hrp0082p1-d2-214 | Reproduction (1) | ESPE2014

Early Medical Treatment of Children with Gender Dysphoria: an Empirical Ethical Study on Arguments of Proponents and Opponents Concerning Early Interventions

de Vries Martine , Vrouenraets Lieke , Wichmann Anne , Schermer Maartje , Fredriks Miranda , Delemarre-van de Waal Henriette

Background: Both The Endocrine Society and the World Professional Association for Transgender Health (WPATH) published guidelines for the treatment of children and adolescents with gender dysphoria (GD). The guidelines recommend the use of GnRH agonists in adolescence to suppress puberty, and the use of cross-sex hormones starting around age 16 for eligible patients. In actual practice, there is no consensus whether to use these early medical interventions. The aim of our stud...

hrp0082p2-d1-409 | Growth Hormone | ESPE2014

Ternary Complex Formation and IGFBP3 Proteolytic Activity During Childhood: Age-Dependent Changes

Renes Judith S , van Doorn Jaap , Hokken-Koelega Anita C S

Background: IGF1 is mainly sequestered in a 150 kDa ternary complex with IGFBP3 and the acid-labile subunit (ALS). Dissociation of IGF1 from the ternary complex is in part regulated by proteolysis of IGFBP3, which reduces its affinity for IGF1. Short children born SGA have lower IGF1 and IGFBP3 levels compared to healthy peers.Objective and hypotheses: To determine complex formation in healthy normal statured children, and assess variables influencing co...

hrp0082p2-d3-563 | Puberty and Neuroendocrinology (2) | ESPE2014

Endocrine Abnormalities in Phosphoglucomutase 1 Deficiency

Mueksch Barbara , Morava Eva , Lefeber Dirk , Claahsen-van der Grinten Hedi , Korsch Eckhard

Introduction: Phosphoglucomutase 1 catalyzes the interconversion of glucose-6-phosphate and glucose-1-phosphate. Phosphoglucomutase 1 deficiency (PGM1-CDG), previously termed glycogenosis type XIV (OMIM 612934), is a rare variant of the congenital disorders of glycolysation (CDG), resulting in abnormal attachment and processing of protein linked N-glycans. We present a girl with PGM1-CDG and delayed pubertal development and review the endocrine findings of the few pat...

hrp0082p3-d1-817 | Growth | ESPE2014

Increased Required Dose of GH in Children with Inborn Panhypopituitarism

Wurm Michael , van der Werf-Grohmann Natascha , Krause Alexandra , Roemer-Pergher Cordula , Schwab Karl Otfried

Introduction: Standard dose for GH deficient children is 0.025 mg/kg per day given subcutaneously once daily. Inborn panhypopituitarism is a special subset of GH deficiency. Its management is difficult because several hormones need to be replaced. We present three patients with perinatal onset panhypopituitarism.Case reports: Case 1 is a 7-year-old boy who had hypoglycaemic seizure with reanimation due to circulatory arrest shortly after birth. Panhypopi...

hrp0084fc7.3 | Growth-promoting therapies | ESPE2015

IGF1 Levels, Complex Formation, and IGF-Bioactivity in GH-Treated Children with Prader–Willi Syndrome

Bakker Nienke , van Doorn Jaap , Renes Judith , Donker Truus , Hokken-Koelega Anita

Background: Children with Prader–Willi syndrome (PWS) attain high serum immunoreactive IGF1 levels during standard dose GH treatment, which leads to concern, but lowering the dose, deteriorates their body composition.Objective and hypotheses: To evaluate serum IGF1, IGFBP3 and acid-labile subunit (ALS) levels, complex formation and IGF-bioactivity in GH-treated PWS children. We hypothesized that GH-treated children with PWS have a normal IGF-bioacti...

hrp0084fc12.4 | Obesity - Clinical | ESPE2015

RM-493, a Melanocortin-4 Receptor (MC4R) Agonist, is Being Therapeutically Evaluated in Patients with Deficiencies in the Leptin – Proopiomelanocortin (POMC) – MC4R Hypothalamic Pathway, Including Prader–Willi Syndrome (PWS)

Kuhnen Peter , Krude Heiko , Wiegand Susanna , van der Ploeg Lex , Fiedorek Fred , Hylan Michelle , Gottesdiener Keith

Background: The hypothalamic leptin–melanocortin signalling pathway is a critical regulator of human appetite and weight regulation. Monogenetic defects in the POMC gene, the MSH ligand generating PC1 gene and the MSH receptor gene MC4R lead to severe early onset and leptin-resistant obesity. In PWS, where the function of genes such as MAGEL2 are impaired, the Magel2-/- mouse model revealed decreased POMC neuronal functioning as one c...

hrp0084p2-350 | Fat | ESPE2015

The Switch in Eating Behaviour in Infants with Prader–Willi Syndrome is Associated with an Increase in the Acylated:Unacylated Ghrelin Ratio: Results of a Longitudinal Study

Kuppens Renske , van der Lely Aart Jan , Delhanty Patric , Huisman Martin , Hokken-Koelega Anita

Background: Prader–Willi syndrome (PWS) is characterized by a switch from failure to thrive to excessive weight gain and hyperphagia with impaired satiety in early childhood. An elevated, more unfavorable ratio between acylated:unacylated ghrelin (AG:UAG) may be involved in the underlying mechanisms of this switch.Objective and hypotheses: To assess the evolution of the appetite regulating hormones AG, UAG, and the AG:UAG ratio in infants with PWS a...

hrp0084p2-403 | GH & IGF | ESPE2015

Homozygous Carriers of a Novel IGFALS Mutation are 1.5 SD Shorter than Heterozygous Relatives and Tend to have Lower Bone Mineral Density

Isik Emregul , van Doorn Jaap , Demirbilek Huseyin , Losekoot Monique , Wit Jan-Maarten

Background: There are limited data on differences in height, bone mineral density (BMD) and pubertal delay between homozygous and heterozygous carriers of IGFALS defects.Objective and hypotheses: To describe clinical and laboratory features and BMD of homozygous and heterozygous carriers of a novel IGFALS mutation in a large Kurdish family.Method: Index cases were two first degree cousins presenting with short stature, low IGF1, ve...

hrp0084p3-605 | Adrenals | ESPE2015

Delayed Diagnosis of Salt Wasting Congenital Adrenal Hyperplasia, without Complications of Cortisol Deficiency: A Case Report

Pijnenburg-Kleizen Karijn , Noordam Kees , Otten Barto , Claahsen-van der Grinten Hedi

Background: In salt wasting congenital adrenal hyperplasia (SW-CAH) patients suffer from a deficiency of both cortisol and aldosterone and develop life-threatening salt wasting crises neonatally. Treatment consists of glucocorticoids, mineralocorticoids and salt supplementation. We present a case with a two years delayed diagnosis of SW-CAH.Case presentation: The patient was admitted to the hospital at the age of two weeks because of poor feeding, irrita...

hrp0084p3-696 | Diabetes | ESPE2015

Influence of hypoglycemic episodes on attention and behavioural abnormalities in diabetic children

Wurm Michael , Niebuhr Vera , Hallermann Kristiane , Krause Alexandra , van der Werf-Grohmann Natascha , Schwab Karl Otfried

Background: Type 1 diabetes may have an influence on concentration, attention and behaviour. These effects are relevant, as they may affect school performance and later career options for paediatric diabetes patients.Objective and hypotheses: This study examined attention, concentration and behavioural difficulties in diabetic children aged 5–13 years and their association with hypoglycaemic episodes and HbA1c.Method: 48 child...