title: 3-M syndrome associated with growth hormone deficiency: 18 year follow-up of a patient.
abstract: 3-M syndrome is a rare autosomal recessive disorder that causes short stature, unusual facial features and skeletal abnormalities. Mutations in the CUL7, OBSL1 and CCDC8 genes could be responsible for 3-M syndrome.Here we describe the growth and evolution of dismorphic features of an Italian boy with 3-M syndrome and growth hormone deficiency (GHD) from birth until adulthood. He was born full term with a very low birth weight (2400 g=-3.36 standard deviation score, SDS) and length (40.0 cm =-6.53 SDS). At birth he presented with a broad, fleshy nose with anteverted nostrils, thick and patulous lips, a square chin, curvilinear shaped eyebrows without synophrys, short thorax and long slender bones. Then, during childhood tall vertebral bodies, hip dislocation, transverse chest groove, winged scapulae and hyperextensible joints became more evident and the diagnosis of 3-M syndrome was made; this was also confirmed by the finding of a homozygous deletion in exon 18 of the CUL7 gene, which has not been previously described.The patient also exhibited severe GHD (GH <5 ng/ml) and from the age of 18 months was treated with rhGH. Notwithstanding the early start of therapy and good compliance, his growth rate was always very low, except for the first two years of treatment and he achieved a final height of 132 cm (-6.42 SDS).
authors.affiliation: Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Piazzale C, Golgi 2, Pavia 27100, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Meazza
authors.forename: Ekkehard
authors.initials: E
authors.lastname: Lausch
authors.forename: Sara
authors.initials: S
authors.lastname: Pagani
authors.forename: Elena
authors.initials: E
authors.lastname: Bozzola
authors.forename: Valeria
authors.initials: V
authors.lastname: Calcaterra
authors.forename: Andrea
authors.initials: A
authors.lastname: Superti-Furga
authors.forename: Margherita
authors.initials: M
authors.lastname: Silengo
authors.forename: Mauro
authors.initials: M
authors.lastname: Bozzola
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000378:metabolism; D001827:Body Height / Q000235:genetics; D001842:Bone and Bones / Q000002:abnormalities; D002872:Chromosome Deletion; D044842:Cullin Proteins / Q000235:genetics*; D004392:Dwarfism / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics*; D004393:Dwarfism, Pituitary / Q000175:diagnosis / Q000188:drug therapy; D005091:Exons; D005145:Face / Q000002:abnormalities; D005500:Follow-Up Studies; D019382:Human Growth Hormone / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009123:Muscle Hypotonia / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics*; D009154:Mutation; D013131:Spine / Q000002:abnormalities; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; C506299:CUL7 protein, human; D044842:Cullin Proteins; D019382:Human Growth Hormone