Endocrine dysfunctions in children with Williams- Beuren syndrome
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: Williams-Beuren syndrome (WBS) is caused by a hemizygous microdeletion of chromosome 7q11.23 and is characterized by global cognitive impairment, dysmorphic facial features, and supravalvular aortic stenosis. Endocrine dysfunctions have been reported in patients with WBS. This study was performed to investigate the frequency, clinical features, and outcomes of endocrine dysfunctions in children with WBS. Methods: One hundred two patients were included. The diagnosis was confirmed by chromosome analysis and fluorescent in situ hybridization. Medical charts were reviewed retrospectively to analyze endocrine dysfunctions such as short stature, precocious puberty, thyroid dysfunctions, and hypocalcemia. Results: The age at diagnosis was 3.7±4.4 years (one month to 19 years). Height- and weight-standard deviation score (SDS) were –1.1±1.1 and –1.4±1.4 at presentation, respectively. Short stature was found in 26 patients (28.3%) among those older than 2 years. Body mass index-SDS increased as the patients grew older (P<0.001). Two males and one female (2.9%) were diagnosed with central precocious puberty. Nine patients (8.8%) were diagnosed with primary hypothyroidism at age 4.0±4.3 years (one month to 12.1 years); their serum thyroid stimulating hormone and free T4 levels were 15.2±5.4 μU/mL and 1.2±0.2 ng/dL, respectively. Hypercalcemia was observed in 12 out of 55 patients under age 3 (22%) at the age of 14.3±6.6 months (7 to 28 months) with a mean serum calcium level of 13.1±2.1 mg/dL. Conclusion: Endocrine dysfunctions are not uncommon causes of morbidity in patients with WBS. The severity and outcomes of their endocrine manifestations were heterogeneous. Long-term follow-up is needed to predict the prognosis of endocrine features.
Abstract
Purpose: Williams-Beuren syndrome (WBS) is caused by a hemizygous microdeletion of chromosome 7q11.23 and is characterized by global cognitive impairment, dysmorphic facial features, and supravalvular aortic stenosis. Endocrine dysfunctions have been reported in patients with WBS. This study was performed to investigate the frequency, clinical features, and outcomes of endocrine dysfunctions in children with WBS. Methods: One hundred two patients were included. The diagnosis was confirmed by chromosome analysis and fluorescent in situ hybridization. Medical charts were reviewed retrospectively to analyze endocrine dysfunctions such as short stature, precocious puberty, thyroid dysfunctions, and hypocalcemia. Results: The age at diagnosis was 3.7±4.4 years (one month to 19 years). Height- and weight-standard deviation score (SDS) were –1.1±1.1 and –1.4±1.4 at presentation, respectively. Short stature was found in 26 patients (28.3%) among those older than 2 years. Body mass index-SDS increased as the patients grew older (P<0.001). Two males and one female (2.9%) were diagnosed with central precocious puberty. Nine patients (8.8%) were diagnosed with primary hypothyroidism at age 4.0±4.3 years (one month to 12.1 years); their serum thyroid stimulating hormone and free T4 levels were 15.2±5.4 μU/mL and 1.2±0.2 ng/dL, respectively. Hypercalcemia was observed in 12 out of 55 patients under age 3 (22%) at the age of 14.3±6.6 months (7 to 28 months) with a mean serum calcium level of 13.1±2.1 mg/dL. Conclusion: Endocrine dysfunctions are not uncommon causes of morbidity in patients with WBS. The severity and outcomes of their endocrine manifestations were heterogeneous. Long-term follow-up is needed to predict the prognosis of endocrine features.
참고문헌 (28)
- Stromme P, "Prevalence estimation of Williams syndrome", J Child Neurol, 17, pp.269~271 (2002)
- Schubert C, "The genomic basis of the Williams-Beuren syndrome", Cell Mol Life Sci, 66, pp.1178~1197 (2009)
- Segura-Puimedon M, "Heterozygous deletion of the Williams-Beuren syndrome critical interval in mice recapitulates most features of the human disorder", Hum Mol Genet, 23, pp.6481~6494 (2014)
- Pober BR, "Williams-Beuren syndrome", N Engl J Med, 362, pp.239~252 (2010)
- Li HH, "Induced chromosome deletions cause hypersociability and other features of Williams-Beuren syndrome in mice", EMBO Mol Med, 1, pp.50~65 (2009)
- Committee on Genetics, "American Academy of Pediatrics:Health care supervision for children with Williams syndrome", Pediatrics, 107, pp.1192~1204 (2001)
- Palacios-Verdu MG, "Metabolic abnormalities in Williams-Beuren syndrome", J Med Genet, 52, pp.248~255 (2015)
- Partsch CJ, "Longitudinal evaluation of growth, puberty, and bone maturation in children with Williams syndrome", J Pediatr, 134, pp.82~89 (1999)
- Francke U, "Williams-Beuren syndrome: genes and mechanisms", Hum Mol Genet, 8, pp.1947~1954 (1999)
- "2007 Korean children and adolescents growth standard: commentary for the development of 2007 growth chart"[URL]
- Hyun SE, "Reference values for serum levels of insulin-like growth factor-I and insulin-like growth factor binding protein-3in Korean children and adolescents", Clin Biochem, 45, pp.16~21 (2012)
- Greulich WW, "Radiographic atlas of skeletal development of the hand and wrist" (1959), Stanford University Press
- Abreu AP, "Central precocious puberty caused by mutations in the imprinted gene MKRN3", N Engl J Med, 368, pp.2467~2475 (2013)
- Corbetta C, "A 7-year experience with low blood TSH cutoff levels for neonatal screening reveals an unsuspected frequency of congenital hypothyroidism (CH)", Clin Endocrinol (Oxf), 71, pp.739~745 (2009)
- Leger J, "European Society for Paediatric Endocrinolog y consensus guidelines on screening, diagnosis, and management of congenital hypothyroidism", J Clin Endocrinol Metab, 99, pp.363~384 (2014)
- Pankau R, "Statural growth in Williams-Beuren syndrome", Eur J Pediatr, 151, pp.751~755 (1992)
- Morris CA, "Natural history of Williams syndrome: physical characteristics", J Pediatr, 113, pp.318~326 (1988)
- 엄혜진, "Williams 증후군 환아의 연령에 따른 임상적 특징", 대한소아신경학회지, 18(2), pp.214~224 (2010), 대한소아신경학회
- Nogueira RJ, "Anthropometric and bodymass composition suggests an intrinsic feature in WilliamsBeuren syndrome", Rev Assoc Med Bras, 57, pp.681~685 (2011)
- Partsch CJ, "Central precocious puberty in girls with Williams syndrome", J Pediatr, 141, pp.441~444 (2002)
- Selicorni A, "Thyroid anomalies in Williams syndrome:i nve st i g at ion of 9 5 p at ient s", A m J Me d G ene t A, 140, pp.1098~1101 (2006)
- Cambiaso P, "Thyroid morphology and subclinical hypothyroidism in children and adolescents with Williams syndrome", J Pediatr, 150, pp.62~65 (2007)
- Dimitriadou M, "Congenital hypothyroidism as the initial presentation that led to the diagnosis of Williams syndrome", Gene, 494, pp.102~104 (2012)
- Stagi S, "Thyroid function and morphology in patients affected by Williams syndrome", Clin Endocrinol (Oxf ), 63, pp.456~460 (2005)
- Helfrich AM, "Late-onset hypercalcemia in Williams-Beuren syndrome: importance of early and frequent screening and intervention", J Pediatr Endocrinol Metab, 28, pp.425~428 (2015)
- Cagle AP, "Severe infantile hypercalcemia associated with Williams syndrome successfully treated with intravenously administered pamidronate", Pediatrics, 114, pp.1091~1095 (2004)
- Letavernier E, "Williams-Beuren syndrome hypercalcemia: is TRPC3 a novel mediator in calcium homeostasis?", Pediatrics, 129, pp.e1626~e1630 (2012)
- Garabedian M, "Ele vated plasma 1,25-dihydroxyvitamin D concentrations in infants with hypercalcemia and an elfin facies", N Engl J Med, 312, pp.948~952 (1985)
