Araújo Cátia, Baptista Carla, Paiva Isabel
Endocrinology, Diabetes and Metabolism, Centro Hospitalar e Universitário de Coimbra, Coimbra, PRT.
Cureus. 2023 Dec 20;15(12):e50819. doi: 10.7759/cureus.50819. eCollection 2023 Dec.
Heterozygous mutations of ()can result in ocular malformations, pituitary abnormalities, or hypopituitarism spanning from isolated growth hormone (GH) deficiency to combined pituitary hormone deficiency. We present a patient exhibiting growth and pubertal disturbances, developmental delay, and pigmentary retinopathy. Further examination revealed deficiencies in GH following clonidine stimulation, hypogonadism, and, subsequently, central hypothyroidism. Brain magnetic resonance imaging uncovered hypoplasia of the pituitary and an ectopic pituitary tissue. Sequence analysis of identified a novel heterozygous mutation c.555_556dup, p.(Ser186Ilefs*21), indicative of a frameshift mutation. Replacement therapy with recombinant human GH, testosterone enanthate, and levothyroxine was started. Notably, GH therapy resulted in significant catch-up growth. This case report contributes to our comprehension of the molecular and clinical findings, particularly highlighting endocrine manifestations and a rare ophthalmologic manifestation associated with mutations in the gene.
()的杂合突变可导致眼部畸形、垂体异常或垂体功能减退,范围从孤立的生长激素(GH)缺乏到联合垂体激素缺乏。我们报告了一名表现出生长和青春期发育障碍、发育迟缓以及色素性视网膜病变的患者。进一步检查发现可乐定刺激后GH缺乏、性腺功能减退,随后出现中枢性甲状腺功能减退。脑部磁共振成像显示垂体发育不全和异位垂体组织。对()的序列分析鉴定出一种新的杂合突变c.555_556dup,p.(Ser186Ilefs*21),表明是一种移码突变。开始使用重组人生长激素、庚酸睾酮和左甲状腺素进行替代治疗。值得注意的是,生长激素治疗导致显著的追赶生长。本病例报告有助于我们理解分子和临床发现,特别强调了与该基因()突变相关的内分泌表现和一种罕见的眼科表现。