Background and objectives: Data on long-term cardiometabolic consequences in patients with congenital adrenal hyperplasia (CAH) are controversial. The aim of our study was to evaluate body mass index (BMI), body composition, blood pressure (BP) and insulin sensitivity in adolescents and young adults with CAH in comparison with healthy controls. Methods. Thirty-two patients with classical CAH (13 males; mean of age 26.0 ± 7.1, years (14.0–37.3) were compared to 32 healthy sex and age-matched controls (13 males; mean of age 28.7 ± 4.6 years (14.1–37.2), p = 0.13). Body composition was evaluated in all subjects with DXA (Hologic Inc., Bedford, MA, USA). Elevated BP was defined as BP > 95th percentile in adolescents, and >140/90 mmHg in adults. Comparisons between the two groups were adjusted for age, gender, pubertal stage and height. An oral glucose tolerance test was performed, and fasting insulin levels were evaluated. Insulin sensitivity was determined using a homeostasis model assessment of insulin resistance index (HOMA-IR). Results. The median BMI was significantly higher in subjects with CAH (1.63 (0.3–2.4) SDS and 0.41 (−0.63–1.19) SDS, respectively, p < 0.001). Visceral adipose tissue (VAT) in grams was significantly higher in CAH females versus control females (467 (231–561) vs. 226 (164–295), p = 0.002). Elevated BP was identified in 34% of CAH patients (nine SW and two SV) and 12.5% (n = 4) of controls (p = 0.038). Impaired fasting glycemia was detected in one SW CAH patient and impaired glucose tolerance in three SV CAH patients; normal glucose tolerance was found in all controls. A strong positive correlation was found between median cumulative hydrocortisone (HC) dose equivalents and LDL-cholesterol and a negative association with lean body mass (r = −0.79, p = 0.036) in females with CAH. BMI, VAT, BP and HOMA-IR were not related to median cumulative HC dose equivalents. Conclusions. CAH patients had higher BMI, VAT and frequency of elevated BP compared to controls. Doses of glucocorticoids were related directly to LDL-cholesterol and inversely to lean body mass in CAH females, but not associated with body composition, insulin sensitivity and BP in the whole cohort of CAH patients.
Background: Although differentiated thyroid carcinoma (DTC) is the most frequent endocrine pediatric cancer, it is rare in childhood and adolescence. While tumor persistence and recurrence are not uncommon, mortality remains extremely low. Complications of treatment are however reported in up to 48% of the survivors. Due to the rarity of the disease current treatment guidelines are predominantly based on the results of small observational retrospective studies and extrapolations from results in adult patients. In order to develop more personalized treatment and follow-up strategies (aiming to reduce complication rates) there is an unmet need for uniform international prospective data collection and clinical trials.
Methods and analysis: The European pediatric thyroid carcinoma (ped-DTC) registry aims to collect clinical data for all patients with a confirmed diagnosis of DTC<18 years of age who have been diagnosed, assessed, or treated at a participating site. This registry will be a component of the wider European Registries for Rare Endocrine Conditions (EuRRECa) project which has close links to Endo-ERN, the European Reference Network for rare Endocrine Conditions. A multidisciplinary expert working group was formed to develop a minimal dataset comprising information regarding demographic data, diagnosis, treatment and outcome. We constructed an umbrella-type registry, with a detailed basic data set. In the future, this may provide the opportunity for research-teams to integrate clinical research questions.
Ethics and dissemination: Written informed consent will be obtained from all participants and/or their parents/guardians. Summaries and descriptive analyses of the registry will be disseminated via conference presentations and peer-reviewed publications.
Santrauka. Pigmento nelaikymo liga – tai genodermatozė, kuriai budingas odos ir kitų ektoderminių organų pažeidimas. Tai reta liga, paveldima su X chromosoma susijusiu dominantiniu būdu. Liga pasireiškia dėl X chromosomoje įvykusio IKBKG/NEMO patogeninio pokyčio. Manoma, kad dėl to audiniuose sutrinka imuninė tolerancija, sukelianti autoimuninę reakciją. Šia liga serga beveik išimtinai mergaitės, nes liga dažniausiai yra letali vyriškosios lyties embrionams. Straipsnyje pristatomas labai retas pigmento nelaikymo klinikinis atvejis, nuo prenatalinės diagnostikos galimybių iki tolesnių paciento priežiūros gairių, apžvelgiami mokslinės literatūros duomenys.
Background. Congenital multiple pituitary hormone deficiency (MPHD) may result from defects of transcription factors that govern the early pituitary development. The most prevalent are two mutation of PROP1 gene: the 296delGA and 150delA 1,2. Pituitary size • Pituitary height ranged from 16.6 mm (+20.2 SD) to 1.4 mm (-15.5 SD) and declined with age (r 2 =0.27, P=0.001).
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