ESPE Abstracts (2022) 95 P1-549

1Ege University Faculty of Medicine, Department of Pediatric Endocrine and DiabetesFaculty of Medicine, Izmir, Turkey; 2Ege University Faculty of Medicine, Department of Medical Genetics, Izmir, Turkey; 3Ege University Faculty of Medicine, Department of Pediatrics, Division of Genetics, Izmir, Turkey; 4Ege University Faculty of Medicine Department of Brain and Nerve Surgery, IzmirTur, Turkey


Introduction: CPHD is characterized by impaired production of GH and one or more other pituitary hormones. Genetic defects causing CPHD typically result in insufficient anterior pituitary gland development.

Aim: The aim of the study is to determine the genetic etiologies that lead tocombined hormone deficiencies. Todetermine phenotype genotype relationship with or without extra-pituitary anomalies.

Material and methods: 27 CPHD cases between 2000 and 2022 were included inthe study. Genetic analyzes were performed with clinical exom sequencing panel based next-generation sequencing.

Results: The history, physical examination and radiological findings of 27 cases are listed in Table 1. Mutation frequency was 33,3 %. POU1F1 gene mutation was found in 3 patients (33%). PROP1, LHX4, HESX1, OTX2, FOXA2 and GLI2 mutations were detected in one patient each. Dysmorphic features as unilateral preaxial polydactyly, coloboma in the eye, strabismus and epicanthus were detected in the case with OTX 2 variant, coarse facial appearance, hypertelorism, right kidney agenesis in FOXA2 variant; cleft palate, micrognathia in GLI2 variant; microcephaly, flattened nasal root in HESX1, frontal bossing, low-set rotated ears, frontal bossing in LHX4 variant. Clinical and molecular features of the genes are summarized in Table 2

Table 1. Clinical data of 27 patients withCPHD
  Clinical feature Results
General data Gender: M/F
Age at diagnosis(median)
70/30%
3.10 (min-max: 0.04 -15.2)
Birth data At term/preterm birth
Micropenis
Cryptorchidism
Prolonged neonatal jaundice
78/22%
53%
32%
26%
Hormon deficiencies
GH
TSH
ADH
ACTH
At diagnosis
70%
15%
4%
11%
Auxological data Height SDS at diagnosis -2.3 ± 1.4
MRI imaging data Hypothalamic–pituitary abnormalities
• Anterior pituitary hypoplasia or aplasia
• APH+ EPP
• Pituitary stalk abnormalities
• Neuropituitary ectopia
81.5%
48%
19%
3.5
11%
Table 2. Clinical and hormonal findings of combined pituitary hormone deficiency patients with mutations
Patient PROP1 POU1F1 LHX4 HESX1 FOXA2 GLI2 OTX2
Number of patients 1 3 1 1 1 1 1
Gender M M/M/F M F M M F
Week of gestation at birth 38 w 32w/34 w/38w 39w 37w 38w 38w 38w
Weigh SDS at diagnosis -1.67 SDS -0.89 SDS
-0.36 SDS
-0.4 SDS
-0.12 SDS -2 SDS -2 SDS -2.7 SDS 2.5 SDS
Height SDS at diagnosis -4.04 SDS -2.86
-0.45
-2
-0.27 -2.2 -2.2 -1.6 -2.6
Hormone deficiencies/
at diagnosis
GH TSH
GH
TSH
TSH ACTH ACTH ACTH GH
Pituitary and cerebral imaging Normal Normal
APH + EPP Normal
EPP Normal APH+EPP+Stal hypoplasia Normal Normal

Conclusions: Phenotype-genotype relationship is essential for follow-up and treatment options of CPHD.

Volume 95

60th Annual ESPE (ESPE 2022)

Rome, Italy
15 Sep 2022 - 17 Sep 2022

European Society for Paediatric Endocrinology 

Browse other volumes

Article tools

My recent searches

No recent searches.

My recently viewed abstracts