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Published in: Italian Journal of Pediatrics 1/2018

Open Access 01-12-2018 | Commentary

Congenital hypopituitarism: how to select the patients for genetic analyses

Authors: Giuseppe Crisafulli, Tommaso Aversa, Giuseppina Zirilli, Filippo De Luca, Romina Gallizzi, Malgorzata Wasniewska

Published in: Italian Journal of Pediatrics | Issue 1/2018

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Abstract

Aim of this commentary is to analyze the relationships between genotypic bases and phenotypic expression of congenital “multiple pituitary hormone deficiency” (MPHD) syndrome and to indicate some reliable criteria for selecting the patients who should undergo genetic analyses in order to clarify the etiology of their disorder.
On the basis of the most recent reports on this topic, it is possible to infer that: 1) in only few patients with congenital MPHD it is possible to detect a causative gene mutation; 2) therefore, it is fundamental to define some criteria for selecting the patients who should undergo genetic analyses; 3) such inclusion criteria should be based on the overall evaluation of hormonal clinical and neuroradiological phenotype; 4) it is crucial to consider whether the cases are sporadic or familial, since the probability of finding a causative gene mutation is distinctly higher in familial cases; 5) for PROP1 gene it is also important to consider the geographical origin of the patients, because this mutation is much more frequent in some ethnic groups.
Literature
1.
go back to reference Murray PG, Dattani MT, Clayton PE. Controversies in the diagnosis and management of growth hormone deficiency in childhood and adolescence. Arch Dis Child. 2016;101:96–100.CrossRefPubMed Murray PG, Dattani MT, Clayton PE. Controversies in the diagnosis and management of growth hormone deficiency in childhood and adolescence. Arch Dis Child. 2016;101:96–100.CrossRefPubMed
2.
go back to reference Giordano M. Genetic causes of isolated and combined pituitary hormone deficiency. Best Pract Res Clin Endocrinol Metab. 2016;30:679–91.CrossRefPubMed Giordano M. Genetic causes of isolated and combined pituitary hormone deficiency. Best Pract Res Clin Endocrinol Metab. 2016;30:679–91.CrossRefPubMed
3.
go back to reference De Rienzo F, Mellone S, Bellone S, Babu D, Fusco I, Prodam F, et al. Frequency of genetic defects in combined pituitary hormone deficiency: a systematic review and analysis of a multicenter Italian cohort. Clin Endocrinol. 2015;83:849–60.CrossRef De Rienzo F, Mellone S, Bellone S, Babu D, Fusco I, Prodam F, et al. Frequency of genetic defects in combined pituitary hormone deficiency: a systematic review and analysis of a multicenter Italian cohort. Clin Endocrinol. 2015;83:849–60.CrossRef
4.
go back to reference Scommegna S, Galeazzi D, Picone S, Farinelli E, Agostino R, Bozzao A, et al. Neonatal identification of pituitary aplasia: a life-saving diagnosis. Review of five cases. Horm Res. 2004;62:10–6.CrossRefPubMed Scommegna S, Galeazzi D, Picone S, Farinelli E, Agostino R, Bozzao A, et al. Neonatal identification of pituitary aplasia: a life-saving diagnosis. Review of five cases. Horm Res. 2004;62:10–6.CrossRefPubMed
5.
go back to reference Arrigo T, Wasniewska M, De Luca F, Valenzise M, Lombardo F, Vivenza D, et al. Congenital adenohypophysis aplasia: clinical features and analysis of the transcriptional factors for embryonic pituitary development. J Endocrinol Investig. 2006;29:208–13.CrossRef Arrigo T, Wasniewska M, De Luca F, Valenzise M, Lombardo F, Vivenza D, et al. Congenital adenohypophysis aplasia: clinical features and analysis of the transcriptional factors for embryonic pituitary development. J Endocrinol Investig. 2006;29:208–13.CrossRef
6.
go back to reference Navardauskaite R, Dusatkova P, Obermannova B, Pfaeffle RW, Blum WF, Adukauskiene D, et al. High prevalence of PROP1 defects in Lithuania: phenotypic findings in an ethnically homogenous cohort of patients with multiple pituitary hormone deficiency. J Clin Endocrinol Metab. 2014;99:299–306.CrossRefPubMed Navardauskaite R, Dusatkova P, Obermannova B, Pfaeffle RW, Blum WF, Adukauskiene D, et al. High prevalence of PROP1 defects in Lithuania: phenotypic findings in an ethnically homogenous cohort of patients with multiple pituitary hormone deficiency. J Clin Endocrinol Metab. 2014;99:299–306.CrossRefPubMed
7.
go back to reference Fofanova OV, Takamura N, Kinoshita E, Yoshimoto M, Tsuji Y, Peterkova VA, et al. Rarity of PIT1 involvement in children from Russia with combined pituitary hormone deficiency. Am J Med Genet. 1998;77:360–5.CrossRefPubMed Fofanova OV, Takamura N, Kinoshita E, Yoshimoto M, Tsuji Y, Peterkova VA, et al. Rarity of PIT1 involvement in children from Russia with combined pituitary hormone deficiency. Am J Med Genet. 1998;77:360–5.CrossRefPubMed
8.
go back to reference Halász Z, Toke J, Patócs A, Bertalan R, Tömböl Z, Sallai A, et al. High prevalence of PROP1 gene mutations in Hungarian patients with childhood-onset combined anterior pituitary hormone deficiency. Endocrine. 2006;30:255–60.CrossRefPubMed Halász Z, Toke J, Patócs A, Bertalan R, Tömböl Z, Sallai A, et al. High prevalence of PROP1 gene mutations in Hungarian patients with childhood-onset combined anterior pituitary hormone deficiency. Endocrine. 2006;30:255–60.CrossRefPubMed
9.
go back to reference Lemos MC, Gomes L, Bastos M, Leite V, Limbert E, Carvalho D, et al. PROP1 gene analysis in Portuguese patients with combined pituitary hormone deficiency. Clin Endocrinol. 2006;65:479–85.CrossRef Lemos MC, Gomes L, Bastos M, Leite V, Limbert E, Carvalho D, et al. PROP1 gene analysis in Portuguese patients with combined pituitary hormone deficiency. Clin Endocrinol. 2006;65:479–85.CrossRef
10.
go back to reference Lebl J, Vosáhlo J, Pfaeffle RW, Stobbe H, Cerná J, Novotná D, et al. Auxological and endocrine phenotype in a population-based cohort of patients with PROP1 gene defects. Eur J Endocrinol. 2005;153:389–96.CrossRefPubMed Lebl J, Vosáhlo J, Pfaeffle RW, Stobbe H, Cerná J, Novotná D, et al. Auxological and endocrine phenotype in a population-based cohort of patients with PROP1 gene defects. Eur J Endocrinol. 2005;153:389–96.CrossRefPubMed
11.
go back to reference Vieira TC, Boldarine VT, Abucham J. Molecular analysis of PROP1, PIT1, HESX1, LHX3, and LHX4 shows high frequency of PROP1 mutations in patients with familial forms of combined pituitary hormone deficiency. Arq Bras Endocrinol Metabol. 2007;51:1097–103.CrossRefPubMed Vieira TC, Boldarine VT, Abucham J. Molecular analysis of PROP1, PIT1, HESX1, LHX3, and LHX4 shows high frequency of PROP1 mutations in patients with familial forms of combined pituitary hormone deficiency. Arq Bras Endocrinol Metabol. 2007;51:1097–103.CrossRefPubMed
12.
go back to reference Turton JP, Mehta A, Raza J, Woods KS, Tiulpakov A, Cassar J, et al. Mutations within the transcription factor PROP1 are rare in a cohort of patients with sporadic combined pituitary hormone deficiency (CPHD). Clin Endocrinol. 2005;63:10–8.CrossRef Turton JP, Mehta A, Raza J, Woods KS, Tiulpakov A, Cassar J, et al. Mutations within the transcription factor PROP1 are rare in a cohort of patients with sporadic combined pituitary hormone deficiency (CPHD). Clin Endocrinol. 2005;63:10–8.CrossRef
13.
go back to reference Riepe FG, Partsch CJ, Blankenstein O, Mönig H, Pfäffle RW, Sippell WG. Longitudinal imaging reveals pituitary enlargement preceding hypoplasia in two brothers with combined pituitary hormone deficiency attributable to PROP1 mutation. J Clin Endocrinol Metab. 2001;86:4353–7.CrossRefPubMed Riepe FG, Partsch CJ, Blankenstein O, Mönig H, Pfäffle RW, Sippell WG. Longitudinal imaging reveals pituitary enlargement preceding hypoplasia in two brothers with combined pituitary hormone deficiency attributable to PROP1 mutation. J Clin Endocrinol Metab. 2001;86:4353–7.CrossRefPubMed
14.
go back to reference Tkacenko N, Lasiene D, Jakstiene S, Basevicius A, Verkauskiene R. Evaluation of pituitary imaging in patients with prop-1 gene mutation. Medicina (Kaunas). 2009;45:693–8. Tkacenko N, Lasiene D, Jakstiene S, Basevicius A, Verkauskiene R. Evaluation of pituitary imaging in patients with prop-1 gene mutation. Medicina (Kaunas). 2009;45:693–8.
15.
go back to reference Choi JH, Jung CW, Kang E, Kim YM, Heo SH, Lee BH, et al. Rare frequency of mutations in pituitary transcription factor genes in combined pituitary hormone or isolated growth hormone deficiencies in Korea. Yonsei Med J. 2017;58:527–32.CrossRefPubMedPubMedCentral Choi JH, Jung CW, Kang E, Kim YM, Heo SH, Lee BH, et al. Rare frequency of mutations in pituitary transcription factor genes in combined pituitary hormone or isolated growth hormone deficiencies in Korea. Yonsei Med J. 2017;58:527–32.CrossRefPubMedPubMedCentral
16.
go back to reference Fang Q, George AS, Brinkmeier ML, Mortensen AH, Gergics P, Cheung LY, et al. Genetics of combined pituitary hormone deficiency: roadmap into the genome era. Endocr Rev. 2016;37:636–75.CrossRefPubMedPubMedCentral Fang Q, George AS, Brinkmeier ML, Mortensen AH, Gergics P, Cheung LY, et al. Genetics of combined pituitary hormone deficiency: roadmap into the genome era. Endocr Rev. 2016;37:636–75.CrossRefPubMedPubMedCentral
17.
go back to reference Elizabeth M, Hokken-Koelega ACS, Schuilwerve J, Peeters RP, Visser TJ, de Graaff LCG. Genetic screening of regulatory regions of pituitary transcription factors in patients with idiopathic pituitary hormone deficiencies. Pituitary. 2018;21:76–83.CrossRefPubMed Elizabeth M, Hokken-Koelega ACS, Schuilwerve J, Peeters RP, Visser TJ, de Graaff LCG. Genetic screening of regulatory regions of pituitary transcription factors in patients with idiopathic pituitary hormone deficiencies. Pituitary. 2018;21:76–83.CrossRefPubMed
Metadata
Title
Congenital hypopituitarism: how to select the patients for genetic analyses
Authors
Giuseppe Crisafulli
Tommaso Aversa
Giuseppina Zirilli
Filippo De Luca
Romina Gallizzi
Malgorzata Wasniewska
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Italian Journal of Pediatrics / Issue 1/2018
Electronic ISSN: 1824-7288
DOI
https://doi.org/10.1186/s13052-018-0484-y

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