Aguirre A, Donnadieu M, Job J C, Chaussain J L
Service d'Endocrinologie Pédiatrique, Hôpital Saint-Vincent-de-Paul, Paris.
Arch Fr Pediatr. 1991 Jan;48(1):5-9.
Laron's type dwarfism (LTD) has clinical features very close to those of congenital isolated growth hormone (GH) deficiency, contrasting with high plasma levels of GH and a complete lack of growth improvement during treatment trials with exogenous GH. Three new cases are presented here. The plasma GH-binding protein (GHBP), which has been recently isolated and identified as similar to the extracellular part of the liver-cells receptor to GH, is lacking in two of the three patients and subnormal in their heterozygous parents, these data suggesting a defect of the GH receptor or of its extracellular part. In contrast, the third patient and her parents had normal plasma levels of GHBP, suggesting that the clinically and biologically obvious lack of receptivity to GH is either at the post-receptor level or limited to the intracellular part of the receptor. These data contribute to demonstrate that there are at least two different genetic defects leading to clinical LTD.
拉龙氏型侏儒症(LTD)的临床特征与先天性孤立性生长激素(GH)缺乏症非常相似,然而其血浆GH水平较高,且在外源性GH治疗试验期间生长并未得到改善。本文报告了三例新病例。血浆GH结合蛋白(GHBP)最近已被分离并鉴定为与肝细胞GH受体的细胞外部分相似,三例患者中有两例缺乏该蛋白,其杂合子父母的该蛋白水平低于正常,这些数据表明GH受体或其细胞外部分存在缺陷。相比之下,第三例患者及其父母的血浆GHBP水平正常,这表明临床上和生物学上明显的GH无反应性要么发生在受体后水平,要么仅限于受体的细胞内部分。这些数据有助于证明至少有两种不同的基因缺陷可导致临床LTD。