ESPE Abstracts

Introduction: Children with CAH need a supraphysiologic dose of hydrocortisone, from 12-20 mg/m2/day to suppress adrenal androgens. Patients with difficult-to-treat CAH typically present with a combination of CAH-related (hyperandrogenemia, advancedbone age and short stature, amenorrhea) and glucocorticoid overtreatment–related clinical symptoms. Continuous subcutaneous hydrocortisone infusion therapy (CSHI) administered via an insulin pump has been used...

Background: X-linked hypophosphatemia (XLH) is a rare disease caused by PHEX pathogenic variants leading to elevated fibroblast growth factor 23 (FGF23). FGF23 was shown to modulate the immune system. Excessive FGF23 signalling in mice with chronic renal disease results in deficient recruitment of neutrophiles in the infected tissues and to inadequate immune reaction against bacterial aggression (Rossaint et al). An increased risk for recurrent infect...

Background/Aim: 25 to 40% of children with well-controlled X-linked hypophosphatemia (XLH) show linear growth failure, despite optimal conventional treatment (oral phosphate supplementation and active forms of vitamin D) with final height -2 SDS. Recombinant human growth hormone (rhGH) may be an adjuvant treatment of the growth retardation in these patients. Therefore, the main objective of this study was to describe how rhGH treatment improves final heigh...

Background: XLHR is due to mutations in the PHEX gene leading to unregulated production of FGF23, hence hypophosphatemia and decreased renal 1,25OH-vitamin D hydroxylation. Amongst other features, XLHR is characterized by leg bowing of variable severity. Phosphate supplements and oral 1,25OH-vitamin D, partially or, in some cases, fully restore the limb straightness. For severe or residual limb deformities, orthopaedic surgery may be recommended.Objectiv...

Background: Pseudohypoparathyroidism type 1A (PHP1A) and PseudoPHP are caused respectively by maternal and paternal mutations involving those GNAS exons that encode the alpha-subunit of the stimulatory G protein (Gsα). Common to different forms of PHP1B is a loss-of-methylation (LOM) at one or several maternal GNAS exons, which likely reduces Gsα expression in certain tissues. In most autosomal dominant PHP1B variants (AD-PHP1B), LOM is restricted t...

Background: For adult patients who do not meet indications to surgery, the calcimimetic cinacalcet is approved for primary hyperparathyroidism (HPT), decreasing calcium and parathyroid hormone (PTH) levels. This drug is largely used in adults, but may be a challenge in daily practice in children, because of the risk of hypocalcemia, increased QT interval and drug interactions. A few pediatric cases have highlighted its potential interest in children with HPT; ...

Background: Since the first description of inactivating PTH/PTHrP signaling disorders [(iPPSD, former pseudohypoparathyroidism (PHP)] a remarkable clinical variability was observed, apparently age-dependent. The main clinical features, including PTH resistance, brachydactyly and short stature, develop during middle and late childhood. Hearing loss (HL) is commonly found in iPPSD/PHP. Only a few studies approached the subject of hearing loss in iPPSD/PHP and th...

Background: X-linked hypophosphatemic rickets (XLHR) represents the most common form of genetic hypophosphatemia. Even though skull and cranio-vertebral anomalies of potential neurosurgical interest are observed in children with XLHR, their actual incidence and characteristics are not well established. We aimed to analyze the incidence of Chiari type I anomalies in children with XLHRMethods and materials: Our retrospecti...

Background: Disproportionate short stature is seen in most individuals with X-linked hypophosphatemia (XLH). Vitamin D and phosphate supplementation can improve growth slightly. Burosumab showed minimal improvement of growth in older children. No growth data of XLH children that started burosumab at a very young age, i.e., between 1 and 4 years, are available.Methods: We included 17 XLH children (11 boys) who started bur...

Introduction: Idiopathic short stature (ISS) is characterized by a reduced height (at least 2 standard deviation scores [SDS]) from expected norms based on age, sex, and population-specific height standards in the absence of growth hormone (GH) deficiency or other known etiologies. ISS is a registered indication for GH therapy in USA but not in Europe. The psychosocial burden of ISS remains underexplored, including its impact on quality of life. Using National...