title: Diencephalic syndrome: a cause of failure to thrive and a model of partial growth hormone resistance.
abstract: Diencephalic syndrome is a rare but potentially lethal cause of failure to thrive in infants and young children. The diencephalic syndrome includes clinical characteristics of severe emaciation, normal linear growth, and normal or precocious intellectual development in association with central nervous system tumors. Our group initially described a series of 9 patients with diencephalic syndrome and found a reduced prevalence of emesis, hyperalertness, or hyperactivity compared with previous reports. Also, the tumors were found to be larger, occur at a younger age, and behave more aggressively than similarly located tumors without diencephalic syndrome. We have been able to extend our follow-up of the original patients, as well as describe 2 additional cases. Because the mechanism of the growth and endocrinologic findings in diencephalic syndrome has not been explained, we report on these patients in light of current research on hypothalamic factors that affect growth and weight. This study emphasizes diencephalic syndrome as a model for additional study of growth hormone resistance and metabolic regulation of adiposity.
authors.affiliation: Division of Endocrinology, Children's Hospital Boston, 300 Longwood Ave, Boston, MA 02115, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Fleischman
authors.forename: Catherine
authors.initials: C
authors.lastname: Brue
authors.forename: Tina Young
authors.initials: TY
authors.lastname: Poussaint
authors.forename: Mark
authors.initials: M
authors.lastname: Kieran
authors.forename: Scott L
authors.initials: SL
authors.lastname: Pomeroy
authors.forename: Liliana
authors.initials: L
authors.lastname: Goumnerova
authors.forename: R Michael
authors.initials: RM
authors.lastname: Scott
authors.forename: Laurie E
authors.initials: LE
authors.lastname: Cohen
mesh_terms: D001254:Astrocytoma / Q000150:complications* / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology / Q000556:secondary; D002446:Celiac Disease / Q000175:diagnosis; D002675:Child, Preschool; D003951:Diagnostic Errors; D004027:Diencephalon / Q000473:pathology*; D018450:Disease Progression; D004614:Emaciation / Q000209:etiology*; D005183:Failure to Thrive / Q000209:etiology*; D005260:Female; D019382:Human Growth Hormone / Q000097:blood / Q000378:metabolism / Q000502:physiology*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D006948:Hyperkinesis / Q000209:etiology; D007029:Hypothalamic Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D007223:Infant; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D008954:Models, Biological; D009759:Nystagmus, Pathologic / Q000209:etiology; D012189:Retrospective Studies; D013120:Spinal Cord Neoplasms / Q000556:secondary; D013577:Syndrome; D014839:Vomiting / Q000209:etiology
chemical_list: D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D006854:Hydrocortisone