title: Long-term follow-up of combined pituitary hormone deficiency in two siblings with a Prophet of Pit-1 gene mutation.
abstract: Combined pituitary hormone deficiency (CPHD) is a rare disorder resulting from an impaired pituitary function due to different causes, characterized by impaired secretion of growth hormone (GH) and one or more of the other anterior pituitary hormones. To date, 16 distinct human Prophet of Pit-1 (Prop1) gene mutations have been identified in patients with CPHD, inducing a phenotype involving GH, follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin and thyroid-stimulating hormone (TSH), and rarely adrenocorticotropic hormone, deficiency. Herein we present two siblings of different sexes from a family with parental consanguinity presenting the 301-302delAG mutation in the Prop1 gene. The female presented failure of growth from the age of 6 years and was treated for 10 years with GH, ending in a final height (standard deviation score) of -0.28. TSH deficiency was manifested after the initiation of GH and was treated with thyroxine while puberty was initiated with conjugated estrogens. The male presented TSH deficiency since childhood, treated with thyroxine, and growth failure at the age of 14 years, treated for a period of 2 years with GH. Puberty was initiated with increasing doses of testosterone, while human chorionic gonadotropin was added in order to achieve increased testicular volume. In conclusion, these two siblings of different sexes with CPHD carrying the 301-302delAG mutation in the Prop1 gene presented a variable phenotype characterized by GH, TSH, LH and FSH deficiency.
authors.affiliation: Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Patras Medical School, Patras, Greece. neoklisg@hol.gr
authors.forename: Neoklis A
authors.initials: NA
authors.lastname: Georgopoulos
authors.forename: Ilias
authors.initials: I
authors.lastname: Katsikis
authors.forename: Petros
authors.initials: P
authors.lastname: Giamalis
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Koika
authors.forename: George
authors.initials: G
authors.lastname: Adonakis
authors.forename: Anargyros
authors.initials: A
authors.lastname: Kourtis
authors.forename: George
authors.initials: G
authors.lastname: Kourounis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Panidis
mesh_terms: D000293:Adolescent; D003241:Consanguinity; D004393:Dwarfism, Pituitary / Q000235:genetics*; D005260:Female; D016368:Frameshift Mutation / Q000235:genetics / Q000502:physiology; D006065:Gonadotropins, Pituitary / Q000172:deficiency*; D013006:Growth Hormone / Q000172:deficiency*; D018398:Homeodomain Proteins / Q000235:genetics*; D006801:Humans; D007006:Hypogonadism / Q000235:genetics*; D008297:Male; D009154:Mutation; D010375:Pedigree; D035781:Siblings
chemical_list: D006065:Gonadotropins, Pituitary; D018398:Homeodomain Proteins; C102134:Prophet of Pit-1 protein; D013006:Growth Hormone