title: Delayed Adrenarche may be an Additional Feature of Immunoglobulin Super Family Member 1 Deficiency Syndrome.
abstract: Immunoglobulin super family member 1 (IGSF1) deficiency syndrome is characterized by central hypothyroidism, delayed surge in testosterone during puberty, macro-orchidism, and in some cases, hypoprolactinemia and/or transient growth hormone (GH) deficiency. Our patient was a 19-year-old male adolescent who had been treated since the age of 9 years with GH and thyroxine for an idiopathic combined GH, thyroid-stimulating hormone (TSH), and prolactin (PRL) deficiency. His GH deficiency proved to be transient, but deficiencies of TSH and PRL persisted, and he had developed macro-orchidism since the end of puberty. Brain magnetic resonance imaging and PROP1 and POU1F1 sequencing were normal. A disharmonious puberty (delayed genital and pubic hair development, bone maturation, and pubertal growth spurt, despite normal testicular growth) was observed as well as a delayed adrenarche, as reflected by very low dehydroepiandrosterone sulfate and delayed pubarche. Direct sequencing of the IGSF1 gene revealed a novel hemizygous mutation, c.3127T>C, p.Cys1043Arg. Pathogenicity of the mutation was demonstrated in vitro. Male children with an idiopathic combined GH, PRL, and TSH deficiency, showing persistent central hypothyroidism but transient GH deficiency upon retesting at adult height, should be screened for mutations in the IGSF1 gene, especially when macro-orchidism and/or hypoprolactinemia are present. We suspect that delayed adrenarche, as a consequence of PRL deficiency, might be part of the clinical phenotype of patients with IGSF1 deficiency.
authors.forename: Severine
authors.initials: S
authors.lastname: Van Hulle
authors.forename: Margarita
authors.initials: M
authors.lastname: Craen
authors.forename: Bert
authors.initials: B
authors.lastname: Callewaert
authors.forename: Sjoerd
authors.initials: S
authors.lastname: Joustra
authors.forename: Wilma
authors.initials: W
authors.lastname: Oostdijk
authors.forename: Monique
authors.initials: M
authors.lastname: Losekoot
authors.forename: Jan Maarten
authors.initials: JM
authors.lastname: Wit
authors.forename: Marc Olivier
authors.initials: MO
authors.lastname: Turgeon
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Bernard
authors.affiliation: University Hospital Gent, Department of Pediatrics, Gent, Belgium, E-mail: Jean.deschepper@uzgent.be.
authors.forename: Jean
authors.initials: J
authors.lastname: De Schepper
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000032:analysis; D001786:Blood Glucose / Q000032:analysis; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1; D003924:Diabetes Mellitus, Type 2; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007223:Infant; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human