hrp0095wg5.3 | ESPE Working Group on Paediatric and Adolescent Gynaecology (PAG) Symposium | ESPE2022

Differential diagnosis of pubertal delay in girls - What’s new?

Howard Sasha

Pubertal delay in females is defined as the lack of development of Tanner breast stage 2 by 13 years of age. Recent cohort studies have recapitulated the findings of classic studies over the last few decades, that constitutional delay (also known as self-limited delayed puberty) is less common in girls than in boys. This diagnosis is found in 30% of girls presenting with delayed puberty, with a further 30% classified as functional hypogonadotropic hypogonadism due to chronic i...

hrp0094s10.2 | Pathways to Improved Diagnosis and Management of Hypothalamo-Pituitary Disorders | ESPE2021

Delayed puberty: A genetic condition?

Howard Sasha ,

Young people presenting with delay in pubertal onset or progression may have one of a spectrum of conditions, with different underlying pathological mechanisms. Whilst environmental factors such as nutrition and emotional well-being can influence the timing of puberty, in the majority of patients presenting with significantly delayed puberty there is a clear family history of delayed or arrested puberty. Pubertal timing is known to be a trait with strong heritability, demonstr...

hrp0097p2-273 | Late Breaking | ESPE2023

Key parameters at puberty onset can help distinguish self-limited delayed puberty from congenital hypogonadotrophic hypogonadism

d'Aniello Francesco , Aung Yuri , Kokotsis Vasilis , R Howard Sasha

Introduction: Delayed puberty (DP), affecting over 2% of adolescents, is defined as pubertal onset 2-2.5 SDs later than the general population. The most common underlying aetiology is self-limited DP (SLDP). However, this can be difficult to differentiate from the more severe condition congenital hypogonadotrophic hypogonadism (HH), especially on first presentation of an adolescent patient with DP. This study sought to elucidate phenotypic and genotypic discre...

hrp0095p1-176 | Sex Differentiation, Gonads and Gynaecology, and Sex Endocrinology | ESPE2022

Diagnostic and management practices of girls presenting with polycystic ovary syndrome (PCOS)-like symptoms to a tertiary paediatric endocrine clinic.

Solanas Martín Blanca , R. Howard Sasha , R. Hughes Claire , L. Storr Helen , H. Willemsen Ruben

Background: Polycystic ovary syndrome (PCOS) continues to be a diagnostic challenge in adolescent girls. Symptoms like oligomenorrhea and acne, and polycystic ovarian morphology on ultrasound can be normal variants in adolescents. In addition to diagnostic difficulties, there is lack of randomized controlled trials for PCOS treatments specific to adolescents. Current guidelines for diagnosis and management of PCOS in adolescents have large variations and rely ...

hrp0089fc13.3 | Pituitary, Neuroendocrinology and Puberty 2 | ESPE2018

Role of GnRH Neuronal Migration and Development in Self-Limited Delayed Puberty

Howard Sasha , Oleari Roberto , Mancini Alessandra , Poliandri Ariel , Saengkaew Tansit , Guasti Leo , Cariboni Anna , Dunkel Leo

Objectives: Several different pathogenic mechanisms may converge on a final common pathway to produce the phenotype of delayed pubertal timing. In our cohort of patients with familial self-limited delayed puberty (DP) we have demonstrated mutations in IGSF10 leading to mis-regulation of the embryonic migration of GnRH neurons (Howard et al, EMBO MM 2016). We aimed to discover novel genetic mutations in pathways regulating GnRH neuronal migration and developme...

hrp0084fc14.2 | Puberty | ESPE2015

A Mutation in HS6ST1 Causes Self-limited Delayed Puberty

Howard Sasha , Poliandri Ariel , Cabrera Claudia , Barnes Michael , Wehkalampi Karoliina , Dunkel Leo

Background: Self-limited delayed puberty (DP) often segregates in an autosomal dominant pattern, suggesting that inheritance is conferred by a small number of genes. However, the underlying genetic background is mostly unknown. By comparison, many genes have been identified where loss-of-function mutations lead to hypogonadotropic hypogonadism (HH). Despite likely overlap between the pathophysiology of delayed puberty and conditions of GnRH deficiency, few studies have examine...

hrp0094fc8.1 | Neuroendocrinology | ESPE2021

Combined omic analysis revealed autism-linked NLGN3 as new candidate gene associated to GnRH neuron development and disease.

Oleari Roberto , Lettieri Antonella , Paganoni Alyssa , Howard Sasha R , Cariboni Anna ,

During development, gonadotropin releasing hormone (GnRH) neurons are born in the nasal placode and migrate to the hypothalamus, where they position to regulate sexual reproduction by pulsatile release of GnRH. Defective GnRH neuron development or action may lead to GnRH deficiency (GD) which is characterized by absent or delayed puberty. Several GD causative genes have been identified so far, but half of the cases are still idiopathic. The employment of complementary research...

hrp0097fc13.3 | Pituitary, neuroendocrinology and puberty 2 | ESPE2023

Variants in Methyl-CpG-binding protein 2 (MECP2) are associated with X-Linked Central Precocious Puberty

E Read Jordan , Guasti Leonardo , Paganoni Alyssa , Korbonits Marta , R Howard Sasha

Whilst several key genetic contributors to the phenotype of central precocious puberty (CPP) have been recognized, many familial cases remain without clear a genetic aetiology. Causal genetic variants are reported in imprinted genes Makorin ring finger protein 3 (MKRN3) and Delta-like homolog 1 (DLK1), alongside Kisspeptin-1 (KISS1) and (KISSR1), implicating mis-regulation of transcriptional control of the kisspeptin and GnRH neuroendocrine systems in onset of CPP. We recently...

hrp0097fc13.5 | Pituitary, neuroendocrinology and puberty 2 | ESPE2023

Systematic review and meta-analysis of spermatogenesis rates after pubertal induction with gonadotropins in males with hypogonadotropic hypogonadism

Alexander Emma , Ng Yin Kyla , Faruqi Duaa , Farquhar Robert , Unadkat Ayesha , Varughese Rachel , Howard Sasha

Background: Hypogonadotropic hypogonadism is characterised by inadequate secretion of gonadotropins (luteinising hormone (LH) and follicle-stimulating hormone (FSH)) leading to absent, partial or arrested puberty. In males, classical treatment with testosterone promotes virilisation but does not facilitate testicular growth and spermatogenesis. Conversely, treatment with gonadotropins or gonadotropin-releasing hormone (GnRH) stimulates Sertoli and Leydig cells...

hrp0092fc15.4 | Late Breaking Abstracts | ESPE2019

Defects in the GnRH Neuroendocrine Network Affect the Timing of Puberty

Saengkaew Tansit , Mancini Alessandra , Ruiz-Babot Gerard , Cabrera Claudia , Barnes Michael , Dunkel Leo , Guasti Leonardo , Howard Sasha

Background: Self-limited delayed puberty (DP) is an extreme variant of normal pubertal timing and it often clusters in families. Although it is highly heritable and is the most common cause of delayed puberty, little is known about the genetic control. GnRH neuronal biology has been implicated as a key element in the pathogenesis of DP. By focusing on genes involved in GnRH neuron development, migration and function we may understand more about the genetic bas...