ESPE Abstracts (2018) 89 S3.1

Diagnosis and Management of Silver-Russell Syndrome: First International Consensus Statement

Irene Netchine


Hôpital Trousseau, INSERM U938, Sorbonne Université, Paris, France


The first Consensus Statement on Silver Russell Syndrome has been held in 2015, on behalf of the COST Action BM1208 (European Network for Human Congenital Imprinting Disorders, http://www.imprinting-disorders.eu), ESPE, PES, APPES and SLEP with the participation of five representatives from a parent support group from different countries. It has been published in 2016 (https://www.nature.com/articles/nrendo.2016.138). For dissimination, a patient « friendly » document has been generated and has been or will shortly be translated into seven languages.This consensus summarizes recommendations for clinical diagnosis, investigation and management of patients with Silver–Russell syndrome, an imprinting disorder that causes prenatal and postnatal growth retardation. Considerable overlap exists between the care of individuals born small for gestational age and those with SRS. However, many specific management issues exist and evidence from controlled trials remains limited. SRS is primarily a clinical diagnosis; however, molecular testing enables confirmation of the clinical diagnosis and defines the subtype. A ‘normal’ result from a molecular test does not exclude the diagnosis of SRS. The management of children with SRS requires an experienced, multidisciplinary approach. Specific issues include growth failure, severe feeding difficulties, gastrointestinal problems, hypoglycaemia, body asymmetry, scoliosis, motor and speech delay and psychosocial challenges. An early emphasis on adequate nutritional status is important, with awareness that rapid postnatal weight gain might lead to subsequent increased risk of metabolic disorders. The benefits of treating patients with SRS with growth hormone include improved body composition, motor development and appetite, reduced risk of hypoglycaemia and increased height. Clinicians should be aware of possible premature adrenarche, fairly early and rapid central puberty and insulin resistance. Treatment with gonadotropin-releasing hormone analogues can delay progression of central puberty and preserve adult height potential. Long-term follow up is essential to determine the natural history and optimal management in adulthood.

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