Nissenkorn Andreea, Levy-Shraga Yael, Banet-Levi Yonit, Lahad Avishay, Sarouk Ifat, Modan-Moses Dalit
Service for Rare Disorders, Pediatric Neurology Unit, The Edmond and Lilly Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel.
The Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Pediatr Res. 2016 Jun;79(6):889-94. doi: 10.1038/pr.2016.19. Epub 2016 Feb 18.
Ataxia telangiectasia (AT) is a genetic multisystem disorder, presenting with progressive ataxia, immune deficiency, and propensity toward malignancy. Endocrine abnormalities (growth retardation, reproductive dysfunction, and diabetes) have been described, however detailed information regarding this aspect is lacking. We aimed to characterize endocrine anomalies and growth patterns in a large cohort of AT patients.
Retrospective study comprising all 52 patients (aged 2-26.2 y) followed at a national AT Clinic. Anthropometric and laboratory measurements were extracted from the charts.
Median height-SDS was already subnormal during infancy, remaining negative throughout follow up to adulthood. Height-SDS was more impaired than weight-SDS up to age 4 y, thereafter weight-SDS steadily decreased, resulting in progressively lower BMI-SDS. IGF-I-SDS was low (-1.53 ± 1.54), but did not correlate with height-SDS. Gonadal failure was present in all 13 females older than 10 y but only in one male. Two patients had diabetes and 10 had dyslipidemia. Vitamin D deficiency was observed in 52.2% of the evaluated patients.
Our results suggest a primary growth abnormality in AT, rather than secondary to nutritional impairment or disease severity. Sex hormone replacement should be considered for female patients. Vitamin D levels should be followed and supplementation given if needed.
共济失调毛细血管扩张症(AT)是一种遗传性多系统疾病,表现为进行性共济失调、免疫缺陷和易患恶性肿瘤。虽然已有关于内分泌异常(生长发育迟缓、生殖功能障碍和糖尿病)的描述,但在这方面缺乏详细信息。我们旨在描述一大群AT患者的内分泌异常和生长模式。
对全国AT诊所随访的所有52例患者(年龄2 - 26.2岁)进行回顾性研究。从病历中提取人体测量和实验室检查数据。
身高标准差评分(SDS)在婴儿期就已低于正常水平,在整个随访至成年期均保持为负值。在4岁之前,身高SDS比体重SDS受损更严重,此后体重SDS稳步下降,导致身体质量指数SDS逐渐降低。胰岛素样生长因子I - SDS较低(-1.53±1.54),但与身高SDS无关。所有13名10岁以上女性均出现性腺功能衰竭,但只有1名男性出现。2例患者患有糖尿病,10例患有血脂异常。在52.2%的评估患者中观察到维生素D缺乏。
我们的结果表明AT存在原发性生长异常,而非继发于营养损害或疾病严重程度。对于女性患者应考虑进行性激素替代治疗。应监测维生素D水平,并在需要时给予补充。