HOMI Fundacion Hospital Pediatrico la Misericordia, Pediatric Endocrinologist, Colombia, South America
Hospital San Vicente Fundación and Associate Professor, Universidad de Antioquia, Pediatric Endocrinologist, Colombia, South America
J Clin Res Pediatr Endocrinol. 2023 Feb 27;15(1):16-24. doi: 10.4274/jcrpe.galenos.2022.2022-4-12. Epub 2022 Aug 19.
Several endocrine manifestations have been described in patients with 22q11 deletion syndrome, including growth retardation, hypoparathyroidism, and thyroid disorders. This study aimed to characterize these abnormalities in a Colombian retrospective cohort of children with this condition.
A retrospective study comprising a cohort of children with 22q11 deletion syndrome in Medellín, Colombia followed up between 2011 and 2017 was conducted.
Thirty-seven patients with a confirmed diagnosis of 22q11 deletion syndrome were included. 37.8% had some endocrinopathy, the most frequent being hypoparathyroidism (21.6%), followed by hypothyroidism (13.5%), hyperthyroidism (2.7%) and growth hormone deficiency (2.7%). There was wide heterogeneity in the clinical presentation, with late onset of severe hypocalcemia associated with seizure or precipitated in postoperative cardiac surgery, which highlights the importance of continuous follow-up as indicated by the guidelines. Short stature was mainly related to nutritional factors. Growth monitoring is required with the use of syndrome-specific charts and careful monitoring of the growth rate.
As previously reported, a significant proportion of patients with endocrine abnormalities were found in this cohort. This highlights that it is essential to carry out an adequate multidisciplinary follow-up, based on the specific clinical guidelines, in order to avoid serious complications such as convulsions due to hypocalcemia. It is important to track size with curves specific to the syndrome and analyze the growth rate.
22q11 缺失综合征患者存在多种内分泌表现,包括生长迟缓、甲状旁腺功能减退症和甲状腺功能障碍。本研究旨在对哥伦比亚一个患有这种疾病的儿童回顾性队列中描述这些异常。
对 2011 年至 2017 年在哥伦比亚麦德林随访的 22q11 缺失综合征患儿进行回顾性研究。
共纳入 37 例确诊为 22q11 缺失综合征的患儿。37.8%的患儿存在某种内分泌疾病,最常见的是甲状旁腺功能减退症(21.6%),其次是甲状腺功能减退症(13.5%)、甲状腺功能亢进症(2.7%)和生长激素缺乏症(2.7%)。临床表现存在广泛的异质性,晚期严重低钙血症与癫痫发作或术后心脏手术后有关,这凸显了根据指南持续随访的重要性。身材矮小主要与营养因素有关。需要使用特定于综合征的图表进行生长监测,并仔细监测生长速度。
与之前的报道一样,本队列发现存在大量患有内分泌异常的患者。这突出表明,根据具体的临床指南,进行充分的多学科随访非常重要,以避免因低钙血症引起的严重并发症,如癫痫发作。重要的是要跟踪与综合征相关的曲线来了解大小,并分析生长速度。