title: Isolated autosomal dominant growth hormone deficiency: an evolving pituitary deficit? A multicenter follow-up study.
abstract: Four distinct familial types of isolated GH deficiency have been described so far, of which type II is the autosomal dominant inherited form. It is mainly caused by mutations within the first 6 bp of intervening sequence 3. However, other splice site and missense mutations have been reported. Based on in vitro experiments and transgenic animal data, there is strong evidence that there is a wide variability in phenotype in terms of the severity of GH deficiency. Therefore, we studied a total of 57 subjects belonging to 19 families suffering from different splice site as well as missense mutations within the GH-1 gene. The subjects presenting with a splice site mutation within the first 2 bp of intervening sequence 3 (5'IVS +1/+2 bp) leading to a skipping of exon 3 were found to be more likely to present in the follow-up with other pituitary hormone deficiencies. In addition, although the patients with missense mutations have previously been reported to be less affected, a number of patients presenting with the P89L missense GH form, showed some pituitary hormone impairment. The development of multiple hormonal deficiencies is not age dependent, and there is a clear variability in onset, severity, and progression, even within the same families. The message of clinical importance from these studies is that the pituitary endocrine status of all such patients should continue to be monitored closely over the years because further hormonal deficiencies may evolve with time.
authors.affiliation: Pediatric Endocrinology, Diabetology, and Metabolism, University Children's Hospital, Inselspital, CH-3010 Bern, Switzerland. primus.mullis@insel.ch
authors.forename: Primus E
authors.initials: PE
authors.lastname: Mullis
authors.forename: Iain C A F
authors.initials: IC
authors.lastname: Robinson
authors.forename: Souzan
authors.initials: S
authors.lastname: Salemi
authors.forename: Andrée
authors.initials: A
authors.lastname: Eblé
authors.forename: Amélie
authors.initials: A
authors.lastname: Besson
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Vuissoz
authors.forename: Johnny
authors.initials: J
authors.lastname: Deladoey
authors.forename: Dominique
authors.initials: D
authors.lastname: Simon
authors.forename: Paul
authors.initials: P
authors.lastname: Czernichow
authors.forename: Gerhard
authors.initials: G
authors.lastname: Binder
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D019382:Human Growth Hormone / Q000172:deficiency* / Q000235:genetics*; D006801:Humans; D007223:Infant; D008297:Male; D009154:Mutation; D010902:Pituitary Gland / Q000473:pathology*; D012326:RNA Splicing
chemical_list: D019382:Human Growth Hormone