Same Phenotype in Children with Growth Hormone Deficiency and Resistance

By definition, about 2.5% of children show a short stature due to several causes. Two clinical conditions are characterized by serum IGF-I low levels, idiopathic GH deficiency (IGHD), and GH insensitivity (GHI), and the phenotypic appearance of these patients may be very similar. We studied two chil...

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Main Authors: Irene Ioimo, Carmen Guarracino, Cristina Meazza, Horacio M. Domené, Mauro Bozzola
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Case Reports in Pediatrics
Online Access:http://dx.doi.org/10.1155/2018/5902835
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author Irene Ioimo
Carmen Guarracino
Cristina Meazza
Horacio M. Domené
Mauro Bozzola
author_facet Irene Ioimo
Carmen Guarracino
Cristina Meazza
Horacio M. Domené
Mauro Bozzola
author_sort Irene Ioimo
collection DOAJ
description By definition, about 2.5% of children show a short stature due to several causes. Two clinical conditions are characterized by serum IGF-I low levels, idiopathic GH deficiency (IGHD), and GH insensitivity (GHI), and the phenotypic appearance of these patients may be very similar. We studied two children with short stature and similar phenotypes. The first case showed frontal bossing, doll face, acromicria, and truncal obesity, with a GH peak <0.05 ng/ml after stimuli and undetectable serum IGF-I levels. After PCR amplification of the whole GH1 gene, type IA idiopathic GHD was diagnosed. The second case had cranium hypoplasia, a large head, protruding forehead, saddle nose, underdeveloped mandible, and a micropenis. Basal GH levels were high (28.4 ng/ml) while serum IGF-I levels were low and unchangeable during the IGF-I generation test. Laron syndrome was confirmed after the molecular analysis of the GH receptor (GHR) gene. IGHD type IA and Laron syndrome is characterized by opposite circulating levels of GH, while both have reduced levels of IGF-I, with an overlapping clinical phenotype, lacking the effects of IGF-I on cartilage. These classical cases show the importance of differential diagnosis in children with severe short stature.
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spelling doaj-art-c3f5bf1431264b20a5c4b9a43be23faa2025-08-20T03:23:11ZengWileyCase Reports in Pediatrics2090-68032090-68112018-01-01201810.1155/2018/59028355902835Same Phenotype in Children with Growth Hormone Deficiency and ResistanceIrene Ioimo0Carmen Guarracino1Cristina Meazza2Horacio M. Domené3Mauro Bozzola4University of Pavia, Piazzale Golgi 2, 27100 Pavia, ItalyUniversity of Pavia, Piazzale Golgi 2, 27100 Pavia, ItalyUniversity of Pavia, Piazzale Golgi 2, 27100 Pavia, ItalyCentro de Investigaciones Endocrinológicas “Dr. César Bergadá” (CEDIE) CONICET-FEI, División de Endocrinología, Hospital de Niños “Ricardo Gutiérrez”, Buenos Aires, ArgentinaUniversity of Pavia, Piazzale Golgi 2, 27100 Pavia, ItalyBy definition, about 2.5% of children show a short stature due to several causes. Two clinical conditions are characterized by serum IGF-I low levels, idiopathic GH deficiency (IGHD), and GH insensitivity (GHI), and the phenotypic appearance of these patients may be very similar. We studied two children with short stature and similar phenotypes. The first case showed frontal bossing, doll face, acromicria, and truncal obesity, with a GH peak <0.05 ng/ml after stimuli and undetectable serum IGF-I levels. After PCR amplification of the whole GH1 gene, type IA idiopathic GHD was diagnosed. The second case had cranium hypoplasia, a large head, protruding forehead, saddle nose, underdeveloped mandible, and a micropenis. Basal GH levels were high (28.4 ng/ml) while serum IGF-I levels were low and unchangeable during the IGF-I generation test. Laron syndrome was confirmed after the molecular analysis of the GH receptor (GHR) gene. IGHD type IA and Laron syndrome is characterized by opposite circulating levels of GH, while both have reduced levels of IGF-I, with an overlapping clinical phenotype, lacking the effects of IGF-I on cartilage. These classical cases show the importance of differential diagnosis in children with severe short stature.http://dx.doi.org/10.1155/2018/5902835
spellingShingle Irene Ioimo
Carmen Guarracino
Cristina Meazza
Horacio M. Domené
Mauro Bozzola
Same Phenotype in Children with Growth Hormone Deficiency and Resistance
Case Reports in Pediatrics
title Same Phenotype in Children with Growth Hormone Deficiency and Resistance
title_full Same Phenotype in Children with Growth Hormone Deficiency and Resistance
title_fullStr Same Phenotype in Children with Growth Hormone Deficiency and Resistance
title_full_unstemmed Same Phenotype in Children with Growth Hormone Deficiency and Resistance
title_short Same Phenotype in Children with Growth Hormone Deficiency and Resistance
title_sort same phenotype in children with growth hormone deficiency and resistance
url http://dx.doi.org/10.1155/2018/5902835
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AT horaciomdomene samephenotypeinchildrenwithgrowthhormonedeficiencyandresistance
AT maurobozzola samephenotypeinchildrenwithgrowthhormonedeficiencyandresistance