Touraine
- Endocrinology and Reproductive Medicine Department, Reference Center for Rare Growth and Development Endocrine Diseases, Assistance Publique-Hôpitaux de Paris, Sorbonne University, Pitié Salpétrière University Hospital, 75013, Paris, France
| | - Jean-Claude Carel
- Pediatric Endocrinology-Diabetology Department, Reference Center for Rare Growth and Development Endocrine Diseases, INSERM NeuroDiderot, Assistance Publique-Hôpitaux de Paris, Université de Paris, Robert Debré University Hospital, 48 Bd Sérurier, 75019, Paris, France
| | - Sophie Christin-Maitre
- Department of Reproductive Endocrinology, Reference Center for Rare Growth and Development Endocrine Diseases, Assistance Publique-Hôpitaux de Paris, Sorbonne University, Saint Antoine Hospital, 75012, Paris, France
| | - Juliane Léger
- Pediatric Endocrinology-Diabetology Department, Reference Center for Rare Growth and Development Endocrine Diseases, INSERM NeuroDiderot, Assistance Publique-Hôpitaux de Paris, Université de Paris, Robert Debré University Hospital, 48 Bd Sérurier, 75019, Paris, France.
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Christin-Maitre S, Givony M, Albarel F, Bachelot A, Bidet M, Blanc JV, Bouvattier C, Brac de la Perrière A, Catteau-Jonard S, Chevalier N, Carel JC, Coutant R, Donadille B, Duranteau L, El-Khattabi L, Hugon-Rodin J, Houang M, Grynberg M, Kerlan V, Leger J, Misrahi M, Pienkowski C, Plu-Bureau G, Polak M, Reynaud R, Siffroi JP, Sonigo C, Touraine P, Zenaty D. Position statement on the diagnosis and management of premature/primary ovarian insufficiency (except Turner Syndrome). Ann Endocrinol (Paris) 2021; 82:555-571. [PMID: 34508691 DOI: 10.1016/j.ando.2021.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Premature ovarian insufficiency (POI) is a rare pathology affecting 1-2% of under-40 year-old women, 1 in 1000 under-30 year-olds and 1 in 10,000 under-20 year-olds. There are multiple etiologies, which can be classified as primary (chromosomal, genetic, auto-immune) and secondary or iatrogenic (surgical, or secondary to chemotherapy and/or radiotherapy). Despite important progress in genetics, more than 60% of cases of primary POI still have no identifiable etiology; these cases are known as idiopathic POI. POI is defined by the association of 1 clinical and 1 biological criterion: primary or secondary amenorrhea or spaniomenorrhea of>4 months with onset before 40 year of age, and elevated follicle-stimulating hormone (FSH)>25IU/L on 2 assays at>4 weeks' interval. Estradiol level is low, and anti-Müllerian hormone (AMH) levels have usually collapsed. Initial etiological work-up comprises auto-immune assessment, karyotype, FMR1 premutation screening and gene-panel study. If all of these are normal, the patient and parents may be offered genome-wide analysis under the "France Génomique" project. The term ovarian insufficiency suggests that the dysfunction is not necessarily definitive. In some cases, ovarian function may fluctuate, and spontaneous pregnancy is possible in around 6% of cases. In confirmed POI, hormone replacement therapy is to be recommended at least up to the physiological menopause age of 51 years. Management in a rare diseases center may be proposed.
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Affiliation(s)
- Sophie Christin-Maitre
- Sorbonne University, Hôpital St Antoine, Assistance Publique- Hôpitaux de Paris (AP-HP), Paris, France.
| | - Maria Givony
- French National Healthcare Network for Rare Endocrine Diseases (FIRENDO), AP-HP, Paris, France
| | - Frédérique Albarel
- Conception University Hospital, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Anne Bachelot
- Sorbonne University, Hôpital de la Pitié-Salpétrière, AP-HP, Paris, France
| | - Maud Bidet
- Clinique mutualiste La Sagesse, Rennes, France
| | - Jean Victor Blanc
- Sorbonne University, Hôpital St Antoine, Assistance Publique- Hôpitaux de Paris (AP-HP), Paris, France
| | | | | | | | | | | | | | - Bruno Donadille
- Sorbonne University, Hôpital St Antoine, Assistance Publique- Hôpitaux de Paris (AP-HP), Paris, France
| | - Lise Duranteau
- Saclay University, Hôpital du Kremlin-Bicêtre, AP-HP, Paris, France
| | - Laïla El-Khattabi
- Paris-Centre University, Hôpital Cochin Port-Royal, AP-HP, Paris, France
| | | | - Muriel Houang
- Sorbonne University, Hôpital Trousseau, AP-HP, Paris, France
| | - Michaël Grynberg
- Saclay University, Hôpital Antoine Béclère, AP-HP, Clamart, France
| | - Véronique Kerlan
- University of Brest, Centre Hospitalier Régional Universitaire, Brest, France
| | - Juliane Leger
- Paris-Centre University, Hôpital Robert Debré, AP-HP, Paris, France
| | | | | | | | - Michel Polak
- Paris Centre University, Hôpital Necker, AP-HP, Paris, France
| | | | | | - Charlotte Sonigo
- Saclay University, Hôpital Antoine Béclère, AP-HP, Clamart, France
| | - Phillipe Touraine
- Sorbonne University, Hôpital de la Pitié-Salpétrière, AP-HP, Paris, France
| | - Delphine Zenaty
- Paris-Centre University, Hôpital Robert Debré, AP-HP, Paris, France
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Saie C, Buffet A, Abeillon J, Drui D, Leboulleux S, Bertherat J, Zenaty D, Storey C, Borson-Chazot F, Burnichon N, Vincent M, Favier J, Baudin E, Giraud S, Gimenez-Roqueplo AP, Amar L, Lussey-Lepoutre C. Screening of a Large Cohort of Asymptomatic SDHx Mutation Carriers in Routine Practice. J Clin Endocrinol Metab 2021; 106:e1301-e1315. [PMID: 33247927 DOI: 10.1210/clinem/dgaa888] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 09/25/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT When an SDHx mutation is identified in a patient with a pheochromocytoma (PCC) or a paraganglioma (PGL), predictive genetic testing can detect mutation carriers that would benefit from screening protocols. OBJECTIVE To define the tumor detection rate in a large cohort of asymptomatic SDHX mutation carriers. DESIGN AND SETTING Retrospective multicentric study in 6 referral centers. PATIENTS Between 2005 and 2019, 249 asymptomatic SDHx (171 SDHB, 31 SDHC, 47 SDHD) mutation carriers, with at least 1 imaging work-up were enrolled. RESULTS Initial work-up, including anatomical (98% of subjects [97-100% according to center]) and/or functional imaging (67% [14-90%]) detected 48 tumors in 40 patients. After a negative initial work-up, 124 patients benefited from 1 to 9 subsequent follow-up assessments (mean: 1.9 per patient), with a median follow-up time of 5 (1-13) years. Anatomical (86% [49-100 %]) and/or functional imaging (36% [7-60 %]) identified 10 new tumors (mean size: 16 mm [4-50]) in 10 patients. Altogether, 58 tumors (55 paraganglioma [PGL], including 45 head and neck PGL, 2 pheochromocytoma [PCC], 1 gastrointestinal stromal tumor [GIST]), were detected in 50 patients (22 [13%] SDHB, 1 [3.2%] SDHC, and 27 [57%] SDHD), with a median age of 41 years old [11-86], 76% without catecholamine secretion and 80% during initial imaging work-up. CONCLUSIONS Imaging screening enabled detection of tumors in 20% of asymptomatic SDHx mutation carriers, with a higher detection rate in SDHD (57%) than in SDHB (13%) and SDHC (3%) mutation carriers, arguing for a gene-by-gene approach. Prospective studies using well-defined protocols are needed to obtain strong and useful data.
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Affiliation(s)
- Clotilde Saie
- Department of Nuclear Medicine, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
| | - Alexandre Buffet
- Service de Génétique AP-HP, Hôpital Européen Georges Pompidou, Paris, France
- Université de Paris, INSERM, PARCC, Equipe Labellisée par la Ligue contre le Cancer, Paris, France
| | - Juliette Abeillon
- Service d'Endocrinologie, Hospices Civils de Lyon, Bron Cedex, France
| | - Delphine Drui
- Service d'Endocrinologie, Diabétologie et Maladies Métaboliques, Institut du Thorax, Centre Hospitalier Universitaire de Nantes, Hôpital Nord Laënnec, Nantes, France
| | - Sophie Leboulleux
- Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy Institut, Cancer Campus Grand Paris, VIllejuif, France
| | - Jérôme Bertherat
- Université de Paris, Service d'Endocrinologie, Centre de Référence des Maladies Rares de la Surrénale, APHP, Hôpital Cochin, Paris, France
| | - Delphine Zenaty
- Department of Pediatric Endocrinology and Diabetology, Robert Debre University Hospital, Reference Center for Growth and Development Endocrine Diseases, Paris, France
| | - Caroline Storey
- Department of Pediatric Endocrinology and Diabetology, Robert Debre University Hospital, Reference Center for Growth and Development Endocrine Diseases, Paris, France
| | | | - Nelly Burnichon
- Service de Génétique AP-HP, Hôpital Européen Georges Pompidou, Paris, France
- Université de Paris, INSERM, PARCC, Equipe Labellisée par la Ligue contre le Cancer, Paris, France
| | - Marie Vincent
- Service de Génétique Médicale, CHU de Nantes, Nantes, France
- Inserm, CNRS, Univ Nantes, Institut du Thorax, Nantes, France
| | - Judith Favier
- Université de Paris, INSERM, PARCC, Equipe Labellisée par la Ligue contre le Cancer, Paris, France
| | - Eric Baudin
- Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy Institut, Cancer Campus Grand Paris, VIllejuif, France
| | - Sophie Giraud
- Genetics Department, Hospices Civils de LYON (HCL), University Hospital, East Biology and Pathology Center, Bron Cedex, France
| | - Anne-Paule Gimenez-Roqueplo
- Service de Génétique AP-HP, Hôpital Européen Georges Pompidou, Paris, France
- Université de Paris, INSERM, PARCC, Equipe Labellisée par la Ligue contre le Cancer, Paris, France
| | - Laurence Amar
- Université de Paris, INSERM, PARCC, Equipe Labellisée par la Ligue contre le Cancer, Paris, France
- Hypertension Unit, Université de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Charlotte Lussey-Lepoutre
- Department of Nuclear Medicine, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
- Université de Paris, INSERM, PARCC, Equipe Labellisée par la Ligue contre le Cancer, Paris, France
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4
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Atger-Lallier L, Guilmin-Crepon S, Boizeau P, Zenaty D, Simon D, Paulsen A, Martinerie L, Storey C, Carel JC, Léger J. Factors Affecting Loss to Follow-Up in Children and Adolescents with Chronic Endocrine Conditions. Horm Res Paediatr 2020; 92:254-261. [PMID: 32023623 DOI: 10.1159/000505517] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 10/09/2019] [Accepted: 12/17/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Most children with endocrine diseases require long-term continuity of care. We investigated the prevalence of loss to follow-up (LTFU) in pediatric patients with chronic endocrine diseases and the risk factors associated with LTFU. METHODS This observational cohort study included all children with chronic endocrine diseases included in the database of a single academic pediatric care center over a period of 8 years. LTFU was defined as a lack of attendance at clinical visits for over 2 years, for unknown reasons. RESULTS LTFU was recorded for 154 of the 1,067 patients included (14%). Median age at diagnosis was 5.8 (0.3-11.8) vs. 1.2 (0.0-6.9) years, and age at last visit was 14.1 (9.7-16.1) vs. 11.7 (6.1-15.8) years, for the LTFU and no-LTFU groups, respectively. In multivariate analysis, the risk of LTFU increased with age at diagnosis (OR 1.18; 95% CI 1.12-1.24) and was higher for patients diagnosed before 2006 (vs. after 2006; OR 4.80; 95% CI 3.00-7.66), with fewer visits in the last 3 years (OR 0.72; 95% CI 0.65-0.80; p < 0.0001) and a lower health insurance classification (OR 1.79; 95% CI 1.10-2.89; p = 0.02). The risk of LTFU was higher for patients with isolated growth hormone deficiency than for those with other endocrine conditions, such as multiple pituitary deficiencies, hypogonadotropic hypogonadism, Turner syndrome, or thyroid, adrenal, or gonadal disorders (OR 5.24; 95% CI 1.13-24.37; p = 0.03). CONCLUSION This study provides the first epidemiological data for LTFU in children and adolescents with chronic endocrine diseases. It should facilitate the targeting of interventions to improve adherence to medical care and healthcare organization during the pediatric period.
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Affiliation(s)
- Laura Atger-Lallier
- Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, Department of Pediatric Endocrinology and Diabetology, Reference Center for Growth and Development Endocrine Diseases, Paris, France,
| | - Sophie Guilmin-Crepon
- Assistance Publique-Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Unit of Clinical Epidemiology, Paris, France.,Inserm, CIC-EC 1426, Paris, France
| | - Priscilla Boizeau
- Assistance Publique-Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Unit of Clinical Epidemiology, Paris, France.,Inserm, CIC-EC 1426, Paris, France
| | - Delphine Zenaty
- Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, Department of Pediatric Endocrinology and Diabetology, Reference Center for Growth and Development Endocrine Diseases, Paris, France
| | - Dominique Simon
- Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, Department of Pediatric Endocrinology and Diabetology, Reference Center for Growth and Development Endocrine Diseases, Paris, France
| | - Anne Paulsen
- Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, Department of Pediatric Endocrinology and Diabetology, Reference Center for Growth and Development Endocrine Diseases, Paris, France
| | - Laetitia Martinerie
- Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, Department of Pediatric Endocrinology and Diabetology, Reference Center for Growth and Development Endocrine Diseases, Paris, France.,Université de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM), UMR 1141, Paris, France
| | - Caroline Storey
- Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, Department of Pediatric Endocrinology and Diabetology, Reference Center for Growth and Development Endocrine Diseases, Paris, France
| | - Jean-Claude Carel
- Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, Department of Pediatric Endocrinology and Diabetology, Reference Center for Growth and Development Endocrine Diseases, Paris, France.,Université de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM), UMR 1141, Paris, France
| | - Juliane Léger
- Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, Department of Pediatric Endocrinology and Diabetology, Reference Center for Growth and Development Endocrine Diseases, Paris, France.,Université de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM), UMR 1141, Paris, France
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5
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Buffet A, Ben Aim L, Leboulleux S, Drui D, Vezzosi D, Libé R, Ajzenberg C, Bernardeschi D, Cariou B, Chabolle F, Chabre O, Darrouzet V, Delemer B, Desailloud R, Goichot B, Esvant A, Offredo L, Herman P, Laboureau S, Lefebvre H, Pierre P, Raingeard I, Reznik Y, Sadoul JL, Hadoux J, Tabarin A, Tauveron I, Zenaty D, Favier J, Bertherat J, Baudin E, Amar L, Gimenez-Roqueplo AP. Positive Impact of Genetic Test on the Management and Outcome of Patients With Paraganglioma and/or Pheochromocytoma. J Clin Endocrinol Metab 2019; 104:1109-1118. [PMID: 30698717 DOI: 10.1210/jc.2018-02411] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [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: 11/07/2018] [Accepted: 01/24/2019] [Indexed: 02/05/2023]
Abstract
CONTEXT Pheochromocytomas and paragangliomas (PPGLs) are characterized by a strong genetic component, with up to 40% of patients carrying a germline mutation in a PPGL susceptibility gene. International guidelines recommend that genetic screening be proposed to all patients with PPGL. OBJECTIVE Our objective was to evaluate how a positive genetic test impacts the management and outcome of patients with SDHx or VHL-related PPGL. DESIGN We performed a multicentric retrospective study involving 221 propositi carrying an SDHB, SDHD, SDHC, or VHL germline mutation. Patients were divided into two groups: genetic patients, who were informed of their genetic status within the year following the first PPGL diagnosis, and historic patients, who only benefited from the genetic test several years after initial PPGL diagnosis. RESULTS Genetic patients had better follow-up than historic patients, with a greater number of examinations and a reduced number of patients lost to follow-up (9.6% vs 72%, respectively). During follow-up, smaller (18.7 vs 27.6 mm; P = 0.0128) new PPGLs and metastases as well as lower metastatic spread were observed in genetic patients. Of note, these differences were reversed in the historic cohort after genetic testing. Genetic patients who developed metachronous metastases had a better 5-year survival rate than historic patients (P = 0.0127). CONCLUSION Altogether, our data suggest that early knowledge of genetic status had a positive impact on the management and clinical outcome of patients with a germline SDHx or VHL mutation.
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Affiliation(s)
- Alexandre Buffet
- Équipe Labellisée par la Ligue Contre le Cancer, INSERM, UMR970, Paris-Centre de Recherche Cardiovasculaire, Paris, France
- Service d'Endocrinologie, Hôpital Larrey, CHU de Toulouse, Toulouse, France
| | - Laurène Ben Aim
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Génétique, Paris, France
| | - Sophie Leboulleux
- Gustave Roussy, Université Paris-Saclay, Service de Médecine Nucléaire et Cancérologie Endocrinienne, Villejuif, France
| | - Delphine Drui
- Service d'Endocrinologie, Diabétologie et Maladies Métaboliques, L'institut du Thorax, Centre Hospitalier Universitaire de Nantes, Hôpital Nord Laënnec, Nantes, France
| | - Delphine Vezzosi
- Service d'Endocrinologie, Hôpital Larrey, CHU de Toulouse, Toulouse, France
| | - Rossella Libé
- Assistance Publique, Hôpitaux de Paris, Hôpital Cochin, Service d'Endocrinologie, Centre de Référence Maladies Rares de la Surrénale, Paris, France
| | - Christiane Ajzenberg
- Assistance Publique, Hôpitaux de Paris, Service de Médecine Interne et Endocrinologie, Hôpital Henri Mondor, Créteil, France
| | - Daniele Bernardeschi
- Assistance Publique-Hôpitaux de Paris, Hôpital Universitaire Pitié-Salpêtrière, Service d'ORL, Unité d'Otologie, Implantologie Auditive et Chirurgie de la Base du Crâne, Paris, France
| | - Bertrand Cariou
- Service d'Endocrinologie, Diabétologie et Maladies Métaboliques, L'institut du Thorax, Centre Hospitalier Universitaire de Nantes, Hôpital Nord Laënnec, Nantes, France
| | - Frédéric Chabolle
- Service d'ORL et de Chirurgie Cervico-Faciale, Hôpital Foch, Suresnes, France
| | - Olivier Chabre
- Service d'Endocrinologie, CHU de Grenoble-Alpes, La Tronche, Grenoble, France
| | - Vincent Darrouzet
- Service d'ORL et de Chirurgie Cervico-Faciale, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France
| | - Brigitte Delemer
- Service d'Endocrinologie, Hôpital Robert Debré, CHU de Reims, Reims, France
| | - Rachel Desailloud
- Service d'Endocrinologie, Hôpital Nord, CHU d'Amiens-Picardie, Amiens, France
| | - Bernard Goichot
- Service de Médecine Interne, Endocrinologie et Nutrition, Hôpitaux Universitaires de Strasbourg, Faculté de Médecine, Université de Strasbourg, Strasbourg, France
| | | | - Lucile Offredo
- Équipe Labellisée par la Ligue Contre le Cancer, INSERM, UMR970, Paris-Centre de Recherche Cardiovasculaire, Paris, France
| | - Philippe Herman
- Assistance Publique, Hôpitaux de Paris, Service ORL-CCF, Hôpital Lariboisière, Université Paris VII, AP-HP, Paris, France
| | - Sandrine Laboureau
- Service d'Endocrinologie, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Hervé Lefebvre
- Centre Hospitalier Universitaire de Rouen, Service d'Endocrinologie, Diabète et Maladies Métaboliques, Rouen, France
| | - Peggy Pierre
- Service d'Endocrinologie, Hôpital Bretonneau, CHU de Tours, Tours, France
| | - Isabelle Raingeard
- Service d'Endocrinologie, CHU Montpellier, Hôpital Lapeyronie, Montpellier, France
| | - Yves Reznik
- Service d'Endocrinologie, CHU de Caen, Caen, France
| | - Jean-Louis Sadoul
- Service d'Endocrinologie, Hôpital de L'Archet, CHU de Nice, Nice, France
| | - Julien Hadoux
- Gustave Roussy, Université Paris-Saclay, Service de Médecine Nucléaire et Cancérologie Endocrinienne, Villejuif, France
| | - Antoine Tabarin
- Service d'Endocrinologie, Hôpital Haut-Lévêque, CHU de Bordeaux, Pessac, France
| | - Igor Tauveron
- Service d'Endocrinologie, Hôpital Gabriel Montpied, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Delphine Zenaty
- Assistance Publique-Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Service d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance et du Développement, Paris, France
| | - Judith Favier
- Équipe Labellisée par la Ligue Contre le Cancer, INSERM, UMR970, Paris-Centre de Recherche Cardiovasculaire, Paris, France
| | - Jérôme Bertherat
- Assistance Publique, Hôpitaux de Paris, Hôpital Cochin, Service d'Endocrinologie, Centre de Référence Maladies Rares de la Surrénale, Paris, France
- Université Paris Descartes, PRES Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - Eric Baudin
- Gustave Roussy, Université Paris-Saclay, Service de Médecine Nucléaire et Cancérologie Endocrinienne, Villejuif, France
| | - Laurence Amar
- Université Paris Descartes, PRES Sorbonne Paris Cité, Faculté de Médecine, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service d'Hypertension Artérielle et Médecine Vasculaire, Paris, France
| | - Anne-Paule Gimenez-Roqueplo
- Équipe Labellisée par la Ligue Contre le Cancer, INSERM, UMR970, Paris-Centre de Recherche Cardiovasculaire, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Génétique, Paris, France
- Université Paris Descartes, PRES Sorbonne Paris Cité, Faculté de Médecine, Paris, France
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Dumeige L, Chatelais L, Bouvattier C, De Kerdanet M, Hyon C, Esteva B, Samara-Boustani D, Zenaty D, Nicolino M, Baron S, Metz-Blond C, Naud-Saudreau C, Dupuis C, Léger J, Siffroi JP, Donadille B, Christin-Maitre S, Carel JC, Coutant R, Martinerie L. Should 45,X/46,XY boys with no or mild anomaly of external genitalia be investigated and followed up? Eur J Endocrinol 2018; 179:181-190. [PMID: 29973376 DOI: 10.1530/eje-18-0309] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 04/12/2018] [Accepted: 07/03/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Few studies of patients with a 45,X/46,XY mosaicism have considered those with normal male phenotype. The purpose of this study was to evaluate the clinical outcome of 45,X/46,XY boys born with normal or minor abnormalities of external genitalia, notably in terms of growth and pubertal development. METHODS Retrospective longitudinal study of 40 patients followed between 1982 and 2017 in France. RESULTS Twenty patients had a prenatal diagnosis, whereas 20 patients had a postnatal diagnosis, mainly for short stature. Most patients had stunted growth, with abnormal growth spurt during puberty and a mean adult height of 158 ± 7.6 cm, i.e. -2.3 DS with correction for target height. Seventy percent of patients presented Turner-like syndrome features including cardiac (6/23 patients investigated) and renal malformations (3/19 patients investigated). Twenty-two patients had minor abnormalities of external genitalia. One patient developed a testicular embryonic carcinoma, suggesting evidence of partial gonadal dysgenesis. Moreover, puberty occurred spontaneously in 93% of patients but 71% (n = 5) of those evaluated at the end of puberty presented signs of declined Sertoli cell function (low inhibin B levels and increased FSH levels). CONCLUSION This study emphasizes the need to identify and follow-up 45,X/46,XY patients born with normal male phenotype until adulthood, as they present similar prognosis than those born with severe genital anomalies. Currently, most patients are diagnosed in adulthood with azoospermia, consistent with our observations of decreased testicular function at the end of puberty. Early management of these patients may lead to fertility preservation strategies.
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Affiliation(s)
- Laurence Dumeige
- Pediatric Endocrinology Department, CHU Robert Debré, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Assistance-Publique Hôpitaux de Paris and Université Paris Diderot, Sorbonne Paris Cité, Paris, France
- INSERM UMR-S1185, Le Kremlin Bicêtre, France
| | | | - Claire Bouvattier
- Pediatric Endocrinology Department, CHU Bicêtre, Centre de Référence des Anomalies du Développement Génital, Assistance-Publique Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | | | - Capucine Hyon
- Genetic Department, CHU Armand Trousseau, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Blandine Esteva
- Pediatric Endocrinology Department, CHU Armand Trousseau, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Dinane Samara-Boustani
- Pediatric Endocrinology Department, CHU Necker-Enfants Malades, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Delphine Zenaty
- Pediatric Endocrinology Department, CHU Robert Debré, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Assistance-Publique Hôpitaux de Paris and Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Marc Nicolino
- Pediatric Endocrinology Department, CHU Lyon, Centre de Référence des Anomalies du Développement Génital, Lyon, France
| | | | | | | | | | - Juliane Léger
- Pediatric Endocrinology Department, CHU Robert Debré, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Assistance-Publique Hôpitaux de Paris and Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Jean-Pierre Siffroi
- Genetic Department, CHU Armand Trousseau, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Bruno Donadille
- Endocrinology Department, CHU St-Antoine, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Sophie Christin-Maitre
- Endocrinology Department, CHU St-Antoine, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Jean-Claude Carel
- Pediatric Endocrinology Department, CHU Robert Debré, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Assistance-Publique Hôpitaux de Paris and Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | | | - Laetitia Martinerie
- Pediatric Endocrinology Department, CHU Robert Debré, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Assistance-Publique Hôpitaux de Paris and Université Paris Diderot, Sorbonne Paris Cité, Paris, France
- INSERM UMR-S1185, Le Kremlin Bicêtre, France
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Reznik Y, Barat P, Bertherat J, Bouvattier C, Castinetti F, Chabre O, Chanson P, Cortet C, Delemer B, Goichot B, Gruson D, Guignat L, Proust-Lemoine E, Sanson MLR, Reynaud R, Boustani DS, Simon D, Tabarin A, Zenaty D. SFE/SFEDP adrenal insufficiency French consensus: Introduction and handbook. Annales d'Endocrinologie 2018; 79:1-22. [DOI: 10.1016/j.ando.2017.12.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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8
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Chabre O, Goichot B, Zenaty D, Bertherat J. Group 1. Epidemiology of primary and secondary adrenal insufficiency: Prevalence and incidence, acute adrenal insufficiency, long-term morbidity and mortality. Annales d'Endocrinologie 2017; 78:490-494. [DOI: 10.1016/j.ando.2017.10.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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9
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Guignat L, Proust-Lemoine E, Reznik Y, Zenaty D. Group 6. Modalities and frequency of monitoring of patients with adrenal insufficiency. Patient education. Annales d'Endocrinologie 2017; 78:544-558. [DOI: 10.1016/j.ando.2017.10.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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10
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Cortet C, Barat P, Zenaty D, Guignat L, Chanson P. Group 5: Acute adrenal insufficiency in adults and pediatric patients. Annales d'Endocrinologie 2017; 78:535-543. [DOI: 10.1016/j.ando.2017.10.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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11
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Carré A, Stoupa A, Kariyawasam D, Gueriouz M, Ramond C, Monus T, Léger J, Gaujoux S, Sebag F, Glaser N, Zenaty D, Nitschke P, Bole-Feysot C, Hubert L, Lyonnet S, Scharfmann R, Munnich A, Besmond C, Taylor W, Polak M. Mutations in BOREALIN cause thyroid dysgenesis. Hum Mol Genet 2017; 26:599-610. [PMID: 28025328 DOI: 10.1093/hmg/ddw419] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 12/02/2016] [Indexed: 12/31/2022] Open
Abstract
Congenital hypothyroidism is the most common neonatal endocrine disorder and is primarily caused by developmental abnormalities otherwise known as thyroid dysgenesis (TD). We performed whole exome sequencing (WES) in a consanguineous family with TD and subsequently sequenced a cohort of 134 probands with TD to identify genetic factors predisposing to the disease. We identified the novel missense mutations p.S148F, p.R114Q and p.L177W in the BOREALIN gene in TD-affected families. Borealin is a major component of the Chromosomal Passenger Complex (CPC) with well-known functions in mitosis. Further analysis of the missense mutations showed no apparent effects on mitosis. In contrast, expression of the mutants in human thyrocytes resulted in defects in adhesion and migration with corresponding changes in gene expression suggesting others functions for this mitotic protein. These results were well correlated with the same gene expression pattern analysed in the thyroid tissue of the patient with BOREALIN-p.R114W. These studies open new avenues in the genetics of TD in humans.
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Affiliation(s)
- Aurore Carré
- INSERM U1016, Cochin Institute, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,IMAGINE Institute affiliate, Paris, France
| | - Athanasia Stoupa
- IMAGINE Institute affiliate, Paris, France.,Pediatric Endocrinology, Gynecology and Diabetology Unit, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - Dulanjalee Kariyawasam
- INSERM U1016, Cochin Institute, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Pediatric Endocrinology, Gynecology and Diabetology Unit, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | | | - Cyrille Ramond
- INSERM U1016, Cochin Institute, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Taylor Monus
- Department of Biological Sciences, University of Toledo, Toledo, Ohio, USA
| | - Juliane Léger
- Pediatric Endocrinology Unit, Hôpital Universitaire Robert Debré, AP-HP, Paris, France.,RARE Disorder Center: Centre des Maladies Endocriniennes Rares de la Croissance
| | - Sébastien Gaujoux
- Department of Digestive and Endocrine Surgery, Cochin Hospital, AP-HP, Université Paris Descartes, Paris, France
| | - Frédéric Sebag
- Department of General, Endocrine and Metabolic Surgery, Hopital de la Conception, Marseille, France
| | - Nicolas Glaser
- INSERM U1016, Cochin Institute, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Delphine Zenaty
- Pediatric Endocrinology Unit, Hôpital Universitaire Robert Debré, AP-HP, Paris, France.,RARE Disorder Center: Centre des Maladies Endocriniennes Rares de la Croissance
| | - Patrick Nitschke
- Bioinformatics Platform, Paris Descartes University, IMAGINE Institute, Paris, France
| | - Christine Bole-Feysot
- Genomic Platform, INSERM UMR 1163, Paris Descartes Sorbonne Paris Cite University, Imagine Institute, Paris, France
| | - Laurence Hubert
- INSERM U1163, IMAGINE Institute, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Stanislas Lyonnet
- INSERM U1163, IMAGINE Institute, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Department of Genetics, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - Raphaël Scharfmann
- INSERM U1016, Cochin Institute, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Arnold Munnich
- INSERM U1163, IMAGINE Institute, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Department of Genetics, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - Claude Besmond
- INSERM U1163, IMAGINE Institute, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - William Taylor
- Department of Biological Sciences, University of Toledo, Toledo, Ohio, USA
| | - Michel Polak
- INSERM U1016, Cochin Institute, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,IMAGINE Institute affiliate, Paris, France.,Pediatric Endocrinology, Gynecology and Diabetology Unit, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France.,RARE Disorder Center: Centre des Maladies Endocriniennes Rares de la Croissance
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Zenaty D, Blumberg J, Liyanage N, Jacqz-Aigrain E, Lahlou N, Carel JC. A 6-Month Trial of the Efficacy and Safety of Triptorelin Pamoate (11.25 mg) Every 3 Months in Children with Precocious Puberty: A Retrospective Comparison with Triptorelin Acetate. Horm Res Paediatr 2017; 86:188-195. [PMID: 27603324 DOI: 10.1159/000448840] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 08/02/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS To evaluate the efficacy and safety of a triptorelin pamoate (11.25 mg) 3-month formulation in the management of central precocious puberty (CPP) (TP Study) and to retrospectively compare it with a triptorelin acetate (11.25 mg) 3-month formulation (TA Study). METHODS We conducted two phase III, multicentre, single-stage, non-comparative, open-label studies. In the TP Study, patients with CPP received an intramuscular injection of triptorelin pamoate 11.25 mg at baseline and 3 months after baseline. Hormonal changes as well as safety and efficacy endpoints were measured at baseline, 3 months, and 6 months. RESULTS The baseline characteristics of the 37 patients in the TP Study were similar to those of the TA Study population. A suppressed luteinising hormone (LH) response (LH peak ≤3 IU/l) to the gonadotrophin-releasing hormone test at 3 months (primary endpoint) occurred in 83.8 and 82.8% of the cases in the TP and the TA Study, respectively. At 6 months, a suppressed LH response occurred in 86.5 and 96.8% of the cases in the TP and the TA Study, respectively. Pubertal development was slowed in both studies. Adverse events were mild to moderate and resolved without sequelae in the TP Study. CONCLUSION Triptorelin pamoate 11.25 mg administered at 3-month intervals is an effective and well-tolerated treatment in patients with CPP. The efficacy and safety profiles appear similar to those reported in the literature for triptorelin acetate 11.25 mg. © 2016 S. Karger AG, Basel.
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Affiliation(s)
- Delphine Zenaty
- Université Paris Diderot, Sorbonne Paris Cité, Paris, France
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Fiot E, Zenaty D, Boizeau P, Haigneré J, Santos SD, Léger J. X-chromosome gene dosage as a determinant of impaired pre and postnatal growth and adult height in Turner syndrome. Eur J Endocrinol 2016; 175:X1. [PMID: 27484588 DOI: 10.1530/eje-15-1000e] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Elodie Fiot
- Assistance Publique-Hôpitaux de ParisHôpital Robert Debré, Service d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, INSERM U 1141, 48 Bd Sérurier, F-75019, Paris, France
| | - Delphine Zenaty
- Assistance Publique-Hôpitaux de ParisHôpital Robert Debré, Service d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, INSERM U 1141, 48 Bd Sérurier, F-75019, Paris, France
| | - Priscilla Boizeau
- AP-HPHôpital Robert Debré, Unit of Clinical Epidemiology, F-75019, Paris, France InsermCIC-EC 1426, F-75019 Paris, France
| | - Jeremy Haigneré
- AP-HPHôpital Robert Debré, Unit of Clinical Epidemiology, F-75019, Paris, France InsermCIC-EC 1426, F-75019 Paris, France
| | - Sophie Dos Santos
- Assistance Publique-Hôpitaux de ParisHôpital Robert Debré, Service d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, INSERM U 1141, 48 Bd Sérurier, F-75019, Paris, France
| | - Juliane Léger
- Assistance Publique-Hôpitaux de ParisHôpital Robert Debré, Service d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, INSERM U 1141, 48 Bd Sérurier, F-75019, Paris, France Université Paris DiderotSorbonne Paris Cité, F-75019 Paris, France Institut National de la Santé et de la Recherche Médicale (Inserm)Unité 1141, DHU Protect, F-75019 Paris, France
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Bardet C, Courson F, Wu Y, Khaddam M, Salmon B, Ribes S, Thumfart J, Yamaguti PM, Rochefort GY, Figueres ML, Breiderhoff T, Garcia-Castaño A, Vallée B, Le Denmat D, Baroukh B, Guilbert T, Schmitt A, Massé JM, Bazin D, Lorenz G, Morawietz M, Hou J, Carvalho-Lobato P, Manzanares MC, Fricain JC, Talmud D, Demontis R, Neves F, Zenaty D, Berdal A, Kiesow A, Petzold M, Menashi S, Linglart A, Acevedo AC, Vargas-Poussou R, Müller D, Houillier P, Chaussain C. Claudin-16 Deficiency Impairs Tight Junction Function in Ameloblasts, Leading to Abnormal Enamel Formation. J Bone Miner Res 2016; 31:498-513. [PMID: 26426912 DOI: 10.1002/jbmr.2726] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [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: 05/15/2015] [Revised: 09/28/2015] [Accepted: 09/29/2015] [Indexed: 12/26/2022]
Abstract
Claudin-16 protein (CLDN16) is a component of tight junctions (TJ) with a restrictive distribution so far demonstrated mainly in the kidney. Here, we demonstrate the expression of CLDN16 also in the tooth germ and show that claudin-16 gene (CLDN16) mutations result in amelogenesis imperfecta (AI) in the 5 studied patients with familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC). To investigate the role of CLDN16 in tooth formation, we studied a murine model of FHHNC and showed that CLDN16 deficiency led to altered secretory ameloblast TJ structure, lowering of extracellular pH in the forming enamel matrix, and abnormal enamel matrix protein processing, resulting in an enamel phenotype closely resembling human AI. This study unravels an association of FHHNC owing to CLDN16 mutations with AI, which is directly related to the loss of function of CLDN16 during amelogenesis. Overall, this study indicates for the first time the importance of a TJ protein in tooth formation and underlines the need to establish a specific dental follow-up for these patients.
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Affiliation(s)
- Claire Bardet
- EA 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Dental School Paris Descartes University, Sorbonne Paris Cité, France
| | - Frédéric Courson
- Department of Odontology, AP-HP, and Reference Center for Rare Diseases of the Metabolism of Calcium and Phosphorus, Nord Val de Seine Hospital, Bretonneau, France
| | - Yong Wu
- EA 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Dental School Paris Descartes University, Sorbonne Paris Cité, France.,Department of Oral and Cranio-maxillofacial Science, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Mayssam Khaddam
- EA 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Dental School Paris Descartes University, Sorbonne Paris Cité, France
| | - Benjamin Salmon
- EA 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Dental School Paris Descartes University, Sorbonne Paris Cité, France.,Department of Odontology, AP-HP, and Reference Center for Rare Diseases of the Metabolism of Calcium and Phosphorus, Nord Val de Seine Hospital, Bretonneau, France
| | - Sandy Ribes
- EA 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Dental School Paris Descartes University, Sorbonne Paris Cité, France
| | - Julia Thumfart
- Department of Pediatric Nephrology, Charité University School of Medicine, Berlin, Germany
| | - Paulo M Yamaguti
- Division of Dentistry, Oral Care Center for Inherited Diseases, University Hospital of Brasilia, Faculty of Health Sciences, University of Brasilia (UnB), Brasilia, Brazil
| | - Gael Y Rochefort
- EA 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Dental School Paris Descartes University, Sorbonne Paris Cité, France
| | - Marie-Lucile Figueres
- INSERM UMRS 1138, Cordeliers Research Center, Paris-Diderot, Pierre et Marie Curie and Paris Descartes Universities, CNRS ERL 8228, Paris, France
| | - Tilman Breiderhoff
- Department of Pediatric Nephrology, Charité University School of Medicine, Berlin, Germany
| | - Alejandro Garcia-Castaño
- Department of Genetics, AP-HP, and Reference Center of Children and Adult Renal Hereditary Diseases (MARHEA), European Hospital Georges Pompidou, Paris, France
| | - Benoit Vallée
- Laboratory CRRET, Paris-Est University, CNRS, Créteil, France
| | - Dominique Le Denmat
- EA 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Dental School Paris Descartes University, Sorbonne Paris Cité, France
| | - Brigitte Baroukh
- EA 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Dental School Paris Descartes University, Sorbonne Paris Cité, France
| | - Thomas Guilbert
- Cochin Institute, Plate-Forme d'Imagerie Photonique, INSERM U1016, CNRS UMR8104, Paris Descartes University Sorbonne Paris Cité, Paris, France
| | - Alain Schmitt
- Cochin Institute, Transmission Electron Microscopy Platform, INSERM U1016, CNRS UMR8104, Paris Descartes University Sorbonne Paris Cité, Paris, France
| | - Jean-Marc Massé
- Cochin Institute, Transmission Electron Microscopy Platform, INSERM U1016, CNRS UMR8104, Paris Descartes University Sorbonne Paris Cité, Paris, France
| | - Dominique Bazin
- Laboratoire de Physique des Solides, CNRS, Paris Sud University, Orsay, and LCMCP-UPMC, Collège de France, Paris, France
| | - Georg Lorenz
- Fraunhofer Institute for Mechanics of Materials IWM, Halle, Germany
| | - Maria Morawietz
- Fraunhofer Institute for Mechanics of Materials IWM, Halle, Germany
| | - Jianghui Hou
- Division of Renal Diseases, Washington University School of Medicine, St. Louis, MO, USA
| | - Patricia Carvalho-Lobato
- Human Anatomy and Embryology, Health University of Barcelona Campus-Bellvitge, University of Barcelona, Barcelona, Spain
| | - Maria Cristina Manzanares
- Human Anatomy and Embryology, Health University of Barcelona Campus-Bellvitge, University of Barcelona, Barcelona, Spain
| | - Jean-Christophe Fricain
- CHU Bordeaux, Dental School, U1026 Tissue Bioengineering, University of Bordeaux/Inserm, Bordeaux, France
| | - Deborah Talmud
- Department of Pediatrics, Centre Hospitalier Régional (CHR) d'Orléans, Orleans, France
| | | | - Francisco Neves
- Laboratory of Molecular Pharmacology, Faculty of Health Sciences, University of Brasilia (UNB), Brasilia, Brazil
| | - Delphine Zenaty
- Department of Pediatric Endocrinology, AP-HP, Paris Diderot University, Robert Debré Hospital, Paris, France
| | - Ariane Berdal
- INSERM UMRS 1138, Cordeliers Research Center, Paris-Diderot, Pierre et Marie Curie and Paris Descartes Universities, CNRS ERL 8228, Paris, France
| | - Andreas Kiesow
- Fraunhofer Institute for Mechanics of Materials IWM, Halle, Germany
| | - Matthias Petzold
- Fraunhofer Institute for Mechanics of Materials IWM, Halle, Germany
| | - Suzanne Menashi
- Laboratory CRRET, Paris-Est University, CNRS, Créteil, France
| | - Agnes Linglart
- Department of Pediatric Endocrinology, AP-HP, Paris Sud University, School of Medicine, and Reference Center for Rare Diseases of the Metabolism of Calcium and Phosphorus, Paris, France
| | - Ana Carolina Acevedo
- Division of Dentistry, Oral Care Center for Inherited Diseases, University Hospital of Brasilia, Faculty of Health Sciences, University of Brasilia (UnB), Brasilia, Brazil
| | - Rosa Vargas-Poussou
- Department of Genetics, AP-HP, and Reference Center of Children and Adult Renal Hereditary Diseases (MARHEA), European Hospital Georges Pompidou, Paris, France
| | - Dominik Müller
- Department of Pediatric Nephrology, Charité University School of Medicine, Berlin, Germany
| | - Pascal Houillier
- INSERM UMRS 1138, Cordeliers Research Center, Paris-Diderot, Pierre et Marie Curie and Paris Descartes Universities, CNRS ERL 8228, Paris, France.,Department of Physiology, AP-HP, and Reference Center of Children and Adult Renal Hereditary Diseases (MARHEA), Georges Pompidou European Hospital, Paris, France
| | - Catherine Chaussain
- EA 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Dental School Paris Descartes University, Sorbonne Paris Cité, France.,Department of Odontology, AP-HP, and Reference Center for Rare Diseases of the Metabolism of Calcium and Phosphorus, Nord Val de Seine Hospital, Bretonneau, France
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Fiot E, Zenaty D, Boizeau P, Haigneré J, Dos Santos S, Léger J. X-chromosome gene dosage as a determinant of impaired pre and postnatal growth and adult height in Turner syndrome. Eur J Endocrinol 2016; 174:281-8. [PMID: 26744895 DOI: 10.1530/eje-15-1000] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [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: 10/09/2015] [Accepted: 12/14/2015] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Short stature is a key aspect of the phenotype of patients with Turner syndrome (TS). SHOX haploinsufficiency is responsible for about two-thirds of the height deficit. The aim was to investigate the effect of X-chromosome gene dosage on anthropometric parameters at birth, spontaneous height, and adult height (AH) after growth hormone (GH) treatment. DESIGN We conducted a national observational multicenter study. METHODS Birth parameter SDS for gestational age, height, and AH before and after GH treatment respectively, and height deficit with respect to target height (SDS) were classified by karyotype subgroup in a cohort of 1501 patients with TS: 45,X (36%), isoXq (19%), 45,X/46,XX (15%), XrX (7%), presence of Y (6%), or other karyotypes (17%). RESULTS Birth weight, length (P<0.0001), and head circumference (P<0.001), height and height deficit with respect to target height (SDS) before GH treatment, at a median age of 8.8 (5.3-11.8) years and after adjustment for age and correction for multiple testing (P<0.0001), and AH deficit with respect to target height at a median age of 19.3 (18.0-21.8) years and with additional adjustment for dose and duration of GH treatment (P=0.006), were significantly associated with karyotype subgroup. Growth retardation tended to be more severe in patients with XrX, isoXq, and, to a lesser extent, 45,X karyotypes than in patients with 45,X/46,XX karyotypes or a Y chromosome. CONCLUSION These data suggest that haploinsufficiency for an unknown Xp gene increases the risk of fetal and postnatal growth deficit and short AH with respect to target height after GH therapy.
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Affiliation(s)
- Elodie Fiot
- Assistance Publique-Hôpitaux de ParisHôpital Robert Debré, Service d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, INSERM U 1141, 48 Bd Sérurier, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (Inserm)Unité 1141, DHU Protect, F-75019 Paris, FranceAP-HPHôpital Robert Debré, Unit of Clinical Epidemiology, F-75019, Paris, FranceInsermCIC-EC 1426, F-75019 Paris, France
| | - Delphine Zenaty
- Assistance Publique-Hôpitaux de ParisHôpital Robert Debré, Service d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, INSERM U 1141, 48 Bd Sérurier, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (Inserm)Unité 1141, DHU Protect, F-75019 Paris, FranceAP-HPHôpital Robert Debré, Unit of Clinical Epidemiology, F-75019, Paris, FranceInsermCIC-EC 1426, F-75019 Paris, France
| | - Priscilla Boizeau
- Assistance Publique-Hôpitaux de ParisHôpital Robert Debré, Service d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, INSERM U 1141, 48 Bd Sérurier, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (Inserm)Unité 1141, DHU Protect, F-75019 Paris, FranceAP-HPHôpital Robert Debré, Unit of Clinical Epidemiology, F-75019, Paris, FranceInsermCIC-EC 1426, F-75019 Paris, France Assistance Publique-Hôpitaux de ParisHôpital Robert Debré, Service d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, INSERM U 1141, 48 Bd Sérurier, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (Inserm)Unité 1141, DHU Protect, F-75019 Paris, FranceAP-HPHôpital Robert Debré, Unit of Clinical Epidemiology, F-75019, Paris, FranceInsermCIC-EC 1426, F-75019 Paris, France
| | - Jeremy Haigneré
- Assistance Publique-Hôpitaux de ParisHôpital Robert Debré, Service d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, INSERM U 1141, 48 Bd Sérurier, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (Inserm)Unité 1141, DHU Protect, F-75019 Paris, FranceAP-HPHôpital Robert Debré, Unit of Clinical Epidemiology, F-75019, Paris, FranceInsermCIC-EC 1426, F-75019 Paris, France Assistance Publique-Hôpitaux de ParisHôpital Robert Debré, Service d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, INSERM U 1141, 48 Bd Sérurier, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (Inserm)Unité 1141, DHU Protect, F-75019 Paris, FranceAP-HPHôpital Robert Debré, Unit of Clinical Epidemiology, F-75019, Paris, FranceInsermCIC-EC 1426, F-75019 Paris, France
| | - Sophie Dos Santos
- Assistance Publique-Hôpitaux de ParisHôpital Robert Debré, Service d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, INSERM U 1141, 48 Bd Sérurier, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (Inserm)Unité 1141, DHU Protect, F-75019 Paris, FranceAP-HPHôpital Robert Debré, Unit of Clinical Epidemiology, F-75019, Paris, FranceInsermCIC-EC 1426, F-75019 Paris, France
| | - Juliane Léger
- Assistance Publique-Hôpitaux de ParisHôpital Robert Debré, Service d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, INSERM U 1141, 48 Bd Sérurier, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (Inserm)Unité 1141, DHU Protect, F-75019 Paris, FranceAP-HPHôpital Robert Debré, Unit of Clinical Epidemiology, F-75019, Paris, FranceInsermCIC-EC 1426, F-75019 Paris, France Assistance Publique-Hôpitaux de ParisHôpital Robert Debré, Service d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, INSERM U 1141, 48 Bd Sérurier, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (Inserm)Unité 1141, DHU Protect, F-75019 Paris, FranceAP-HPHôpital Robert Debré, Unit of Clinical Epidemiology, F-75019, Paris, FranceInsermCIC-EC 1426, F-75019 Paris, France Assistance Publique-Hôpitaux de ParisHôpital Robert Debré, Service d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, INSERM U 1141, 48 Bd Sérurier, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (Inserm)Unité 1141, DHU Protect, F-75019 Paris, FranceAP-HPHôpital Robert Debré, Unit of Clinical Epidemiology, F-75019, Paris, FranceInsermCIC-EC 1426, F-75019 Paris, France
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Bernard V, Donadille B, Zenaty D, Courtillot C, Salenave S, Brac de la Perrière A, Albarel F, Fèvre A, Kerlan V, Brue T, Delemer B, Borson-Chazot F, Carel JC, Chanson P, Léger J, Touraine P, Christin-Maitre S. Spontaneous fertility and pregnancy outcomes amongst 480 women with Turner syndrome. Hum Reprod 2016; 31:782-8. [DOI: 10.1093/humrep/dew012] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 01/13/2016] [Indexed: 12/15/2022] Open
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Simon D, Ba I, Mekhail N, Ecosse E, Paulsen A, Zenaty D, Houang M, Jesuran Perelroizen M, de Filippo GP, Salerno M, Simonin G, Reynaud R, Carel JC, Léger J, de Roux N. Mutations in the maternally imprinted gene MKRN3 are common in familial central precocious puberty. Eur J Endocrinol 2016; 174:1-8. [PMID: 26431553 DOI: 10.1530/eje-15-0488] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [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: 05/13/2015] [Accepted: 10/01/2015] [Indexed: 11/08/2022]
Abstract
CONTEXT AND OBJECTIVE Idiopathic central precocious puberty (iCPP) is defined as early activation of the hypothalamic-pituitary-gonadal axis in the absence of identifiable central lesions. Mutations of the makorin RING finger 3 (MKRN3) gene are associated with iCPP. We aimed to assess the frequency of MKRN3 mutations in iCPP and to compare the phenotypes of patients with and without MKRN3 mutations. DESIGN An observational study was carried out on patients recruited at pediatric hospitals in France and Italy. Forty-six index CPP cases were screened for mutations in the MKRN3 coding sequence: 28 index cases of familial cases and 18 cases did not report any familial history of CPP. The endocrine phenotype was compared between MKRN3 mutated and non-mutated patients. RESULTS MKRN3 mutations were identified in one sporadic and 13 familial cases. We identified five new heterozygous missense mutations predicted to be deleterious for protein function and two frameshift mutations, one new and the other recurrent, predicted to result in truncated proteins. Age at puberty onset varied very little among patients with MKRN3 mutations and puberty occurred earlier in these patients than in those without MKRN3 mutations (6.0 years (5.4-6.0) vs 7.0 years (6.0-7.0), P=0.01). CONCLUSIONS MKRN3 mutations are common in familial iCPP. MKRN3 is one of the gatekeepers of the postnatal activation of the gonadotropic axis.
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Affiliation(s)
- Dominique Simon
- AP-HPService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, Paris F-75019, FranceUniversité Paris DiderotSorbonne Paris Cité F-75019, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, Paris F-75019, FranceAP-HPINSERM U1141, Laboratoire de Biochimie, Hôpital Robert Debré, 48 Boulevard Sérurier, Paris F-75019, FranceAP-HPExplorations Fonctionnelles Endocriniennes, Hôpital Armand Trousseau, Paris F-75012, FranceCentre d'Endocrinologie Pédiatrique14 Rue du Rempart St-Etienne, Toulouse F-31000, FrancePediatric Endocrinology UnitGaetano Rummo Hospital, Benevento 82100, ItalyPediatric Endocrinology UnitFederico II University, Naples 80131, ItalyService de Pédiatrie MultidisciplinaireCentre de Référence des Maladies Rares d'Origine Hypophysaire, Assistance Publique-Hopitaux de Marseille (APHM), Hôpital de la Timone, Aix-Marseille Université, Marseille F-13385, France AP-HPService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, Paris F-75019, FranceUniversité Paris DiderotSorbonne Paris Cité F-75019, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, Paris F-75019, FranceAP-HPINSERM U1141, Laboratoire de Biochimie, Hôpital Robert Debré, 48 Boulevard Sérurier, Paris F-75019, FranceAP-HPExplorations Fonctionnelles Endocriniennes, Hôpital Armand Trousseau, Paris F-75012, FranceCentre d'Endocrinologie Pédiatrique14 Rue du Rempart St-Etienne, Toulouse F-31000, FrancePediatric Endocrinology UnitGaetano Rummo Hospital, Benevento 82100, ItalyPediatric Endocrinology UnitFederico II University, Naples 80131, ItalyService de Pédiatrie MultidisciplinaireCentre de Référence des Maladies Rares d'Origine Hypophysaire, Assistance Publique-Hopitaux de Marseille (APHM), Hôpital de la T
| | - Ibrahima Ba
- AP-HPService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, Paris F-75019, FranceUniversité Paris DiderotSorbonne Paris Cité F-75019, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, Paris F-75019, FranceAP-HPINSERM U1141, Laboratoire de Biochimie, Hôpital Robert Debré, 48 Boulevard Sérurier, Paris F-75019, FranceAP-HPExplorations Fonctionnelles Endocriniennes, Hôpital Armand Trousseau, Paris F-75012, FranceCentre d'Endocrinologie Pédiatrique14 Rue du Rempart St-Etienne, Toulouse F-31000, FrancePediatric Endocrinology UnitGaetano Rummo Hospital, Benevento 82100, ItalyPediatric Endocrinology UnitFederico II University, Naples 80131, ItalyService de Pédiatrie MultidisciplinaireCentre de Référence des Maladies Rares d'Origine Hypophysaire, Assistance Publique-Hopitaux de Marseille (APHM), Hôpital de la Timone, Aix-Marseille Université, Marseille F-13385, France
| | - Nancy Mekhail
- AP-HPService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, Paris F-75019, FranceUniversité Paris DiderotSorbonne Paris Cité F-75019, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, Paris F-75019, FranceAP-HPINSERM U1141, Laboratoire de Biochimie, Hôpital Robert Debré, 48 Boulevard Sérurier, Paris F-75019, FranceAP-HPExplorations Fonctionnelles Endocriniennes, Hôpital Armand Trousseau, Paris F-75012, FranceCentre d'Endocrinologie Pédiatrique14 Rue du Rempart St-Etienne, Toulouse F-31000, FrancePediatric Endocrinology UnitGaetano Rummo Hospital, Benevento 82100, ItalyPediatric Endocrinology UnitFederico II University, Naples 80131, ItalyService de Pédiatrie MultidisciplinaireCentre de Référence des Maladies Rares d'Origine Hypophysaire, Assistance Publique-Hopitaux de Marseille (APHM), Hôpital de la Timone, Aix-Marseille Université, Marseille F-13385, France
| | - Emmanuel Ecosse
- AP-HPService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, Paris F-75019, FranceUniversité Paris DiderotSorbonne Paris Cité F-75019, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, Paris F-75019, FranceAP-HPINSERM U1141, Laboratoire de Biochimie, Hôpital Robert Debré, 48 Boulevard Sérurier, Paris F-75019, FranceAP-HPExplorations Fonctionnelles Endocriniennes, Hôpital Armand Trousseau, Paris F-75012, FranceCentre d'Endocrinologie Pédiatrique14 Rue du Rempart St-Etienne, Toulouse F-31000, FrancePediatric Endocrinology UnitGaetano Rummo Hospital, Benevento 82100, ItalyPediatric Endocrinology UnitFederico II University, Naples 80131, ItalyService de Pédiatrie MultidisciplinaireCentre de Référence des Maladies Rares d'Origine Hypophysaire, Assistance Publique-Hopitaux de Marseille (APHM), Hôpital de la Timone, Aix-Marseille Université, Marseille F-13385, France
| | - Anne Paulsen
- AP-HPService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, Paris F-75019, FranceUniversité Paris DiderotSorbonne Paris Cité F-75019, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, Paris F-75019, FranceAP-HPINSERM U1141, Laboratoire de Biochimie, Hôpital Robert Debré, 48 Boulevard Sérurier, Paris F-75019, FranceAP-HPExplorations Fonctionnelles Endocriniennes, Hôpital Armand Trousseau, Paris F-75012, FranceCentre d'Endocrinologie Pédiatrique14 Rue du Rempart St-Etienne, Toulouse F-31000, FrancePediatric Endocrinology UnitGaetano Rummo Hospital, Benevento 82100, ItalyPediatric Endocrinology UnitFederico II University, Naples 80131, ItalyService de Pédiatrie MultidisciplinaireCentre de Référence des Maladies Rares d'Origine Hypophysaire, Assistance Publique-Hopitaux de Marseille (APHM), Hôpital de la Timone, Aix-Marseille Université, Marseille F-13385, France
| | - Delphine Zenaty
- AP-HPService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, Paris F-75019, FranceUniversité Paris DiderotSorbonne Paris Cité F-75019, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, Paris F-75019, FranceAP-HPINSERM U1141, Laboratoire de Biochimie, Hôpital Robert Debré, 48 Boulevard Sérurier, Paris F-75019, FranceAP-HPExplorations Fonctionnelles Endocriniennes, Hôpital Armand Trousseau, Paris F-75012, FranceCentre d'Endocrinologie Pédiatrique14 Rue du Rempart St-Etienne, Toulouse F-31000, FrancePediatric Endocrinology UnitGaetano Rummo Hospital, Benevento 82100, ItalyPediatric Endocrinology UnitFederico II University, Naples 80131, ItalyService de Pédiatrie MultidisciplinaireCentre de Référence des Maladies Rares d'Origine Hypophysaire, Assistance Publique-Hopitaux de Marseille (APHM), Hôpital de la Timone, Aix-Marseille Université, Marseille F-13385, France AP-HPService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, Paris F-75019, FranceUniversité Paris DiderotSorbonne Paris Cité F-75019, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, Paris F-75019, FranceAP-HPINSERM U1141, Laboratoire de Biochimie, Hôpital Robert Debré, 48 Boulevard Sérurier, Paris F-75019, FranceAP-HPExplorations Fonctionnelles Endocriniennes, Hôpital Armand Trousseau, Paris F-75012, FranceCentre d'Endocrinologie Pédiatrique14 Rue du Rempart St-Etienne, Toulouse F-31000, FrancePediatric Endocrinology UnitGaetano Rummo Hospital, Benevento 82100, ItalyPediatric Endocrinology UnitFederico II University, Naples 80131, ItalyService de Pédiatrie MultidisciplinaireCentre de Référence des Maladies Rares d'Origine Hypophysaire, Assistance Publique-Hopitaux de Marseille (APHM), Hôpital de la T
| | - Muriel Houang
- AP-HPService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, Paris F-75019, FranceUniversité Paris DiderotSorbonne Paris Cité F-75019, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, Paris F-75019, FranceAP-HPINSERM U1141, Laboratoire de Biochimie, Hôpital Robert Debré, 48 Boulevard Sérurier, Paris F-75019, FranceAP-HPExplorations Fonctionnelles Endocriniennes, Hôpital Armand Trousseau, Paris F-75012, FranceCentre d'Endocrinologie Pédiatrique14 Rue du Rempart St-Etienne, Toulouse F-31000, FrancePediatric Endocrinology UnitGaetano Rummo Hospital, Benevento 82100, ItalyPediatric Endocrinology UnitFederico II University, Naples 80131, ItalyService de Pédiatrie MultidisciplinaireCentre de Référence des Maladies Rares d'Origine Hypophysaire, Assistance Publique-Hopitaux de Marseille (APHM), Hôpital de la Timone, Aix-Marseille Université, Marseille F-13385, France
| | - Monique Jesuran Perelroizen
- AP-HPService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, Paris F-75019, FranceUniversité Paris DiderotSorbonne Paris Cité F-75019, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, Paris F-75019, FranceAP-HPINSERM U1141, Laboratoire de Biochimie, Hôpital Robert Debré, 48 Boulevard Sérurier, Paris F-75019, FranceAP-HPExplorations Fonctionnelles Endocriniennes, Hôpital Armand Trousseau, Paris F-75012, FranceCentre d'Endocrinologie Pédiatrique14 Rue du Rempart St-Etienne, Toulouse F-31000, FrancePediatric Endocrinology UnitGaetano Rummo Hospital, Benevento 82100, ItalyPediatric Endocrinology UnitFederico II University, Naples 80131, ItalyService de Pédiatrie MultidisciplinaireCentre de Référence des Maladies Rares d'Origine Hypophysaire, Assistance Publique-Hopitaux de Marseille (APHM), Hôpital de la Timone, Aix-Marseille Université, Marseille F-13385, France
| | - Gian-Paolo de Filippo
- AP-HPService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, Paris F-75019, FranceUniversité Paris DiderotSorbonne Paris Cité F-75019, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, Paris F-75019, FranceAP-HPINSERM U1141, Laboratoire de Biochimie, Hôpital Robert Debré, 48 Boulevard Sérurier, Paris F-75019, FranceAP-HPExplorations Fonctionnelles Endocriniennes, Hôpital Armand Trousseau, Paris F-75012, FranceCentre d'Endocrinologie Pédiatrique14 Rue du Rempart St-Etienne, Toulouse F-31000, FrancePediatric Endocrinology UnitGaetano Rummo Hospital, Benevento 82100, ItalyPediatric Endocrinology UnitFederico II University, Naples 80131, ItalyService de Pédiatrie MultidisciplinaireCentre de Référence des Maladies Rares d'Origine Hypophysaire, Assistance Publique-Hopitaux de Marseille (APHM), Hôpital de la Timone, Aix-Marseille Université, Marseille F-13385, France
| | - Mariacarolina Salerno
- AP-HPService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, Paris F-75019, FranceUniversité Paris DiderotSorbonne Paris Cité F-75019, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, Paris F-75019, FranceAP-HPINSERM U1141, Laboratoire de Biochimie, Hôpital Robert Debré, 48 Boulevard Sérurier, Paris F-75019, FranceAP-HPExplorations Fonctionnelles Endocriniennes, Hôpital Armand Trousseau, Paris F-75012, FranceCentre d'Endocrinologie Pédiatrique14 Rue du Rempart St-Etienne, Toulouse F-31000, FrancePediatric Endocrinology UnitGaetano Rummo Hospital, Benevento 82100, ItalyPediatric Endocrinology UnitFederico II University, Naples 80131, ItalyService de Pédiatrie MultidisciplinaireCentre de Référence des Maladies Rares d'Origine Hypophysaire, Assistance Publique-Hopitaux de Marseille (APHM), Hôpital de la Timone, Aix-Marseille Université, Marseille F-13385, France
| | - Gilbert Simonin
- AP-HPService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, Paris F-75019, FranceUniversité Paris DiderotSorbonne Paris Cité F-75019, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, Paris F-75019, FranceAP-HPINSERM U1141, Laboratoire de Biochimie, Hôpital Robert Debré, 48 Boulevard Sérurier, Paris F-75019, FranceAP-HPExplorations Fonctionnelles Endocriniennes, Hôpital Armand Trousseau, Paris F-75012, FranceCentre d'Endocrinologie Pédiatrique14 Rue du Rempart St-Etienne, Toulouse F-31000, FrancePediatric Endocrinology UnitGaetano Rummo Hospital, Benevento 82100, ItalyPediatric Endocrinology UnitFederico II University, Naples 80131, ItalyService de Pédiatrie MultidisciplinaireCentre de Référence des Maladies Rares d'Origine Hypophysaire, Assistance Publique-Hopitaux de Marseille (APHM), Hôpital de la Timone, Aix-Marseille Université, Marseille F-13385, France
| | - Rachel Reynaud
- AP-HPService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, Paris F-75019, FranceUniversité Paris DiderotSorbonne Paris Cité F-75019, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, Paris F-75019, FranceAP-HPINSERM U1141, Laboratoire de Biochimie, Hôpital Robert Debré, 48 Boulevard Sérurier, Paris F-75019, FranceAP-HPExplorations Fonctionnelles Endocriniennes, Hôpital Armand Trousseau, Paris F-75012, FranceCentre d'Endocrinologie Pédiatrique14 Rue du Rempart St-Etienne, Toulouse F-31000, FrancePediatric Endocrinology UnitGaetano Rummo Hospital, Benevento 82100, ItalyPediatric Endocrinology UnitFederico II University, Naples 80131, ItalyService de Pédiatrie MultidisciplinaireCentre de Référence des Maladies Rares d'Origine Hypophysaire, Assistance Publique-Hopitaux de Marseille (APHM), Hôpital de la Timone, Aix-Marseille Université, Marseille F-13385, France
| | - Jean-Claude Carel
- AP-HPService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, Paris F-75019, FranceUniversité Paris DiderotSorbonne Paris Cité F-75019, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, Paris F-75019, FranceAP-HPINSERM U1141, Laboratoire de Biochimie, Hôpital Robert Debré, 48 Boulevard Sérurier, Paris F-75019, FranceAP-HPExplorations Fonctionnelles Endocriniennes, Hôpital Armand Trousseau, Paris F-75012, FranceCentre d'Endocrinologie Pédiatrique14 Rue du Rempart St-Etienne, Toulouse F-31000, FrancePediatric Endocrinology UnitGaetano Rummo Hospital, Benevento 82100, ItalyPediatric Endocrinology UnitFederico II University, Naples 80131, ItalyService de Pédiatrie MultidisciplinaireCentre de Référence des Maladies Rares d'Origine Hypophysaire, Assistance Publique-Hopitaux de Marseille (APHM), Hôpital de la Timone, Aix-Marseille Université, Marseille F-13385, France AP-HPService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, Paris F-75019, FranceUniversité Paris DiderotSorbonne Paris Cité F-75019, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, Paris F-75019, FranceAP-HPINSERM U1141, Laboratoire de Biochimie, Hôpital Robert Debré, 48 Boulevard Sérurier, Paris F-75019, FranceAP-HPExplorations Fonctionnelles Endocriniennes, Hôpital Armand Trousseau, Paris F-75012, FranceCentre d'Endocrinologie Pédiatrique14 Rue du Rempart St-Etienne, Toulouse F-31000, FrancePediatric Endocrinology UnitGaetano Rummo Hospital, Benevento 82100, ItalyPediatric Endocrinology UnitFederico II University, Naples 80131, ItalyService de Pédiatrie MultidisciplinaireCentre de Référence des Maladies Rares d'Origine Hypophysaire, Assistance Publique-Hopitaux de Marseille (APHM), Hôpital de la T
| | - Juliane Léger
- AP-HPService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, Paris F-75019, FranceUniversité Paris DiderotSorbonne Paris Cité F-75019, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, Paris F-75019, FranceAP-HPINSERM U1141, Laboratoire de Biochimie, Hôpital Robert Debré, 48 Boulevard Sérurier, Paris F-75019, FranceAP-HPExplorations Fonctionnelles Endocriniennes, Hôpital Armand Trousseau, Paris F-75012, FranceCentre d'Endocrinologie Pédiatrique14 Rue du Rempart St-Etienne, Toulouse F-31000, FrancePediatric Endocrinology UnitGaetano Rummo Hospital, Benevento 82100, ItalyPediatric Endocrinology UnitFederico II University, Naples 80131, ItalyService de Pédiatrie MultidisciplinaireCentre de Référence des Maladies Rares d'Origine Hypophysaire, Assistance Publique-Hopitaux de Marseille (APHM), Hôpital de la Timone, Aix-Marseille Université, Marseille F-13385, France AP-HPService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, Paris F-75019, FranceUniversité Paris DiderotSorbonne Paris Cité F-75019, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, Paris F-75019, FranceAP-HPINSERM U1141, Laboratoire de Biochimie, Hôpital Robert Debré, 48 Boulevard Sérurier, Paris F-75019, FranceAP-HPExplorations Fonctionnelles Endocriniennes, Hôpital Armand Trousseau, Paris F-75012, FranceCentre d'Endocrinologie Pédiatrique14 Rue du Rempart St-Etienne, Toulouse F-31000, FrancePediatric Endocrinology UnitGaetano Rummo Hospital, Benevento 82100, ItalyPediatric Endocrinology UnitFederico II University, Naples 80131, ItalyService de Pédiatrie MultidisciplinaireCentre de Référence des Maladies Rares d'Origine Hypophysaire, Assistance Publique-Hopitaux de Marseille (APHM), Hôpital de la T
| | - Nicolas de Roux
- AP-HPService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, Paris F-75019, FranceUniversité Paris DiderotSorbonne Paris Cité F-75019, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, Paris F-75019, FranceAP-HPINSERM U1141, Laboratoire de Biochimie, Hôpital Robert Debré, 48 Boulevard Sérurier, Paris F-75019, FranceAP-HPExplorations Fonctionnelles Endocriniennes, Hôpital Armand Trousseau, Paris F-75012, FranceCentre d'Endocrinologie Pédiatrique14 Rue du Rempart St-Etienne, Toulouse F-31000, FrancePediatric Endocrinology UnitGaetano Rummo Hospital, Benevento 82100, ItalyPediatric Endocrinology UnitFederico II University, Naples 80131, ItalyService de Pédiatrie MultidisciplinaireCentre de Référence des Maladies Rares d'Origine Hypophysaire, Assistance Publique-Hopitaux de Marseille (APHM), Hôpital de la Timone, Aix-Marseille Université, Marseille F-13385, France AP-HPService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, Paris F-75019, FranceUniversité Paris DiderotSorbonne Paris Cité F-75019, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, Paris F-75019, FranceAP-HPINSERM U1141, Laboratoire de Biochimie, Hôpital Robert Debré, 48 Boulevard Sérurier, Paris F-75019, FranceAP-HPExplorations Fonctionnelles Endocriniennes, Hôpital Armand Trousseau, Paris F-75012, FranceCentre d'Endocrinologie Pédiatrique14 Rue du Rempart St-Etienne, Toulouse F-31000, FrancePediatric Endocrinology UnitGaetano Rummo Hospital, Benevento 82100, ItalyPediatric Endocrinology UnitFederico II University, Naples 80131, ItalyService de Pédiatrie MultidisciplinaireCentre de Référence des Maladies Rares d'Origine Hypophysaire, Assistance Publique-Hopitaux de Marseille (APHM), Hôpital de la T
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Castanet M, Goischke A, Léger J, Thalassinos C, Rodrigue D, Cabrol S, Zenaty D, al-Harbi M, Polak M, Czernichow P. Natural history and management of congenital hypothyroidism with in situ thyroid gland. Horm Res Paediatr 2015; 83:102-10. [PMID: 25634148 DOI: 10.1159/000362234] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 02/25/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/OBJECTIVE Normally sited glands account for increasing congenital hypothyroidism (CH). Mechanisms often remain unknown. To report the incidence of CH with in situ thyroid gland (ISTG) and describe the natural history of the disease without known etiology. METHOD Clinical, biochemical and imaging data at diagnosis were retrospectively analyzed in 285 children positively screened for CH in Ile-de-France between 2005 and 2008. If treatment was discontinued, management of hormonal substitution and follow-up of biochemical thyroid function was performed. RESULTS 93 full-term CH neonates displayed ISTG (40.6%), including 50 with unexplained mechanism. Follow-up data were available in 32 of them. Therapy was withdrawn from 20 children at a median age of 23.5 months (6-66), among whom 18 remained still untreated over a median duration of 15.3 months (4.4-29.6). In 11 children, levothyroxine (L-T4) dosage was increased over time to maintain biochemical euthyroidism. No statistical differences in initial TSH or FT4 levels, iodine status or birth weight were found between children with transient and permanent hypothyroidism. CONCLUSION Withdrawal of L-T4 substitution was feasible in 56.2% of full-term children with CH with ISTG but unexplained mechanism, emphasizing the need for systematic therapy withdrawal. However, further studies are warranted to standardize withdrawal protocol.
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Affiliation(s)
- Mireille Castanet
- Service d'Endocrinologie, Gynécologie et Diabétologie Pédiatrique, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
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19
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Harvengt J, Boizeau P, Chevenne D, Zenaty D, Paulsen A, Simon D, Guilmin Crepon S, Alberti C, Carel JC, Léger J. Triiodothyronine-predominant Graves' disease in childhood: detection and therapeutic implications. Eur J Endocrinol 2015; 172:715-23. [PMID: 25766047 DOI: 10.1530/eje-14-0959] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [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: 11/06/2014] [Accepted: 03/12/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To assess in a pediatric population, the clinical characteristics and management of triiodothyronine-predominant Graves' disease (T3-P-GD), a rare condition well known in adults, but not previously described in children. DESIGN We conducted a university hospital-based observational study. METHODS All patients with GD followed for more than 1 year between 2003 and 2013 (n=60) were included. T3-P-GD (group I) was defined as high free T3 (fT3) concentration (>8.0 pmol/l) associated with a normal free thyroxine (fT4) concentration and undetectable TSH more than 1 month after the initiation of antithyroid drug (ATD) treatment. Group II contained patients with classical GD without T3-P-GD. RESULTS Eight (13%) of the patients were found to have T3-P-GD, a median of 6.3 (3.0-10.5) months after initial diagnosis (n=4) or 2.8 (2.0-11.9) months after the first relapse after treatment discontinuation (n=4). At GD diagnosis, group I patients were more likely to be younger (6.8 (4.3-11.0) vs 10.7 (7.2-13.7) years) and had more severe disease than group II patients, with higher serum TSH receptor autoantibodies (TRAb) levels: 40 (31-69) vs 17 (8-25) IU/l, P<0.04, and with slightly higher serum fT4 (92 (64-99) vs 63 (44-83) pmol/l) and fT3 (31 (30-46) vs 25 (17-31) pmol/l) concentrations. During the 3 years following T3-P-GD diagnosis, a double dose of ATD was required and median serum fT4:fT3 ratio remained lower in group I than in group II. CONCLUSION Severe hyperthyroidism, with particularly high TRAb concentrations at diagnosis, may facilitate the identification of patients requiring regular serum fT3 determinations and potentially needing higher doses of ATD dosage during follow-up.
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Affiliation(s)
- Julie Harvengt
- Assistance Publique-Hôpitaux de ParisService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, F-75019 Paris, FranceINSERMCIC 1426, UMR 1123, Paris, FranceAssistance Publique-Hôpitaux de ParisService de Biochimie-HormonologieAssistance Publique-Hôpitaux de ParisUnité d'Épidémiologie Clinique, Hôpital Robert Debré, Paris, France
| | - Priscilla Boizeau
- Assistance Publique-Hôpitaux de ParisService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, F-75019 Paris, FranceINSERMCIC 1426, UMR 1123, Paris, FranceAssistance Publique-Hôpitaux de ParisService de Biochimie-HormonologieAssistance Publique-Hôpitaux de ParisUnité d'Épidémiologie Clinique, Hôpital Robert Debré, Paris, France Assistance Publique-Hôpitaux de ParisService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, F-75019 Paris, FranceINSERMCIC 1426, UMR 1123, Paris, FranceAssistance Publique-Hôpitaux de ParisService de Biochimie-HormonologieAssistance Publique-Hôpitaux de ParisUnité d'Épidémiologie Clinique, Hôpital Robert Debré, Paris, France
| | - Didier Chevenne
- Assistance Publique-Hôpitaux de ParisService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, F-75019 Paris, FranceINSERMCIC 1426, UMR 1123, Paris, FranceAssistance Publique-Hôpitaux de ParisService de Biochimie-HormonologieAssistance Publique-Hôpitaux de ParisUnité d'Épidémiologie Clinique, Hôpital Robert Debré, Paris, France
| | - Delphine Zenaty
- Assistance Publique-Hôpitaux de ParisService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, F-75019 Paris, FranceINSERMCIC 1426, UMR 1123, Paris, FranceAssistance Publique-Hôpitaux de ParisService de Biochimie-HormonologieAssistance Publique-Hôpitaux de ParisUnité d'Épidémiologie Clinique, Hôpital Robert Debré, Paris, France
| | - Anne Paulsen
- Assistance Publique-Hôpitaux de ParisService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, F-75019 Paris, FranceINSERMCIC 1426, UMR 1123, Paris, FranceAssistance Publique-Hôpitaux de ParisService de Biochimie-HormonologieAssistance Publique-Hôpitaux de ParisUnité d'Épidémiologie Clinique, Hôpital Robert Debré, Paris, France
| | - Dominique Simon
- Assistance Publique-Hôpitaux de ParisService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, F-75019 Paris, FranceINSERMCIC 1426, UMR 1123, Paris, FranceAssistance Publique-Hôpitaux de ParisService de Biochimie-HormonologieAssistance Publique-Hôpitaux de ParisUnité d'Épidémiologie Clinique, Hôpital Robert Debré, Paris, France
| | - Sophie Guilmin Crepon
- Assistance Publique-Hôpitaux de ParisService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, F-75019 Paris, FranceINSERMCIC 1426, UMR 1123, Paris, FranceAssistance Publique-Hôpitaux de ParisService de Biochimie-HormonologieAssistance Publique-Hôpitaux de ParisUnité d'Épidémiologie Clinique, Hôpital Robert Debré, Paris, France Assistance Publique-Hôpitaux de ParisService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, F-75019 Paris, FranceINSERMCIC 1426, UMR 1123, Paris, FranceAssistance Publique-Hôpitaux de ParisService de Biochimie-HormonologieAssistance Publique-Hôpitaux de ParisUnité d'Épidémiologie Clinique, Hôpital Robert Debré, Paris, France Assistance Publique-Hôpitaux de ParisService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, F-75019 Paris, FranceINSERMCIC 1426, UMR 1123, Paris, FranceAssistance Publique-Hôpitaux de ParisService de Biochimie-HormonologieAssistance Publique-Hôpitaux de ParisUnité d'Épidémiologie Clinique, Hôpital Robert Debré, Paris, France
| | - Corinne Alberti
- Assistance Publique-Hôpitaux de ParisService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, F-75019 Paris, FranceINSERMCIC 1426, UMR 1123, Paris, FranceAssistance Publique-Hôpitaux de ParisService de Biochimie-HormonologieAssistance Publique-Hôpitaux de ParisUnité d'Épidémiologie Clinique, Hôpital Robert Debré, Paris, France Assistance Publique-Hôpitaux de ParisService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, F-75019 Paris, FranceINSERMCIC 1426, UMR 1123, Paris, FranceAssistance Publique-Hôpitaux de ParisService de Biochimie-HormonologieAssistance Publique-Hôpitaux de ParisUnité d'Épidémiologie Clinique, Hôpital Robert Debré, Paris, France Assistance Publique-Hôpitaux de ParisService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, F-75019 Paris, FranceINSERMCIC 1426, UMR 1123, Paris, FranceAssistance Publique-Hôpitaux de ParisService de Biochimie-HormonologieAssistance Publique-Hôpitaux de ParisUnité d'Épidémiologie Clinique, Hôpital Robert Debré, Paris, France
| | - Jean-Claude Carel
- Assistance Publique-Hôpitaux de ParisService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, F-75019 Paris, FranceINSERMCIC 1426, UMR 1123, Paris, FranceAssistance Publique-Hôpitaux de ParisService de Biochimie-HormonologieAssistance Publique-Hôpitaux de ParisUnité d'Épidémiologie Clinique, Hôpital Robert Debré, Paris, France Assistance Publique-Hôpitaux de ParisService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, F-75019 Paris, FranceINSERMCIC 1426, UMR 1123, Paris, FranceAssistance Publique-Hôpitaux de ParisService de Biochimie-HormonologieAssistance Publique-Hôpitaux de ParisUnité d'Épidémiologie Clinique, Hôpital Robert Debré, Paris, France Assistance Publique-Hôpitaux de ParisService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, F-75019 Paris, FranceINSERMCIC 1426, UMR 1123, Paris, FranceAssistance Publique-Hôpitaux de ParisService de Biochimie-HormonologieAssistance Publique-Hôpitaux de ParisUnité d'Épidémiologie Clinique, Hôpital Robert Debré, Paris, France
| | - Juliane Léger
- Assistance Publique-Hôpitaux de ParisService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, F-75019 Paris, FranceINSERMCIC 1426, UMR 1123, Paris, FranceAssistance Publique-Hôpitaux de ParisService de Biochimie-HormonologieAssistance Publique-Hôpitaux de ParisUnité d'Épidémiologie Clinique, Hôpital Robert Debré, Paris, France Assistance Publique-Hôpitaux de ParisService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, F-75019 Paris, FranceINSERMCIC 1426, UMR 1123, Paris, FranceAssistance Publique-Hôpitaux de ParisService de Biochimie-HormonologieAssistance Publique-Hôpitaux de ParisUnité d'Épidémiologie Clinique, Hôpital Robert Debré, Paris, France Assistance Publique-Hôpitaux de ParisService d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, F-75019 Paris, FranceUniversité Paris DiderotSorbonne Paris Cité, F-75019 Paris, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM)Unité 1141, DHU Protect, F-75019 Paris, FranceINSERMCIC 1426, UMR 1123, Paris, FranceAssistance Publique-Hôpitaux de ParisService de Biochimie-HormonologieAssistance Publique-Hôpitaux de ParisUnité d'Épidémiologie Clinique, Hôpital Robert Debré, Paris, France
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Simon D, Mekhail N, Ba I, Paulsen A, Zenaty D, Houang M, Jesuran Perelroizen M, De Filippo G, Salerno M, Carel J, Leger J, de Roux N. CO-71 – Les mutations de MKRN3 sont souvent retrouvées dans les pubertés précoces idiopathiques familiales. Arch Pediatr 2015. [DOI: 10.1016/s0929-693x(15)30171-8] [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: 11/25/2022]
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Zenaty D, Léger J. Syndrome de Turner : apport d’un suivi de cohorte. Arch Pediatr 2013. [DOI: 10.1016/s0929-693x(13)71333-2] [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: 10/26/2022]
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Donadille B, Rousseau A, Zenaty D, Cabrol S, Courtillot C, Samara-Boustani D, Salenave S, Monnier-Cholley L, Meuleman C, Jondeau G, Iserin L, Duranteau L, Cabanes L, Bourcigaux N, Bonnet D, Bouchard P, Chanson P, Polak M, Touraine P, Lebouc Y, Carel JC, Léger J, Christin-Maitre S. Cardiovascular findings and management in Turner syndrome: insights from a French cohort. Eur J Endocrinol 2012; 167:517-22. [PMID: 22802424 DOI: 10.1530/eje-12-0434] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [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] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Congenital cardiovascular malformations and aortic dilatation are frequent in patients with Turner syndrome (TS). The objective of this study was to investigate the cardiovascular findings and management in a large cohort of patients, including children and adults. DESIGN/METHODS We recruited 336 patients with TS from a network of tertiary centers. We reviewed their files, checking for cardiovascular events, cardiac valve abnormalities, and aortic diameters indexed to body surface area (BSA) from magnetic resonance imaging (n=110) or echocardiography (n=300). RESULTS Informative cardiovascular data were available for only 233 patients. Vascular surgery was reported in 7.4% of the cohort. The first cause of surgery was aortic coarctation, detected in 6.9% at a median age of 9.5 (range: 0-60) years. Bicuspid aortic valve (BAV) was detected in 21% at a median age of 20 years (25th-75th percentiles: 15-30). At least one aortic diameter exceeded 32 mm in 12% of the cohort. This was detected at a median age of 19 (7-30) years. When indexed to BSA, at least one aortic diameter exceeded 20 mm/m(2) in 39% of the cohort. CONCLUSION Our study shows that cardiovascular monitoring for TS patients is currently insufficient in France. BAV is present at birth, but often remains undiagnosed until later in life. Therefore, improved management in cardiovascular monitoring is required and a more systematic approach should be taken.
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Affiliation(s)
- Bruno Donadille
- Department of Endocrinology, Centre de référence des Maladies Endocriniennes Rares de la Croissance (CMERC), Assistance Publique - Hôpitaux de Paris, Saint Antoine Hospital, 184 Rue du Faubourg Saint-Antoine, 75011 Paris, France.
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Zenaty D, Laurent M, Carel J, Léger J. Le syndrome de Turner : quoi de neuf dans la prise en charge ? Arch Pediatr 2011; 18:1343-7. [DOI: 10.1016/j.arcped.2011.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Revised: 09/09/2011] [Accepted: 09/13/2011] [Indexed: 01/15/2023]
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Philibert P, Paris F, Audran F, Kalfa N, Polak M, Thibaud E, Pinto G, Houang M, Zenaty D, Leger J, Mas JC, Pienkowski C, Einaudi S, Damiani D, Ten S, Sinha S, Poulat F, Sultan C. Phenotypic variation of SF1 gene mutations. Adv Exp Med Biol 2011; 707:67-72. [PMID: 21691958 DOI: 10.1007/978-1-4419-8002-1_16] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Pascal Philibert
- Service d'Hormonologie, Hôpital Lapeyronie, CHU Montpellier, Montpellier, France.
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Valtat B, Dupuis C, Zenaty D, Singh-Estivalet A, Tronche F, Bréant B, Blondeau B. Genetic evidence of the programming of beta cell mass and function by glucocorticoids in mice. Diabetologia 2011; 54:350-9. [PMID: 20857084 DOI: 10.1007/s00125-010-1898-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [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: 03/25/2010] [Accepted: 08/03/2010] [Indexed: 01/21/2023]
Abstract
AIMS/HYPOTHESIS Prenatal exposure to excess glucocorticoids associates with low birthweight in rodents, primates and humans and its involvement in programming glucose homeostasis is suspected. Our aim was to further dissect the role of glucocorticoids on beta cell development and function in mice. METHODS Using the model of maternal general food restriction during the last week of pregnancy, we thoroughly studied in the CD1 mouse-mothers and fetal and adult offspring--the pancreatic, metabolic and molecular consequences of maternal undernutrition associated with excess glucocorticoids. The specific involvement of the glucocorticoid receptor (GR) was studied in mutant fetuses lacking GR in pancreatic precursors or mature beta cells. RESULTS Maternal general food restriction in the mouse is associated with decreased maternal glucose and increased corticosterone levels. Fetuses from underfed dams had increased corticosterone levels, decreased pancreatic endocrine gene expression but increased exocrine gene expression and a lower beta cell mass. The offspring of these dams had a low birthweight, permanent postnatal growth retardation and, as adults, impaired glucose tolerance, decreased beta cell mass (-50%) and massively reduced islet expression (-80%) of most of the genes involved in beta cell function (e.g. Pdx1, Sur1 [also known as Abcc8], insulin). Moreover, using mutant fetuses lacking GR in pancreatic precursors or beta cells we show that the deleterious effect of undernutrition on fetal beta cell development requires the presence of the GR in pancreatic precursor cells. CONCLUSIONS/INTERPRETATION These results demonstrate the crucial role of excess fetal glucocorticoids and the importance of GR signalling in progenitor cells to programme beta cell mass and dysfunction.
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Affiliation(s)
- B Valtat
- INSERM UMR-S 872, Centre de Recherche des Cordeliers, 15 rue de l'Ecole de Médecine, 75006 Paris, France.
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Abstract
BACKGROUND Kallmann syndrome (KS) is a rare genetic disorder characterised by central hypogonadism with a lack of sense of smell and in some cases renal aplasia, deafness, syndactyly, cleft lip/palate, and dental agenesis. To date, five genes for KS have been identified: KAL1, located on the X chromosome, and FGFR1, PROKR2, PROK2 and FGF8, which are involved in autosomally transmitted forms of KS. AIM The study characterised the dental ageneses of individuals with KS associated with mutations in the FGFR1 gene. DESIGN Six individuals displaying dental agenesis were included. Clinical and radiological dental evaluations as well as medical anamneses were carried out. RESULTS Microdontia, screwdriver-shaped mandibular incisors, thin molar roots, and patterns of dental agenesis in both dentitions were observed. One to nine teeth were missing, most frequently, in descending order, lateral mandibular incisors, second premolars of upper and lower jaws, and lateral maxillary incisors. The pattern of dental agenesis is associated with four new mutations in the FGFR1 gene. CONCLUSION Dental agenesis may be a clinical feature of Kallmann syndrome caused by a mutation in the FGFR1 gene. These findings highlight the role that odontologists can play in the early diagnosis and treatment of gonadotropic deficiency.
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Affiliation(s)
- Isabelle Bailleul-Forestier
- Paediatric Dentistry, Garancière Hotel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Paris Diderot University, France
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Philibert P, Leprieur E, Zenaty D, Thibaud E, Polak M, Frances AM, Lespinasse J, Raingeard I, Servant N, Audran F, Paris F, Sultan C. Steroidogenic factor-1 (SF-1) gene mutation as a frequent cause of primary amenorrhea in 46,XY female adolescents with low testosterone concentration. Reprod Biol Endocrinol 2010; 8:28. [PMID: 20302644 PMCID: PMC2848664 DOI: 10.1186/1477-7827-8-28] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2010] [Accepted: 03/19/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Primary amenorrhea due to 46,XY disorders of sex differentiation (DSD) is a frequent reason for consultation in endocrine and gynecology clinics. Among the genetic causes of low-testosterone primary amenorrhea due to 46,XY DSD, SRY gene is reported to be frequently involved, but other genes, such as SF1 and WT1, have never been studied for their prevalence. METHODS We directly sequenced SRY, SF1 and WT1 genes in 15 adolescent girls with primary amenorrhea, low testosterone concentration, and XY karyotype, to determine the prevalence of mutations. We also analyzed the LH receptor gene in patients with high LH and normal FSH concentrations. RESULTS Among the 15 adolescents with primary amenorrhea and low testosterone concentration, we identified two new SRY mutations, five new SF1 mutations and one new LH receptor gene mutation. Our study confirms the 10-15% prevalence of SRY mutations and shows the high prevalence (33%) of SF1 abnormalities in primary amenorrhea due to 46,XY DSD with low plasma testosterone concentration. CONCLUSIONS The genetic analysis of low-testosterone primary amenorrhea is complex as several factors may be involved. This work underlines the need to systematically analyze the SF1 sequence in girls with primary amenorrhea due to 46,XY DSD and low testosterone, as well as in newborns with 46,XY DSD.
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Affiliation(s)
- Pascal Philibert
- Service d'Hormonologie, Hôpital Lapeyronie, CHU Montpellier, and Université Montpellier 1, France
| | - Elodie Leprieur
- Service d'Hormonologie, Hôpital Lapeyronie, CHU Montpellier, and Université Montpellier 1, France
- Unité d'Endocrinologie et Gynécologie Pédiatrique, Hôpital Arnaud de Villeneuve, CHU Montpellier, and Université Montpellier 1, France
| | - Delphine Zenaty
- Service de Pédiatrie, Hôpital Robert Debré, AP-HP, Paris, France
| | - Elisabeth Thibaud
- Service d'Endocrinologie et Gynécologie de l'Enfant, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
| | - Michel Polak
- Service d'Endocrinologie et Gynécologie de l'Enfant, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
| | - Anne-Marie Frances
- Service de Génétique Médicale, Hôpital Intercommunal de Toulon-La Seyne sur Mer, Toulon, France
| | | | | | - Nadège Servant
- Service d'Hormonologie, Hôpital Lapeyronie, CHU Montpellier, and Université Montpellier 1, France
| | - Françoise Audran
- Service d'Hormonologie, Hôpital Lapeyronie, CHU Montpellier, and Université Montpellier 1, France
| | - Françoise Paris
- Service d'Hormonologie, Hôpital Lapeyronie, CHU Montpellier, and Université Montpellier 1, France
- Unité d'Endocrinologie et Gynécologie Pédiatrique, Hôpital Arnaud de Villeneuve, CHU Montpellier, and Université Montpellier 1, France
| | - Charles Sultan
- Service d'Hormonologie, Hôpital Lapeyronie, CHU Montpellier, and Université Montpellier 1, France
- Unité d'Endocrinologie et Gynécologie Pédiatrique, Hôpital Arnaud de Villeneuve, CHU Montpellier, and Université Montpellier 1, France
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Zenaty D, Aigrain Y, Peuchmaur M, Philippe-Chomette P, Baumann C, Cornelis F, Hugot JP, Chevenne D, Barbu V, Guillausseau PJ, Schlumberger M, Carel JC, Travagli JP, Léger J. Medullary thyroid carcinoma identified within the first year of life in children with hereditary multiple endocrine neoplasia type 2A (codon 634) and 2B. Eur J Endocrinol 2009; 160:807-13. [PMID: 19240193 DOI: 10.1530/eje-08-0854] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [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] [Indexed: 12/18/2022]
Abstract
CONTEXT Early prophylactic thyroidectomy in patients with multiple endocrine neoplasia (MEN) type 2 offers the best chance for a normal life expectancy. OBJECTIVE To analyze the results of thyroidectomy performed during the first year of life in six patients with MEN 2A (codon 634) or MEN 2B (codon 918) syndrome. DESIGN AND SETTING A university hospital-based prospective study from 2001 to 2008. SUBJECTS AND METHODS Six family members affected either by MEN 2A (n=3) or MEN 2B (n=3) syndrome were identified through neonatal genetic screening. RESULTS Total thyroidectomy was performed at a median age of 0.8 year in the six patients, with central lymph node dissection in five. Bilateral millimetric medullary thyroid carcinoma (MTC) was found in all patients, with a unilateral lymph node micrometastasis in two of the three MEN 2B patients. Before thyroidectomy, MEN 2B patients had much higher basal serum calcitonin levels than those with MEN 2A and controls. After thyroidectomy, with a median follow-up of 3.3 years, the six patients had no evidence of persistent MTC. CONCLUSION Bilateral millimetric MTC may be present during the first year of life in these patients, with lymph node metastases also occurring in MEN 2B patients. These results support a total thyroidectomy at the age of about one year in MEN 2A (codon 634) children with an abnormal serum calcitonin level, and a total thyroidectomy with central neck dissection within the first weeks of life in MEN 2B patients.
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Affiliation(s)
- D Zenaty
- Paediatric Endocrinology Department, Centre de Référence Maladies Endocriniennes Rares de la Croissance Paediatric Surgery Department Pathology, Assistance Publique-Hôpitaux de Paris, Robert Debré Hospital, 75019 Paris, France
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Carel JC, Zenaty D, Paulsen A, Simon D, Léger J. [Precocious pubertal]. Rev Prat 2008; 58:1317-1323. [PMID: 18714652] [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] [Indexed: 05/26/2023]
Abstract
Precocious pubertal is frequent and should lead to a rigorous evaluation. It is important to precisely evaluate the timing of pubertal development, and to search for an hypothalamic lesion in cases of central precocious puberty. It is also important to recognize that many cases of precocious puberty will not progress and therefore do not need treatment. When central precocious puberty has been confirmed, GnRH agonists should be considered. Management issues, as well as long term results of these treatments are presented.
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Affiliation(s)
- Jean-Claude Carel
- Service d'endocrinologie-diabétologie pédiatrique, centre de référence des maladies endocriniennes rares de la croissance, hôpital Robert-Debré, Université Paris-Diderot Paris-7, 75935 Paris Cedex 19, France.
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Philibert P, Zenaty D, Lin L, Soskin S, Audran F, Léger J, Achermann JC, Sultan C. Mutational analysis of steroidogenic factor 1 (NR5a1) in 24 boys with bilateral anorchia: a French collaborative study. Hum Reprod 2007; 22:3255-61. [PMID: 17940071 PMCID: PMC2990861 DOI: 10.1093/humrep/dem278] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.1] [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] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Steroidogenic factor 1 (SF1/AdBP4/FTZF1, NR5A1) is a nuclear receptor transcription factor that plays a key role in regulating adrenal and gonadal development, steroidogenesis and reproduction. Recently, haploinsufficiency of SF1 has been described in several 46,XY individuals with mild gonadal dysgenesis and impaired androgenization, but normal adrenal function, suggesting that dosage-sensitive or domain-specific effects of SF1 action are important in human testicular development and function. Our objective was to investigate whether partial defects in SF1 function might be associated with milder male reproductive phenotypes, such as bilateral anorchia ('vanishing testis syndrome') and micropenis. METHODS This study involved mutational analysis of NR5A1 in 24 individuals with bilateral anorchia and micropenis from the French Collaborative Anorchia study, as well as in vitro functional studies of SF1-dependent transcriptional activation and computer modeling. RESULTS A novel heterozygous missense mutation (V355M) in SF1 was found in one boy with a micropenis and testicular regression syndrome. This non-synonymous change was found to affect a highly conserved amino acid within helix 7 of the ligand-binding domain of SF1. This V355M mutation did not affect stability or nuclear localization, but did result in an approximately 50% reduction in SF1 activity in several different assay systems. CONCLUSIONS In conclusion, heterozygous partial loss of function mutations in SF1 may be associated with bilateral anorchia ('vanishing testis syndrome') and micropenis in humans.
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Affiliation(s)
- Pascal Philibert
- Service d’Hormonologie, Hôpital Lapeyronie, CHU Montpellier, 34295 Montpellier cedex 5, France
| | - Delphine Zenaty
- Service d’Endocrinologie Pédiatrique, Hôpital Robert Debré, AP-HP, 75935 Paris, France
| | - Lin Lin
- Developmental Endocrinology Research Group, Clinical and Molecular Genetics, UCL Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Sylvie Soskin
- Service de Pédiatrie I, Unité d’Endocrinologie, Hôpitaux Universitaires de Strasbourg, 67200 Strasbourg, France
| | - Françoise Audran
- Service d’Hormonologie, Hôpital Lapeyronie, CHU Montpellier, 34295 Montpellier cedex 5, France
| | - Juliane Léger
- Service d’Endocrinologie Pédiatrique, Hôpital Robert Debré, AP-HP, 75935 Paris, France
| | - John C. Achermann
- Developmental Endocrinology Research Group, Clinical and Molecular Genetics, UCL Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Charles Sultan
- Service d’Hormonologie, Hôpital Lapeyronie, CHU Montpellier, 34295 Montpellier cedex 5, France
- Unité d’Endocrinologie Pédiatrique (C.S.), Hôpital Arnaud de Villeneuve, CHU Montpellier, 34295 Montpellier, France
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Zenaty D, Dijoud F, Morel Y, Cabrol S, Mouriquand P, Nicolino M, Bouvatier C, Pinto G, Lecointre C, Pienkowski C, Soskin S, Bost M, Bertrand AM, El-Ghoneimi A, Nihoul-Fekete C, Léger J. Bilateral anorchia in infancy: occurence of micropenis and the effect of testosterone treatment. J Pediatr 2006; 149:687-91. [PMID: 17095345 DOI: 10.1016/j.jpeds.2006.07.044] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [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: 01/03/2006] [Revised: 05/05/2006] [Accepted: 07/25/2006] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To analyze the clinical and histological findings in boys with bilateral anorchia and the response to testosterone treatment on penis length. STUDY DESIGN Patients were divided into two groups according to the absence (group A, n = 29) or the presence (group B, n = 26) of palpable intrascrotal or inguinal mass at first clinical examination. RESULTS A micropenis was found in 46% of patients (n = 24) with a similar proportion in both groups. Testosterone treatment induced a mean penis length gain of 1.9 +/- 1.3 SDS (standard deviation score). However, micropenis persisted in six patients. Histological examination (n = 18) confirmed the absence of any testicular structure with deferent ducts being present unilaterally or bilaterally in all but three patients. In these three patients, a hemorrhagic testis, probably as a result of a mechanical torsion, was found. CONCLUSIONS The presence of isolated micropenis in almost half of patients with bilateral anorchia strongly suggests that the testicular damage frequently occurs during the second half of gestation after male sexual differentiation. In most cases, testosterone treatment stimulates the penile growth. Although the pathogenesis of bilateral anorchia may be heterogeneous, our study suggests that gonads may have been functionally abnormal before they disappeared, and suggests that some patients have an intrinsic endocrine disorder.
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Affiliation(s)
- D Zenaty
- Assistance Publique-Hôpitaux de Paris, Robert Debré Hospital, Paediatric Endocrinology Unit and Inserm U457, Paris, France
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Zenaty D, Bretones P, Lambe C, Guemas I, David M, Léger J, de Roux N. Paediatric phenotype of Kallmann syndrome due to mutations of fibroblast growth factor receptor 1 (FGFR1). Mol Cell Endocrinol 2006; 254-255:78-83. [PMID: 16757108 DOI: 10.1016/j.mce.2006.04.006] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [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] [Indexed: 11/28/2022]
Abstract
Kallmann syndrome characterised by hypogonadotropic hypogonadism (HH) and anosmia is genetically heterogeneous with X-linked, autosomal dominant and autosomal recessive forms. The autosomal dominant form due to loss of function mutation in the fibroblast growth factor receptor 1 (FGFR1) accounts for about 10% of cases. We report here three paediatric cases of Kallmann syndrome with unusual phenotype in two unrelated patients with severe ear anomalies (hypoplasia or agenesis of external ear) associated with classical features, such as cleft palate, dental agenesis, syndactylia, micropenis and cryptorchidism. We found de novo mutation in these two patients (Cys178Ser and Arg622Gly, respectively), and one inherited Arg622Gln mutation with intrafamilial variable phenotype. These genotype-phenotype correlations indicate that paediatric phenotypic expression of FGFR1 loss of function mutations is highly variable, the severity of the oro-facial malformations at birth does not predict gonadotropic function at the puberty and that de novo mutations of FGFR1 are relatively frequent.
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Affiliation(s)
- Delphine Zenaty
- Assistance Publique Hôpitaux de Paris, Robert Debre Hospital Paediatric Endocrinology unit, Robert Debré Hospital, Paris, France
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Zenaty D, Garel C, Limoni C, Czernichow P, Léger J. Presence of magnetic resonance imaging abnormalities of the hypothalamic-pituitary axis is a significant determinant of the first 3 years growth response to human growth hormone treatment in prepubertal children with nonacquired growth hormone deficiency. Clin Endocrinol (Oxf) 2003; 58:647-52. [PMID: 12699449] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
OBJECTIVE The factors influencing the highly variable growth response to GH treatment in GH-deficient children are not fully understood. Despite a real benefit with GH treatment in term of growth response, most of these patients attain a mean adult height below their target height and the strategy to optimise final height has to be improved. The aim of this study was to investigate whether the presence of congenital abnormalities of the hypothalamic-pituitary axis on magnetic resonance imaging (MRI) could be a determinant of the growth response in nonacquired prepubertal GH-deficient children, and to identify which pretreatment variables most significantly affect the first 3 years growth response to human GH (hGH) therapy. PATIENTS AND METHODS The growth response to hGH treatment (0.55 +/- 0.1 IU/kg/week) was evaluated in 69 prepubertal children with nonacquired GH deficiency, according to the absence (group A: chronological age = 4.8 +/- 2.4 years, n= 37) or the presence (group B: chronological age = 3.4 +/- 2.7 years, n= 32) of developmental abnormalities on cerebral magnetic imaging and, after controlling for GH dose, age, height, height velocity (SDS) and body mass index at start of treatment, maximum stimulated GH peak concentration, GH deficiency type (isolated vs. multiple deficiency), parental height, size at birth and sex. RESULTS After 3 years of treatment, the mean height gain was significantly higher in patients of group B vs. group A (2.2 +/- 1.3 vs. 1.6 +/- 1 SDS; P < 0.05). In a multiple regression analysis, age (r2 = 0.19, negatively correlated), pretreatment height velocity (r2 = 0.11, negatively correlated), GH dose (r2 = 0.05, positively correlated) and presence of magnetic resonance imaging developmental abnormalities (r2 = 0.05, positively correlated) were found to significantly explain 40% of the variability in growth response. CONCLUSIONS The detection of congenital abnormalities in the hypothalamic-pituitary area on MRI is more important than the level of maximum stimulated GH to predict the growth response to hGH treatment in prepubertal nonacquired GH-deficient children. Although the persistence of GH deficiency remains to be confirmed during follow-up by reassessment of GH secretion in isolated GH-deficient patients with normal MRI findings, further studies are needed to evaluate whether an increased hGH dose in these patients could improve long-term growth response.
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Affiliation(s)
- Delphine Zenaty
- Paediatric Endocrinology Unit, Radiology Department, Paris, France
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Perreaux F, Zenaty D, Capron F, Trioche P, Odièvre M, Labrune P. Azathioprine-induced lung toxicity and efficacy of cyclosporin A in a young girl with type 2 autoimmune hepatitis. J Pediatr Gastroenterol Nutr 2000; 31:190-2. [PMID: 10941975 DOI: 10.1097/00005176-200008000-00020] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [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] [Indexed: 12/29/2022]
Affiliation(s)
- F Perreaux
- Service de Pédiatrie, Hôpital Antoine Béclère, Clamart, France
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Perreaux F, Zenaty D, Trioche P, Capron F, Keros L, Odièvre M, Labrune P. Pneumopathie d'hypersensiblité à l'azathioprine et efficacité du traitement par la ciclosporine a chez une jeune fille ayant une hepatite chronique active auto-immune. Arch Pediatr 1999. [DOI: 10.1016/s0929-693x(99)80552-1] [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: 11/30/2022]
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