ESPE Abstracts

Introduction: Nephroblastoma or Wilms tumor is the most common pediatric abdominal malignancy. Typically, it is found in children younger than 5 years old, girls being more likely to have Wilms tumor than boys. The etiology of the disease is genetic, due to alteration in the development of the genitourinary tract.[1] Treatment is represented by surgery (unilateral nephrectomy), chemo- and radio-therapy. Paraneoplastic endocrine disorders may occur, but there a...

Background: Congenital hypopituitarism (CH) is a group of disorders characterized by deficiencies in one or more hypophyseal hormones and a marked variability in genotype-phenotype correlations. Central diabetes insipidus (DI) is caused by a decreased release of ADH and results in a variable degree of polyuria. Their association is normally found in congenital cerebral midline abnormalities, such as septo-optic dysplasia.Objectiv...

Objective: To analyze the clinical characteristics and treatment of non-germinomatous germ cell tumor (NGGCT) in one girl with the initial onset of homosexual peripheral precocious puberty (PPP) and central diabetes insipidus (CDI) and eventually progressed into central precocious puberty (CPP).Methods: The clinical data of a girl who was diagnosed as NGGCT with the onset of PPP and CDI and eventually progressed into CPP...

Introduction: Pallister-Hall syndrome (PHS) is a rare disease with autosomal dominant pattern of inheritance caused by CHD7 gene mutation and characterized by epiglottis malformation, polydactyly or oligodactyly, hypothalamic hamartoma and visceral abnormalities. Central precocious puberty is the most common endocrine abnormality detected in PHS. Regardless isolated growth hormone deficiency, pan hypopituitarism and genitourinary malformation are reported in P...

Introduction: Ceratonia siliqua L. (CS) is from the legumes (Fabaceae) family, and different forms such as carob extract and flour are preferred by parents because it is a natural sweetener and a source of vegetable carbohydrates. CS is rich in polyphenols and flavonoids. When we questioned histories of the cases of early puberty and puberty variants who applied to our clinic, we noticed long-term and regular use in some cases. We planned to experimen...

Background: Central diabetes insipidus (CDI) is a rare disorder in the pediatric population. CDI may be the first symptom of a brain tumor, metastatic lesions, or granulomas. The close follow-up of patients with CDI may early detect pathologic processes, especially intracranial tumors.Methods: We present four pediatric patients diagnosed with CDI of different etiology.Pat...

Introduction: Pituitary adenomas (PPAs) are uncommon in childhood and adolescence, accounting for 2-6% of all intracranial neoplasms. Most data are based on case reports and only a few series have been reported. Delayed puberty, short stature, galactorrhea and weight gain are common features at presentation in pediatric patients. Functional tumors constitute a vast majority (90%) of PPAs including corticotropinomas in the first decade followed by relative upsu...

Central precocious puberty (CPP) caused by early maturation of the hypothalamic–pituitary–gonadal axis, resulting in early appearance of secondary sexual characteristics That affects children’s normal life and their adulthood’s final height. GnRH agonist therapy inhibits stimulating effects of endogenous GnRH by desensitizing hypophyseal gonadotropic cells and thus acceleration in bone maturation and early puberty is suppressed. So the aim of this longi...

Case presentation: We report the case of Imad, a 2-year- old Algerian boy referred with a 2-month history of polyuria and polydipsia. Diabetes insipidus was diagnosed by confirming hypernatremia with hyperosmolar serum and inappropriately dilute urine. His polyuria and polydipsia improved dramatically using the oral vasopressin analog. The child had no clinical signs of underlying disease, serum tumor markers were not detected and a skeletal survey suggested n...

(DPG)-plus syndrome is a rare craniofacial anomaly. It usually occurs in combination with other craniofacial defects. The etiology of this condition remains unknown. Survivors to late childhood have either preserved pituitary function or central precious puberty. Idiopathic infantile hypercalcemia (IHH) is another rare condition that predominantly affects infants. The co-occurrence of (DPG)-plus syndrome and IIH has not been reported previously. We will also present a case rep...

Introduction: Hypopituitarism is the partial or complete insufficiency of a single or multiple pituitary hormones. The clinical manifestation of hypopituitarism varies depending on the number and severity of hormone deficiencies. Familial cases are rare, compared to the sporadic ones. Its estimated incidence is between 1:4000-1:10000 live births.Case report: We report the clinical case of familial hypopituitarism in a fa...

Background:In children and adolescents suffered form primary intracranial germ cell tumors, bifocal GCTs are rare and were reported a bad prognosis. In this study, we report a case and summarize the clinical characteristics and prognosis.Methods: A boy suffered form bifocal GCTs (Basal ganglia and pineal region) was diagnosed in our hospital and accepted chemotherapy+radiotherapy, and was followed up.<p class="abstex...

Introduction: Central diabetes insipidus (CDI) is a rare disorder in children. The etiology of CDI in childhood is heterogeneous: tumors or surgery in the hypothalamic-pituitary region, head trauma, vascular and inflammatory diseases. Neuroimaging plays an important role in the differential diagnosis of CDI in children and adolescents. The MRI may detect brain malformations, but also is the gold standard when evaluating the sellar-suprasellar region in CDI.</p...

Introduction: The genomic disorders caused by rearrangements in region 5q35, including the NSD1 (nuclear receptor SET domain containing protein-1) gene have various phenotypes depending on presence of deletions, duplications or inversions. Patients carrying microduplication have microcephaly, short stature, and mild to moderate intellectual delay or learning disability.Patients and methods: A six-year-old boy wa...

Background: Central diabetes insipidus (CDI) is characterised by a central deficiency of arginine vasopressin (AVP) with polyuria and polydipsia. The etiology is heterogeneous. The treatment of choice is the oral or nasal application of DDAVP (synthetic analogue of AVP). CDI in the context of coronavirus disease 2019 (COVID19) has been reported in an individual case.Case report: We present a 9-year old male with CDI of u...

Background: McCune-Albright Syndrome(MAS）includes fibrous dysplasia(FD), cafe-au-lait spots and gonadotropin-independent precocious puberty(PP). Adenohypophyseal hyperfunction syndromes is uncommon but may be potentially severe complication.Objective: To report a girl who has been confirmed McCune-Albright syndrome and has been found pituitary adenoma during follow-up.Methods:</stron...

Introduction: Pituitary stalk interruption syndrome is a rare congenital abnormality of the pituitary that is responsible for anterior pituitary deficiency. It is characterized by a classic triad of interrupted pituitary stalk, absent or ectopic posterior pituitary, and anterior pituitary hypoplasia or aplasia. Clinical presentation varies according to age. Early diagnosis and treatment of this rare disease can prevent permanent short statue of the patient. We...

Introduction: Craniopharyngiomas are benign midline intracranial tumors commonly seen in pediatric population. They constitute approximately 10% of primary brain tumors in children which can cause considerable morbidity and mortality due to local aggressiveness of tumor itself or its treatment effecting hypothalamo-pituitary axis, visual defects, and effects of raised intracranial pressure The aim of this study is to report the characteristics of epidemiologic...

Background: 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.<p class="abst...

Object: To raise the awareness of clinical manifestations about vasculitis-related moyamoya syndrome by summarizing the clinical characteristics of a girl with central precocious puberty, vasculitis-related moyamoya syndrome and reviewing the literature. Method: We carried on the review analysis to the patient with central precocious puberty, vasculitis-related moyamoya syndrome and reviewed the literature. Result: The bilateral breast development was the prim...

McCune-Albright syndrome is a rare, sporadic disorder defined by the triad of café-au-lait spots, fibrous bone dysplasia, and endocrinopathy. The diagnosis is often made on bone or endocrine involvement, but must be suspected on the particular morphology of café-au-lait spots. We report a case of McCune-Albright syndrome diagnosed on these cutaneous signs and precocious puberty. This is a 4.5-year-old girl referred by a gynecologist for a pediatric endocrinology ...

Introduction: McCune Albright syndrome (MAS) is classically defined by the clinical triad: fibrous dysplasia of bone, café-au-lait skin pigmentation and endocrinopathies :The most frequent is precocious puberty. Linked to a somatic mutation of the α subunit of the Gs protein, this syndrome leads to a constitutive activation of adenylate cyclase, to the excessive production of AMPcCase presentation: Here we r...

Introduction: Physical examination remains the cornerstone of medical practice. However, its importance has been underestimated during COVID-19 pandemic because of concerns related to exposure risk and use of personal protective equipment. Solitary median maxillary central incisor (SMMCI) may be an isolated clinical trait or associated with other anomalies and endocrine pathologies including hypopituitarism, hypothyroidism, isolated growth hormone (GH) deficie...

Pituitary hyperplasia (PH) is absolute increase in the number of one or more adenohypophyseal cell subtypes, manifesting radiologically as pituitary enlargement beyond what is considered normal. Diagnosis of PH remains predominantly clinical, hormonal, and radiological. Case presentation: we present a clinical course, diagnosis, and management of a case of pituitary gland hyperplasia in 10 years old Egyptian girl, one of twins who sought medical advice when the mother noticed ...

Background: Septo-optic dysplasia (SOD) is characterized by two or more features of the triad: optic nerve (ON) hypoplasia, middle brain defects and pituitaty deficiencies. Pituitary Stalk Interruption Syndrome (PSIS) presents as a lack of a visible pituitary stalk and/ or no eutopic posterior lobe hypersignal in the shallow sella turcica. Both conditions usually result in hypopituitarism. The diagnosis is based on clinical signs and MRI findings; only small n...

Introduction: We refer to precocious puberty when signs of puberty appear early: before the age of 8 in females and before the age of 9.5 in males. The objective of our study is to evaluate the interest of the LHRH test in the exploration of early puberty.Materials and Methods: A retrospective descriptive study including 19 cases who presented with signs of precocious puberty. A clinical and hormonal evaluation was perfo...

Central precocious puberty is more common in girls than boys and over 90% of girls central precocious puberty is idiopathic Pathological causes of central precocious puberty in very young girls include tumors, hydrocephalus, CNS infections, or post-traumatic events Astrocytoma is one of the very rare causes. Pilocytic astrocytomas are usually benign and may be diagnosed before the onset of precocious puberty due to neurological symptoms or be diagnosed for the first time in ch...

Introduction: Primary polydipsia is rare during adolescence and is known to be associated with psychiatric disorders or psychological stress. Differential diagnosis includes endocrine, neurologic, renal, and iatrogenic causes.Case Report: A 14-year-old male presented with polydipsia and polyuria that persisted for 6 years. His fluid intake was about 9 liters a day and he woke up for voiding once or two times every night....

Introduction: McCune-Albright syndrome (MAS) is characterized by fibrous dysplasia (FD), cafe-au-lait skin spots and precocious puberty (PP). SAM is a rare disease and its prevalence is estimated between 1/100,000 and 1/1,000,000. Somatic activating mutations of the GNAS gene located on chromosome 20q13 encoding the α subunit of the regulatory protein Gsα are responsible for the entity.Case report: This is a ...

Introduction: Delayed puberty is defined as the absence of the development of sexual characteristics beyond the age of 14 for boys and 13 for girls. To better understand this pathology, we conducted a retrospective study over a period of 7 years; between 2013 and 2020, involving 11 patients with a delayed puberty, followed by a pediatric endocrinology consultation at the children’s hospital Ibn Sina in Rabat.Patients:</stro...

Introduction: Pituitary deficiency, or hypopituitarism, is defined by insufficient synthesis of one or more anterior pituitary hormones (growth hormone, TSH, ACTH, LHFSH, prolactin) associated or not with diabetes insipidus (ADH deficiency). In children it is more frequently congenital, due to abnormal pituitary development; it is then a rare disease with an estimated prevalence of between 1/16.000 and 1/150.000.Case report:</str...

Background: Functioning gonadotroph adenomas (FGAs) are very rare gonadotropin-secreting pituitary adenomas. Clinically, FGAs present only with mass effects. Nevertheless, central precocious puberty (CPP) has also been reported. Published data have demonstrated controversial opinions on the use of GnRH agonists in these patients, considering the risk of increase in tumor size and stimulating gonadotropin secretion. We herein report 3 cases diagnosed with CPP d...

Langerhans cell histiocytosis (LCH) is a rare disorder of unknown etiology affecting the mononuclear phagocyte system. It is characterized by clonal uncontrolled proliferation and accumulation of immature dendritic cells in different organs. Affected cells express CD1-alpha and/or CD207 (Langerin) on immunohistochemistry. Although bone is the most commonly affected organ (80%), all other organs can be affected either alone or in combination. LCH is classified into Single syste...

We present the cases of a 3 yo girl diagnosed with precoccious puberty, with a personal history of premature telarchy, genital hair development and vaginal blood discharge at 1yo 2mo, currently in treatment with GnRH agonist, and the case of her younger sister, aged 1 yo, who also presented with premature telarchy. They have 2 older siblings, both of them are clinically healthy boys. Their mother and paternal aunt had normal pubertal development. No other history from females ...

Introduction: McCune-Albright syndrome (MAS) is characterized by fibrous dysplasia (FD), cafe-au-lait skin spots and precocious puberty (PP). SAM is a rare disease and its prevalence is estimated between 1/100,000 and 1/1,000,000. Somatic activating mutations of the GNAS gene located on chromosome 20q13 encoding the α subunit of the regulatory protein Gsα are responsible for the entity.Case report: This is a ...