ESPE Abstracts

Background: Osteogenesis imperfecta (OI) is a genetic disorder mostly associated with mutation in one of the two genes encoding a chains of collagen type 1 (COL1A1 and COL1A2). Severity of the symptoms varies widely, caused by increase bone fragility and low bone mass. However, there is no direct relation reported in osteogenesis imperfecta and panhypopituitarism.Clinical case: Nineteen months old boy was clinically diagnosed with osteogenesis i...

Background: Growth hormone plays a primary role in stimulating postnatal growth by way of insulin-like growth factor 1 (IGF1) which is produced in the liver in response to GH. A deficiency of GH arrests maturation during childhood, and the stature of such subjects is generally much shorter than the average stature. However, some cases of GH deficiency attain normal stature as adults.Case presentation: A 20 years old man was referred for a further evaluat...

Common cause of hypopituitarism is congenital, genetically determined abnormality called pituitary stalk interruption syndrome (PSIS). It is characterised by hypoplastic anterior pituitary gland with thin or absent infundibulum and ectopic posterior pituitary location in MRI examination. Post-traumatic hypopituitarism may mimic this image. We present 7 years and 10 months old girl who was admitted to Pediatrics Institute due to hypoglycemia during an acute gastroenteritis. Hyp...

Background: Nonsurgical development of nasal cerebrospinal fluid (CSF) leaks may occur in the setting of pituitary adenomas, especially following a favorable response of invasive prolactinomas to initiation of Dopamine Agonist (DA) therapy, but this has not previously described in children.Case description: A girl of Srilankan origin, aged 13.8 years, whose parents spoke no English, presented with headaches and secondary amenorrhea. Pituitary MRI reveale...

Background: Septo-optic dysplasia (SOD) is a congenital affection characterized by classic triade: optic nerve hypoplasia, hypothalamic-pituitary endocrine deficits and mdline abnormalities of the brain. It is typically diagnosed in infancy and has a variable presentation.Case presentation: The patient is an 5 year old Algerian girl. At birth, bilateral congenital nystagmus and strabism was noted? Right blindness was suspected by parents at age of 2 year...

Background: Children under 25 diagnosed with neuroendocrine tumors often suffer from Malnutrition which raises the risk of infections. Being immunocompromised, there is a marked reduction on quality of life (QoL) and health outcome. Malnutrition also enhances the incidence of postoperative complications such as delayed wound healing, wound dehiscence, morbidities and mortalities.Aims: To investigate malnutrition among children diagnose with neuroendocrin...

Introduction: Central Diabetes Insipitus (CDI) results from the inability to secrete ADH secreted by the neurohypophysis system to control water-electrolyte metabolism. In the etiology of CDI many congenital and acquired CNS tumors, infiltrative diseases,infections, autoimmune events, head trauma and idiopathic can be responsible. In this article, a child case with CDI due to intracranial occurence which is very rare in etiology is presented and the approach and follow up are ...

We report the case of a female newborn, first child of healthy, non-consanguineous parents, born at 42+0 weeks of gestation, who was admitted 21 h after birth with severe hypoglycemia, hypothermia, decreased muscle tone, inspiratory stridor and edema. The course included poor feeding and failure to thrive, hyperbilirubinemia and cholestasis. Infectious or metabolic diseases were ruled out by clinical and laboratory investigations. Hormonal evaluation confirmed the diagnosis of...

Background: Hypothalamic-pituitary (HP) deficiencies are frequent in childhood brain tumor survivors (CBTS) after cranial radiation. There is currently no consensus on the most optimal way to screen for HP dysfunction regarding diagnostic tests or time interval. It is not known whether MRI changes in time in the HP-region or in brain volume are predictive of HP dysfunction.Aim: To quantify changes in the HP-region and in brain volume on MRI in CBTS after...

GR and GT are diamniotic monochorial preterm twins (32 GA), both AGA (GR: W -1 SDS, L -1.5 SDS; GT: W and L 0 SDS), with normal karyotype and array-CGH on amniotic fluid, with no major complications associated to prematurity. At birth GT presented bilaterally cryptorchidism associated with micropenis, GR presented normal male genitalia. In the first year of life a severe growth deceleration in length (from -3SDS to -5 SDS) was observed, mainly after six months of life in both ...

Background: Arteriovenous malformations (AVMs) are rare in kids, estimated to represent 3% of all AVMs. They tend to rupture more frequently than in adults and, usually, are brought to attention after rupture, as the most common non-traumatic intracerebral hemorrhage. AVMs could also present with recurrent seizures or headaches. Their optimal management remains controversial.Case report: We present the case of a 4.5 y old boy, presented in our department...

Introduction: Hypothyroidism without treatment usually leads to delayed puberty in pediatric patients, sometimes it may rarely lead Van Wyk Grumbach syndrome (VWGS) which is characterized by isosexual precocious puberty. Exact mechanism of VWSG is unknown. High thyroid stimulating hormone (TSH) levels may directly effect on follicular stimulating hormone (FSH) receptors and lead precocious puberty. Interestingly simple thyroid hormone replacement therapy resolves symptoms in t...

Background & objective: The occurrence of CPP seems to be increasing in our clinical practice thesedays. It is known that CPP causes socio-psychological disturbances relating to early pubertal changes and finally leads to a significant decrease in the final adult height because of premature closure of the growth plate. This study was conducted to see major factors affecting to the bone maturation, which is closely related to the final adult height in girls with CPP.<p ...

Aim: Premature pubarche is defined as the start of axillary and pubic hair before age 9 in boys and 8 in girls. 10 times more common in girls than boys. Central precocious puberty is a condition due to early activation of hypothalamic-pituitary- gonadal axis associated with breast development before age 8 in girls and testicular volume growth before age 9 in boys. Despite this axle is not known exactly which hormones are respnsible for the activation, the role of kisspeptin&#1...

McCune-Albright Syndrome is a rare genetic disorder characterized by triad of polyostotic fibrous dysplasia of bone, precocious puberty and café au lait skin pigmentation. It is resulted from an activating mutation in the GNAS gene encoding the alpha subunitof stimulatory G protein. Here we present two cases with McCune Albright syndrome presenting with different clinical findings.Case 1: A 7-year and 6 month-old girl presented with breast ...

Background: McCune-Albright syndrome (MAS) is a rare, heterogenous, clinical condition caused by a rare genetic mutation. The disorder is more common in females and is characterized by a triad of cutaneous, bone and endocrine abnormalities.Case Presentation: We report a girl with MAS, presenting initially with vaginal bleeding at the age of 12 months. Ultrasonography revealed bilateral ovarian cysts and ureteral and ovarian enlargement. Bone age rapidly ...

Introduction and Aim: Pubertal gynecomastia is the transient proliferation of glandular tissue in breasts of men without any endocrin pathology. Relatively higher levels of estrogen than plasma testosteron levels and imbalance between tissue estrogen and testosteron levels are considered to be important in pathogenesis. In this study it is aimed to determine the clinical and laboratory properties of our patients who were diagnosed as pubertal gynecomastia and compare with heal...

Background: Langerhans cell histiocytosis (LCH) is a rare disease with an incidence of less than 10 per million, and characterized by the clonal proliferation of pathogenic Langerhans cells. The clinical courses are diverse, ranging from spontaneously remitting single organ disease to life-threatening multisystem involvement. One of the serious complications of LCH is diabetes insipidus (DI), and patients with CNS-risk lesions had higher cumulative incidence of DI. On the othe...

Precocious puberty is defined by the development of secondary sexual characteristics before the age of 8 in girls and before the age of 9 in boys. If not diagnosed and treated at an early stage, precocious puberty can compromise final adult height and trigger psychological disturbances. Gonadotropin- releasing hormone analogs (GnRHa) contributes to achievement of target final height by reducing the acceleration of bone maturation.Objectives: To analyze c...

Background: The current standard method to diagnose central precocious puberty(CPP) is gonadotropin releasing hormone stimulation test (GnRHST). But, it is inconvenient for children because of time-consuming and multiple samples. This study aimed to present utility of morning basal luteinizing hormone (LH) for the screening of central precocious puberty with emphasis on the influence of diurnal variation.Methods: This study is a retrospective review of 1...

Epiphysis inhibits formation and secretion of the most pituitary hormones and at the first turn gonadotropins. Frequency of epiphysis tumors, pinealomas in children is 2.5% of all verified tumors of brain. 75% of epiphysis tumors are malignant. Endocrinological disturbances can be the first signs of pinealoma. In 10% cases there is precocious puberty syndrome. A 2.5 year-old boy presented to the endocrinology department with an 16-month history of accelerated physical developm...

Presentation of case: A 3-year-old boy with central precocious puberty as a result of the organic lesion of brain (hamartoma of hypotalamus). Complains.Increased height velocity, masculinization, fast growth of external genitalia, frequent erections, acne, low voice. Medical history. The baby was born with weight 3400 g. The age of the mother at birth of the child was 23 years. The breast feeding 6 months. In the age of 24 months boy started to grow very fastly. In the age of ...

Ectopic hormone products are typical for cancerous cells. Cancerous cells can produce ACTH, lipotropin, alfa-melanocytostimulating hormone, beta-endorfin, vasopressin, oxytocin, insuline, glucagon, gastrin, secretin, VIP, calcitonin, hypothalamic releasing-hormones, prolactin, parathyroid hormone, growth hormone, chorionic gonadotropin, growth factors. In the majority of ectopic hormone-producing tumor cases clinical symptoms are absent. This is explained by the fact that tumo...

Aims: To describe a case of premature adrenarche with pseudohypoparathyroidism, an as yet unreported combination.Case: An otherwise well 8 year old girl presented to a Paediatric Endocrine Clinic with early pubic hair development suggestive of Premature Adrenarche. Blood tests revealed hypocalcaemia, elevated phosphate and highly elevated parathyroid hormone (PTH) level, giving a biochemical diagnosis of pseudohypoparathyroidism. She had normal stature (...

Objective: To evaluate the effect of Ziyin Xiehuo granules (ZYXH) and Zishen Qinggan granules (ZQ7G) on partial precocious puberty (PPP).Methods: The present study was a multicenter, randomized, single-blinded, positive-controlled trial. A total of 143 patients were assigned to either the ZYXH group or the ZQ7G group using a random number table. The ZYXH group received ZYXH three times daily for 6 months, while the ZQ7G group received ZQ7G three times da...

Introduction: Glucagon-like peptide 1 (GLP-1) receptor agonists have been successfully used in adults with hypothalamic obesity, showing a BMI decrease and metabolic profile improvement. Data on GLP-1 receptor agonist treatment for children and adolescents is limited. Herein, we present a clinical case of a male adolescent treated with GLP-1 receptor agonist for hypothalamic obesity, secondary to craniopharyngioma.Case report: A 15.8 year-old boy (Height...

Poland’s syndrome is characterised by unilateral absence or hypoplasia of the pectoralis muscle, associated with the ipsilateral malformation of the hand. The syndrome is usually sporadic and occurs in about 1:32.000 live births. Poland’s syndrome has been described associated with other abnormalities, including renal aplasia or hypoplasia, hemivertebra, Klippel-Feil syndrome and Moebius’ syndrome. In literature are reported six cases of Moebius syndrome associa...

Background: Abnormalities of cervical spine have been described in association with pituitary anomalies in the context of malformative syndromes with midline defects. Several genes are involved in the control of pituitary gland development, differentiation and function. In particular, the presence of os odontoideum has been reported in one case of pituitary hypoplasia, associated with leg anomalies, renal dysplasia and no aberrations of the BMP4, BMP2 and PTX1 genes. In anothe...

Introduction: Premature thelarche is considered a benign condition of breast development in prepubertal girls. It usually resolves after a certain period of time.Materials and methods: A 1.5 year old girl was referred to the pediatric Endocrinology department due to breast development which appeared two months prior to the visit.Results: Upon clinical examination the patient had Tanner breast stage M2-3 bilaterally, but otherwise a...

Introduction: Micromastia or breast hypoplasia is a condition which is described as postpubertal underdevelopment of a woman’s mammary tissue. Breast hypoplasia may be congenital or acquired. The defect can be isolated or associated with other pathology, including syndromes and chest wall anomalies, it can also be unilateral or bilateral. Unilateral congenital breast hypoplasia is a rare anomaly of breast development, whose incidence is unclear.Meth...

Background: Klinefelter Syndrome (KS) is the most common sex chromosome disorder in males caused by additional X chromosome. It is characterized by progressive testicular failure. KS patient usually have complete male sexual differentiation without genital ambiguity. The prevalence of KS is 1 in 660 males which only 10% are detected before or during puberty, and about two third so fall men with X-chromosome polyploidies fail to be identified during their lifetime.<p class=...

Background: Suppression of hypothalamic-pituitary-gonadal system activity by luliberin analogues in premature sexual development of the central genesis is accompanied by a decrease in growth’s velocity, sexual development and progression of bone age.Aim: Study of the effectiveness of gonadotropin-releasing hormone agonist therapy, their influence on the physical developmentMethods: 66 patients were treated by triptorelin. Idio...

Background: Central Precocious Puberty (CPP) may be lead to consequences such as limitation adult stature, sexual abuse, and emotional distress. GnRH agonist therapy in patients with CPP has been demonstrated in increasing adult height and improving emotional distress in puberty stage.Objective: Evaluating the efficacy of treatment in patients with central precocious puberty after one year in Children Hospital 2, Vietnam in 7 years, from 01/2017 to 12/20...

Objectives: To describe the characteristics of central precocious puberty in patients at Children’s Hospital 2, Vietnam from 1/2010 to 12/2016.Method: Cross – sectional analysis.Results: There were 504 cases of central precocious puberty. The mean age was 7.6±1.4 years old; most of them were females (females/males: 71/1). The rate of overweight or obesity was 52.4%, accelerated height was recorded in 64.2%. The most ...

Introduction: Telemedicine, or the use of CIT (Communication and Information Technology) to deliver and/or share medical remote assistance and knowledge, is of paramount importance, mainly in large countries, with social and economic disparities, as Brazil, by means of teleconferences, webconferences, webcasts and use of a wide range of interactive technologies, helping activities of assistance and professional health education. One of the activities provided by our RUTE (Univ...

Background: Prolactin (PRL) stimulates mammary glands and milk production in adult women. Also, high PRL level causes gonadal dysfunction by suppression of gonadotropin releasing hormone (GnRH) and luteinizing hormone (LH).Purpose: The aim of this study was to evaluate, if any, the relationship between PRL level and development of puberty in girls with precocious breast development.Methods: One hundred and ten girls with onset of b...

Background: Sotos syndrome is a rare syndrome; with distinctive clinical findings include typical facial appearance, learning disability; and overgrowth. Advanced bone age can be detected in some cases while precocious puberty reported only in two cases until now.Case: A 6,5 months of age male infant admitted to clinic with neuromotor delay and macrogenitalia. He was second child of unrelated healthy parents, and birth-weight was 4200 g. In physical exa...

Objective: To describe six cases of possible partial ectopic posterior pituitary gland (PEPP) seen on head magnetic resonance imaging (MRI) and their associated clinical and endocrinological manifestations.Methods: This is a single-center case series, from a tertiary public university health center in Montreal, Canada. Cases of children with possible PEPP were selected prospectively from 2005 to 2017, based on head MRI findings. Medical history, exam fi...