Presentation
AB - The genetic basis for combined pituitary hormone deficiency (CPHD) is complex, involving 30 genes in a variety of syndromic and nonsyndromic presentations. [experts.umich.edu]
For example, children with Turner syndrome (loss of X chromosome) often present with short stature, while children with Klinefelter syndrome (extra X syndrome) present with tall stature. [hormones.gr]
Management and treatment At present, there is no specific treatment. [orpha.net]
All affected children presented with congenital hypothyroidism and early growth failure. They all were GH-, PRL-, and TSH- deficient. [cags.org.ae]
Entire Body System
- Short Stature
We present a case of short stature due to combined growth hormone and other anterior pituitary hormone deficiencies with ectopic posterior pituitary. 2. [file.scirp.org]
If untreated, main symptoms include short stature, cognitive alterations or delayed puberty. Etiology Congenital hypopituitarism is due to mutations of several genes encoding pituitary transcription factors. [orpha.net]
Test Details Technical Information Clinical Significance: Detects mutations in the coding sequence of the POU1F1 and PROP1 genes Typical Presentation: Severe short stature and failure to thrive in young children Indications for testing: Combined deficiencies [athenadiagnostics.com]
In pre‐pubertal short children, the most common symptoms of idiopathic GHD are short stature and reduced growth velocity for age. [intechopen.com]
Also in some cases severe mental retardation along with short stature may present. Diagnosis of CPHD is based on testing for deficient secretion of GH, TSH, LH, FSH, PrL, and ACTH. [cags.org.ae]
- Crying
Her behavioral and psychological disorders after onset of puberty have been challenging to control and are associated with episodes of unprovoked yelling and crying. [hormones.gr]
- Short Stature in Children
For example, children with Turner syndrome (loss of X chromosome) often present with short stature, while children with Klinefelter syndrome (extra X syndrome) present with tall stature. [hormones.gr]
- Enuresis
Her other medical problems included chronic constipation, enuresis and sleep apnea, for which a BiPAP machine is being used. Her intelligence quotient was 60 at 8 years of age. [hormones.gr]
Ears
- Low Set Ears
The patient was noted as having dysmorphic features including hypertelorism, low-set ears, epicanthal folds and a flat nasal bridge. [hormones.gr]
Neurologic
- Nystagmus
[…] insufficiency and intellectual disability, and, according to case reports, skeletal abnormalities, aplastic anemia and systemic lupus erythematous. 3-4 Some characteristic facial features seen are epicanthic folds, flat nasal bridge, hypertelorism and nystagmus [hormones.gr]
Urogenital
- Vaginal Bleeding
At that time, she developed an episode of vaginal bleeding which lasted 5 days but did not recur. Her LH was 5.9 U/L, FSH was 2.6 U/L and estradiol was 31.6 pg/mL ( Table 1 ). Figure 4. Patient features. [hormones.gr]
Treatment
[…] nodules; and new coverage of when and when not to use radioiodine in the treatment of patients with thyroid cancer. [books.google.com]
The material is in no way intended to replace professional medical care by a qualified specialist and should not be used as a basis for diagnosis or treatment. [orpha.net]
In conclusion, the side effects of GH treatment are uncommon in children and the treatment can be considered safe. [intechopen.com]
It requires lifelong treatment with one or more medicines. [en.wikipedia.org]
Prognosis
Prognosis Prognosis is equivalent to patients without pituitary deficiencies if treatment is started immediately when diagnosis is confirmed, and if a specialized follow-up is performed. [orpha.net]
What is the prognosis for a person with PROP1-related Combined Pituitary Hormone Deficiency? People with PROP1-related CPHD are typically able to live a normal lifespan. [counsyl.com]
For example, patients with craniopharyngioma and/or patients treated with radiotherapy were included in some 4, 6, 8, 9 but not all studies. 5, 7 Craniopharyngiomas carry a worse prognosis than pituitary adenomas, 13 and radiotherapy has been identified [clinicalgate.com]
While effective treatment of the underlying hormone deficiencies may improve these risks, it is often necessary to treat them directly. [6] Prognosis [ edit ] Several studies have shown that hypopituitarism is associated with an increased risk of cardiovascular [en.wikipedia.org]
Etiology
The final section describes the different etiologies of GH deficiency, from molecular mechanisms and gene abnormalities to cranial radiation and traumatic brain injury, along with syndromes related to this deficiency. [books.google.com]
(See Etiology.) Regulation of the development of the mammalian anterior pituitary gland by transcription factors. [emedicine.medscape.com]
Etiology Congenital hypopituitarism is due to mutations of several genes encoding pituitary transcription factors. [orpha.net]
We report the progressive CPHD and its molecular etiology in a woman with CPHD presenting with first symptoms of ACTH/ cortisol deficiency at the age of 48 years. [link.springer.com]
Epidemiology
The adult GH deficiency section spans the epidemiology and diagnosis of GH deficiency with a strong reminder for the clinician that the transition period represents a critical time of somatic maturation, which continues for years after cessation of liner [books.google.com]
Summary Epidemiology The incidence of congenital hypopituitarism is estimated to be between 1:3000 and 1:4000 births. [orpha.net]
Relevant External Links for PROP1 Genetic Association Database (GAD) PROP1 Human Genome Epidemiology (HuGE) Navigator PROP1 Atlas of Genetics and Cytogenetics in Oncology and Haematology: PROP1 No data available for Genatlas for PROP1 Gene Mutations in [genecards.org]
Data from six epidemiologic studies, 4 – 9 comprising patients aged between 46 and 52 years who were followed for 10 to 13 years, report increased mortality with standardized mortality rates (SMRs) from 1.2 to 2.2. [clinicalgate.com]
Pathophysiology
II) GABAergic neuron and PNN abnormalities have been reported in several brain regions, including the amygdala and PFC, brain regions involved in cognitive and emotion processing and in the pathophysiology of SZ. [grantome.com]
[…] of hypopituitarism, in particular diabetes insipidus and decreased linear growth velocity, are frequently overlooked in patients with craniopharyngioma. ( 1 ) Objectives After completing this article, readers should be able to: Describe the various pathophysiologic [pedsinreview.aappublications.org]
Pathophysiology [ edit ] The pituitary gland is located at the base of the brain, and intimately connected with the hypothalamus. [en.wikipedia.org]
Prevention
Some of these mutations prevent the production of a functional OTX2 protein. Other mutations lead to a defective version of the protein that cannot regulate the activity of other genes. [ghr.nlm.nih.gov]
Thyroid hormone replacement therapy should never be given before glucocorticoids have been replaced to prevent precipitating an Addisonian crisis. TABLE 6. [ocw.tufts.edu]
Treatments are directed towards preventing and treating possible existing complications associated with the syndrome such as hormone replacement for hormonal imbalance and suitable correction lenses for myopia and astigmatism. [f1000research.com]
[…] follicles. 10 Therefore, it has been suggested that patients with tetrasomy X should be screened for ovarian insufficiency during early adolescence, as hormone replacement therapy may be required for the development of secondary sex characteristics and for prevention [hormones.gr]