Growth hormone deficiency screening: Difference between revisions
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==Screening== | ==Screening== | ||
=== ''Genetic screening indications:'' === | === ''Genetic screening indications:''<ref>{{Cite journal | ||
| title = Consensus guidelines for the diagnosis and treatment of growth hormone (GH) deficiency in childhood and adolescence: summary statement of the GH Research Society. GH Research Society | |||
| journal = [[The Journal of clinical endocrinology and metabolism]] | |||
| volume = 85 | |||
| issue = 11 | |||
| pages = 3990–3993 | |||
| year = 2000 | |||
| month = November | |||
| doi = 10.1210/jcem.85.11.6984 | |||
| pmid = 11095419 | |||
}}</ref> === | |||
* Early onset of growth failure | * Early onset of growth failure | ||
* Positive family history and possible consanguinity | * Positive family history and possible consanguinity | ||
* Height more than 3 sd below the mean | * Height more than 3 sd below the mean | ||
* Extremely low GH response to provocation tests, including GHRH, and very low IGF-I and IGF-binding protein-3 (IGFBP-3) levels | * Extremely low GH response to provocation tests, including GHRH, and very low IGF-I and IGF-binding protein-3 (IGFBP-3) levels | ||
* GHD patients have been screened for mutations in the GH1 and GHRH gene.<ref>{{Cite journal | |||
| author = [[Marcela M. Franca]], [[Alexander A. L. Jorge]], [[Kyriaki S. Alatzoglou]], [[Luciani R. S. Carvalho]], [[Berenice B. Mendonca]], [[Laura Audi]], [[Antonio Carrascosa]], [[Mehul T. Dattani]] & [[Ivo J. P. Arnhold]] | |||
| title = Absence of GH-releasing hormone (GHRH) mutations in selected patients with isolated GH deficiency | |||
| journal = [[The Journal of clinical endocrinology and metabolism]] | |||
| volume = 96 | |||
| issue = 9 | |||
| pages = E1457–E1460 | |||
| year = 2011 | |||
| month = September | |||
| doi = 10.1210/jc.2011-0170 | |||
| pmid = 21715545 | |||
}}</ref> | |||
* A recent study recommended testing for GH1 and GHRHR mutations in children with severe GHD and a family history of GHD.<ref>{{Cite journal | |||
| author = [[J. M. Wit]], [[W. Kiess]] & [[P. Mullis]] | |||
| title = Genetic evaluation of short stature | |||
| journal = [[Best practice & research. Clinical endocrinology & metabolism]] | |||
| volume = 25 | |||
| issue = 1 | |||
| pages = 1–17 | |||
| year = 2011 | |||
| month = February | |||
| doi = 10.1016/j.beem.2010.06.007 | |||
| pmid = 21396571 | |||
}}</ref> | |||
* The patient with HMGA2 mutation had severe short stature, low IGF-I, abnormal response to provocative GH testing, and abnormal MRI, and responded well to growth hormone therapy.<ref>{{Cite journal | |||
| author = [[Darya Gorbenko del Blanco]], [[Laura C. G. de Graaff]], [[Dirk Posthouwer]], [[Theo J. Visser]] & [[Anita C. S. Hokken-Koelega]] | |||
| title = Isolated GH deficiency: mutation screening and copy number analysis of HMGA2 and CDK6 genes | |||
| journal = [[European journal of endocrinology]] | |||
| volume = 165 | |||
| issue = 4 | |||
| pages = 537–544 | |||
| year = 2011 | |||
| month = October | |||
| doi = 10.1530/EJE-11-0478 | |||
| pmid = 21803798 | |||
}}</ref> The importance of the HMGA2 gene in growth has been described through a study of patients with 12q14 microdeletion syndrome, which is characterized by developmental delay, severe short stature, and abnormal facies.<ref>{{Cite journal | |||
| author = [[Sally Ann Lynch]], [[Nicola Foulds]], [[Ann-Charlotte Thuresson]], [[Amanda L. Collins]], [[Goran Anneren]], [[Bernt-Oves Hedberg]], [[Carol A. Delaney]], [[James Iremonger]], [[Caroline M. Murray]], [[John A. Crolla]], [[Colm Costigan]], [[Wayne Lam]], [[David R. Fitzpatrick]], [[Regina Regan]], [[Sean Ennis]] & [[Freddie Sharkey]] | |||
| title = The 12q14 microdeletion syndrome: six new cases confirming the role of HMGA2 in growth | |||
| journal = [[European journal of human genetics : EJHG]] | |||
| volume = 19 | |||
| issue = 5 | |||
| pages = 534–539 | |||
| year = 2011 | |||
| month = May | |||
| doi = 10.1038/ejhg.2010.215 | |||
| pmid = 21267005 | |||
}}</ref> | |||
* Testing for a polymorphism in the IGFBP-3 gene may also aid in the diagnosis of GHD and prediction of response to therapy. <ref>{{Cite journal | |||
| author = [[J. A. 3rd Phillips]] & [[J. D. Cogan]] | |||
| title = Genetic basis of endocrine disease. 6. Molecular basis of familial human growth hormone deficiency | |||
| journal = [[The Journal of clinical endocrinology and metabolism]] | |||
| volume = 78 | |||
| issue = 1 | |||
| pages = 11–16 | |||
| year = 1994 | |||
| month = January | |||
| doi = 10.1210/jcem.78.1.8288694 | |||
| pmid = 8288694 | |||
}}</ref> | |||
* Understanding of genetic contributions to GHD opens the possibility for a more rational approach to the diagnosis and management of GHD.<ref>{{Cite journal | |||
| author = [[Takara Stanley]] | |||
| title = Diagnosis of growth hormone deficiency in childhood | |||
| journal = [[Current opinion in endocrinology, diabetes, and obesity]] | |||
| volume = 19 | |||
| issue = 1 | |||
| pages = 47–52 | |||
| year = 2012 | |||
| month = February | |||
| doi = 10.1097/MED.0b013e32834ec952 | |||
| pmid = 22157400 | |||
}}</ref> | |||
==References== | ==References== |
Revision as of 19:06, 18 August 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Screening
Genetic screening indications:[1]
- Early onset of growth failure
- Positive family history and possible consanguinity
- Height more than 3 sd below the mean
- Extremely low GH response to provocation tests, including GHRH, and very low IGF-I and IGF-binding protein-3 (IGFBP-3) levels
- GHD patients have been screened for mutations in the GH1 and GHRH gene.[2]
- A recent study recommended testing for GH1 and GHRHR mutations in children with severe GHD and a family history of GHD.[3]
- The patient with HMGA2 mutation had severe short stature, low IGF-I, abnormal response to provocative GH testing, and abnormal MRI, and responded well to growth hormone therapy.[4] The importance of the HMGA2 gene in growth has been described through a study of patients with 12q14 microdeletion syndrome, which is characterized by developmental delay, severe short stature, and abnormal facies.[5]
- Testing for a polymorphism in the IGFBP-3 gene may also aid in the diagnosis of GHD and prediction of response to therapy. [6]
- Understanding of genetic contributions to GHD opens the possibility for a more rational approach to the diagnosis and management of GHD.[7]
References
- ↑ "Consensus guidelines for the diagnosis and treatment of growth hormone (GH) deficiency in childhood and adolescence: summary statement of the GH Research Society. GH Research Society". The Journal of clinical endocrinology and metabolism. 85 (11): 3990–3993. 2000. doi:10.1210/jcem.85.11.6984. PMID 11095419. Unknown parameter
|month=
ignored (help) - ↑ Marcela M. Franca, Alexander A. L. Jorge, Kyriaki S. Alatzoglou, Luciani R. S. Carvalho, Berenice B. Mendonca, Laura Audi, Antonio Carrascosa, Mehul T. Dattani & Ivo J. P. Arnhold (2011). "Absence of GH-releasing hormone (GHRH) mutations in selected patients with isolated GH deficiency". The Journal of clinical endocrinology and metabolism. 96 (9): E1457–E1460. doi:10.1210/jc.2011-0170. PMID 21715545. Unknown parameter
|month=
ignored (help) - ↑ J. M. Wit, W. Kiess & P. Mullis (2011). "Genetic evaluation of short stature". Best practice & research. Clinical endocrinology & metabolism. 25 (1): 1–17. doi:10.1016/j.beem.2010.06.007. PMID 21396571. Unknown parameter
|month=
ignored (help) - ↑ Darya Gorbenko del Blanco, Laura C. G. de Graaff, Dirk Posthouwer, Theo J. Visser & Anita C. S. Hokken-Koelega (2011). "Isolated GH deficiency: mutation screening and copy number analysis of HMGA2 and CDK6 genes". European journal of endocrinology. 165 (4): 537–544. doi:10.1530/EJE-11-0478. PMID 21803798. Unknown parameter
|month=
ignored (help) - ↑ Sally Ann Lynch, Nicola Foulds, Ann-Charlotte Thuresson, Amanda L. Collins, Goran Anneren, Bernt-Oves Hedberg, Carol A. Delaney, James Iremonger, Caroline M. Murray, John A. Crolla, Colm Costigan, Wayne Lam, David R. Fitzpatrick, Regina Regan, Sean Ennis & Freddie Sharkey (2011). "The 12q14 microdeletion syndrome: six new cases confirming the role of HMGA2 in growth". European journal of human genetics : EJHG. 19 (5): 534–539. doi:10.1038/ejhg.2010.215. PMID 21267005. Unknown parameter
|month=
ignored (help) - ↑ J. A. 3rd Phillips & J. D. Cogan (1994). "Genetic basis of endocrine disease. 6. Molecular basis of familial human growth hormone deficiency". The Journal of clinical endocrinology and metabolism. 78 (1): 11–16. doi:10.1210/jcem.78.1.8288694. PMID 8288694. Unknown parameter
|month=
ignored (help) - ↑ Takara Stanley (2012). "Diagnosis of growth hormone deficiency in childhood". Current opinion in endocrinology, diabetes, and obesity. 19 (1): 47–52. doi:10.1097/MED.0b013e32834ec952. PMID 22157400. Unknown parameter
|month=
ignored (help)