Phenotypic Features and Response to GH Treatment of Patients With a Molecular Defect of the IGF-1 Receptor.

Autor:	Walenkamp MJE; Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands., Robers JML; Department of Clinical Genetics, Leiden University Medical Center, Leiden, Netherlands., Wit JM; Department of Pediatrics, Leiden University Medical Center, Leiden, Netherlands., Zandwijken GRJ; Dutch Growth Research Foundation, Rotterdam, Netherlands., van Duyvenvoorde HA; Department of Clinical Genetics, Leiden University Medical Center, Leiden, Netherlands., Oostdijk W; Department of Pediatrics, Leiden University Medical Center, Leiden, Netherlands., Hokken-Koelega ACS; Dutch Growth Research Foundation, Rotterdam, Netherlands.; Department of Pediatrics, Subdivision of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands., Kant SG; Department of Clinical Genetics, Leiden University Medical Center, Leiden, Netherlands., Losekoot M; Department of Clinical Genetics, Leiden University Medical Center, Leiden, Netherlands.
Jazyk:	angličtina
Zdroj:	The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2019 Aug 01; Vol. 104 (8), pp. 3157-3171.
DOI:	10.1210/jc.2018-02065
Abstrakt:	Context: The phenotype and response to GH treatment of children with an IGF1R defect is insufficiently known. Objective: To develop a clinical score for selecting children with short stature for genetic testing and evaluate the efficacy of treatment. Design and Setting: Case series with an IGF1R defect identified in a university genetic laboratory. Patients and Interventions: Of all patients with sufficient clinical data, 18 had (likely) pathogenic mutations (group 1) and 7 had 15q deletions including IGF1R (group 2); 19 patients were treated with GH. Main Outcome Measures: Phenotype and response to GH treatment. Results: In groups 1 and 2, mean (range) birth weight, length, and head circumference (HC) SD scores (SDSs) were -2.1 (-3.7 to -0.4), -2.7 (-5.0 to -1.0), and -1.6 (-3.0 to 0.0), respectively. At presentation, height, HC, and serum IGF-1 SDSs were -3.0 (-5.5 to -1.7), -2.5 (-4.2 to -0.5), and +1.2 (-1.3 to 3.2), respectively. Feeding problems were reported in 15 of 19 patients. A clinical score with 76% sensitivity is proposed. After 3 years of GH treatment [1.1 (0.2) mg/m2/d] height gain in groups 1 (n = 12) and 2 (n = 7) was 0.9 SDS and 1.3 SDS (at a mean IGF-1 of 3.5 SDS), less than reported for small for gestational age (1.8 SDS). Conclusion: A clinical score encompassing birth weight and/or length, short stature, microcephaly, and IGF-1 is useful for selecting patients for IGF1R analysis. Feeding problems are common and the growth response to GH treatment is moderate. (Copyright © 2019 Endocrine Society.)
Databáze:	MEDLINE
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