ESPE Abstracts

Congenital hypopituitarism (CH) is a highly variable disorder affecting 1:3000 - 1:4000 live births, and is characterized by deficiencies in one or more of the 7 pituitary hormones, with growth hormone (GH) being the most frequently-occurring deficiency. It may be associated with a range of syndromic features including visual impairment, midline brain abnormalities and facial clefting. The development of the pituitary gland is closely associated with that of the forebrain and ...

Introduction: Childhood obesity is associated with pre-diabetes and type 2 diabetes mellitus. The gold standard investigation for these is an oral glucose tolerance test (OGTT). The aim of our study is to investigate glycaemic dysregulation in children and young people (CYP) with obesity using continuous glucose monitoring (CGM) and evaluate the effect of intense lifestyle intervention on various complications.Methods: 3...

Background: Loss of function mutations in SGPL1 have previously been described by our group in association with a multisystemic disorder encompassing PAI and nephrotic syndrome. SGPL1 encodes, sphingosine 1-phosphate lyase (SGPL1), which irreversibly binds sphingosine 1-phosphate (S1P) and commits it to the final degradative step in sphingolipid metabolism. SGPL1 is therefore a major modulator of S1P signalling. Several sphingolipid intermediates such as cera...

Background: GH insensitivity (GHI) encompasses growth failure, low serum IGF-1 and normal/elevated serum growth hormone (GH) (basal level >5 μg/L and/or peak on provocation testing >10 μg/L). In a significant number of children the molecular cause is unknown.Objective: To investigate the genetic etiology of GHI in a cohort of children by candidate gene (CGS) and whole exome (WES) sequencing.Methods: About 109 pati...

Sphingosine 1-phosphate lyase insufficiency syndrome (SPLIS) was described in 2017 as a novel condition affecting sphingolipid metabolism, with bi-allelic loss of function mutations in SGPL1. There is a multisystemic phenotype including steroid resistant nephrotic syndrome and primary adrenal insufficiency (PAI) and to a lesser extent ichthyosis, neurological disease and lymphopenia. Hypogonadism is described amongst some affected patients. To interrogate the steroid ...

Background: Socioeconomic deprivation is an important determinant of health.Objectives: This study examined the relationship between incidence of hospital admissions for patients with Type 1 diabetes mellitus (T1DM) and their socioeconomic deprivation.Methods: All hospital admissions of patients with T1DM from 0 to16 years were identified during a 5-year period between 2007 and 2012 using the hospital episodes statistics database (...

Background: Socioeconomic deprivation, obesity and emotional well-being are important determinants of health inequalities and poor glycaemic control in adults with type 1 diabetes mellitus (T1DM).Objectives: This study aims to look at the effect of social deprivation, BMI and patient reported emotional well-being on glycaemic control in children and young adults with T1DM.Methods: Socioeconomic status was measured by cross-referenc...

Hypoparathyroidism is treated with oral calcium carbonate and vitamin D analogues to increase serum calcium levels. Recombinant human parathyroid hormone (rhPTH) therapy can be considered in patients with poorly controlled hypocalcaemia or side effects to conventional treatment. Constipation, a known side effect of calcium carbonate, is often easily managed with simple laxatives. We describe resolution of severe constipation by changing conventional treatment to rhPTH. A femal...

Introduction: Obesity is a recognised risk factor for raised intracranial pressure in the adult population but is still under-recognised in children and young people. The pathophysiology of raised intracranial pressure in relation to obesity remains unclear. The aim of our study is to investigate the association between idiopathic intracranial hypertension (IIH) and obesity in children and young people.Method: Patients d...

Introduction: Impaired glucose tolerance and type 2 diabetes mellitus are known complications associated with childhood obesity. At present, an oral glucose tolerance test (OGTT) is the gold standard investigation. Continuous glucose monitors (CGM) are used in children and young people (CYP) with type 1 diabetes mellitus. The aim of our study is to investigate whether the use of a CGM is more effective in identifying glycaemic dysregulation, compared to an OGT...