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Pituitary hormone deficiency, combined or isolated, 8(CPHD8)

MedGen UID:
1841011
Concept ID:
C5830375
Disease or Syndrome
Synonym: CPHD8
 
Gene (location): ROBO1 (3p12.3)
 
Monarch Initiative: MONDO:0957208
OMIM®: 620303

Definition

Combined pituitary hormone deficiency-8 (CPHD8) is an autosomal dominant disorder characterized by deficiency of one or more of the pituitary hormones. Affected individuals have short stature due to growth hormone (GH; 139250) deficiency with variable deficiencies of other pituitary hormones, including TSH (see 188540), ACTH, and LH/FSH (see 118850). Posterior pituitary deficiency leading to central diabetes insipidus is rare (Bashamboo et al., 2017). Many patients are diagnosed with 'pituitary stalk interruption syndrome' (PSIS), which is characterized by a thin or absent pituitary stalk, absent or ectopic posterior pituitary, and hypoplasia of the anterior pituitary demonstrated on brain imaging, although this classic triad may be incomplete. Brauner et al. (2020) noted the complex phenotypic and genetic heterogeneity of PSIS, and concluded that it is a feature of genetic disorders or syndromes rather than a specific clinical entity. For a discussion of genetic heterogeneity of combined pituitary hormone deficiency, see CPHD1 (613038). [from OMIM]

Clinical features

From HPO
Short stature
MedGen UID:
87607
Concept ID:
C0349588
Finding
A height below that which is expected according to age and gender norms. Although there is no universally accepted definition of short stature, many refer to "short stature" as height more than 2 standard deviations below the mean for age and gender (or below the 3rd percentile for age and gender dependent norms).
Anterior pituitary hypoplasia
MedGen UID:
347950
Concept ID:
C1859775
Congenital Abnormality
Underdevelopment of the anterior pituitary gland.
Ectopic posterior pituitary
MedGen UID:
481201
Concept ID:
C3279571
Finding
An abnormal anatomical location of the posterior lobe of the hypophysis, also known as the neurohypophysis. The posterior pituitary is normally present in the dorsal portion of the sella turcica, but when ectopic is usually near the median eminence. This defect is likely to be due to abnormal migration during embryogenesis.
Anterior pituitary agenesis
MedGen UID:
866893
Concept ID:
C4021249
Finding
Absence of the anterior pituitary gland resulting from a developmental defect.
Decreased thyroid-stimulating hormone level
MedGen UID:
717708
Concept ID:
C1295607
Finding
Reduced amount of the thyroid-stimulating hormone (TSH), which is produced by the anterior pituitary gland and stimulates the function of the thyroid gland.
Decreased circulating follicle stimulating hormone concentration
MedGen UID:
892977
Concept ID:
C4072889
Finding
A reduction of the circulating level of follicle-stimulating hormone (FSH).
Decreased circulating luteinizing hormone level
MedGen UID:
893008
Concept ID:
C4072890
Finding
A reduction in the circulating level of luteinizing hormone (LH).
Decreased serum insulin-like growth factor 1
MedGen UID:
892792
Concept ID:
C4072897
Finding
A reduced level of insulin-like growth factor 1 (IGF1) in the blood circulation.
Absent pituitary stalk
MedGen UID:
1795565
Concept ID:
C5563355
Congenital Abnormality
A developmental defect characterized by failure to develop of the pituitary stalk. The pituitary stalk, also known as the infundibulum or infundibular stalk, is the connection between the hypothalamus and the pituitary gland.
Reduced circulating growth hormone concentration
MedGen UID:
1815075
Concept ID:
C5706169
Finding
Concentration of growth hormone in the blood circulation below normal limits.
Decreased circulating ACTH concentration
MedGen UID:
1841520
Concept ID:
C5826343
Finding
The concentration of corticotropin, also known as adrenocorticotropic hormone (ACTH), is below the lower limit of normal in the blood circulation.
Interrupted pituitary stalk
MedGen UID:
1841791
Concept ID:
C5826809
Congenital Abnormality
A developmental defect characterized by a discontinuity of the pituitary stalk. The pituitary stalk, also known as the infundibulum or infundibular stalk, is the connection between the hypothalamus and the pituitary gland.
Ptosis
MedGen UID:
2287
Concept ID:
C0005745
Disease or Syndrome
The upper eyelid margin is positioned 3 mm or more lower than usual and covers the superior portion of the iris (objective); or, the upper lid margin obscures at least part of the pupil (subjective).
Hypermetropia
MedGen UID:
43780
Concept ID:
C0020490
Disease or Syndrome
An abnormality of refraction characterized by the ability to see objects in the distance clearly, while objects nearby appear blurry.
Strabismus
MedGen UID:
21337
Concept ID:
C0038379
Disease or Syndrome
A misalignment of the eyes so that the visual axes deviate from bifoveal fixation. The classification of strabismus may be based on a number of features including the relative position of the eyes, whether the deviation is latent or manifest, intermittent or constant, concomitant or otherwise and according to the age of onset and the relevance of any associated refractive error.

Professional guidelines

PubMed

Lebrun-Frénay C, Okuda DT, Siva A, Landes-Chateau C, Azevedo CJ, Mondot L, Carra-Dallière C, Zephir H, Louapre C, Durand-Dubief F, Le Page E, Bensa C, Ruet A, Ciron J, Laplaud DA, Casez O, Mathey G, de Seze J, Zeydan B, Makhani N, Tutuncu M, Levraut M, Cohen M, Thouvenot E, Pelletier D, Kantarci OH
Brain 2023 Aug 1;146(8):3431-3443. doi: 10.1093/brain/awad073. PMID: 36864688Free PMC Article
Schneider JW, Dittmer DP
Am J Clin Dermatol 2017 Aug;18(4):529-539. doi: 10.1007/s40257-017-0270-4. PMID: 28324233Free PMC Article
Dominici M, Le Blanc K, Mueller I, Slaper-Cortenbach I, Marini F, Krause D, Deans R, Keating A, Prockop Dj, Horwitz E
Cytotherapy 2006;8(4):315-7. doi: 10.1080/14653240600855905. PMID: 16923606

Recent clinical studies

Etiology

Lee SC, Baranowski ES, Sakremath R, Saraff V, Mohamed Z
Front Endocrinol (Lausanne) 2023;14:1198519. Epub 2023 Nov 20 doi: 10.3389/fendo.2023.1198519. PMID: 38053731Free PMC Article
Garofalo V, Condorelli RA, Cannarella R, Aversa A, Calogero AE, La Vignera S
Nutrients 2023 Nov 15;15(22) doi: 10.3390/nu15224790. PMID: 38004184Free PMC Article
Heidelbaugh JJ
FP Essent 2016 Dec;451:25-30. PMID: 27936532
Khandelwal D, Tandon N
Drugs 2012 Jan 1;72(1):17-33. doi: 10.2165/11598070-000000000-00000. PMID: 22191793
Schneider HJ, Aimaretti G, Kreitschmann-Andermahr I, Stalla GK, Ghigo E
Lancet 2007 Apr 28;369(9571):1461-1470. doi: 10.1016/S0140-6736(07)60673-4. PMID: 17467517

Diagnosis

Stagi S, Tufano M, Chiti N, Cerutti M, Li Pomi A, Aversa T, Wasniewska M
Int J Mol Sci 2023 Jun 14;24(12) doi: 10.3390/ijms241210114. PMID: 37373261Free PMC Article
Lauffer P, Zwaveling-Soonawala N, Naafs JC, Boelen A, van Trotsenburg ASP
Front Endocrinol (Lausanne) 2021;12:686317. Epub 2021 Sep 9 doi: 10.3389/fendo.2021.686317. PMID: 34566885Free PMC Article
Heidelbaugh JJ
FP Essent 2016 Dec;451:25-30. PMID: 27936532
Heidelbaugh JJ
FP Essent 2016 Dec;451:17-24. PMID: 27936531
Persani L
J Clin Endocrinol Metab 2012 Sep;97(9):3068-78. Epub 2012 Jul 31 doi: 10.1210/jc.2012-1616. PMID: 22851492

Therapy

Lauffer P, Zwaveling-Soonawala N, Naafs JC, Boelen A, van Trotsenburg ASP
Front Endocrinol (Lausanne) 2021;12:686317. Epub 2021 Sep 9 doi: 10.3389/fendo.2021.686317. PMID: 34566885Free PMC Article
Heidelbaugh JJ
FP Essent 2016 Dec;451:17-24. PMID: 27936531
Persani L
J Clin Endocrinol Metab 2012 Sep;97(9):3068-78. Epub 2012 Jul 31 doi: 10.1210/jc.2012-1616. PMID: 22851492
Khandelwal D, Tandon N
Drugs 2012 Jan 1;72(1):17-33. doi: 10.2165/11598070-000000000-00000. PMID: 22191793
Schneider HJ, Aimaretti G, Kreitschmann-Andermahr I, Stalla GK, Ghigo E
Lancet 2007 Apr 28;369(9571):1461-1470. doi: 10.1016/S0140-6736(07)60673-4. PMID: 17467517

Prognosis

Jakobsen LK, Jensen RB, Birkebæk NH, Hansen D, Christensen AR, Bjerrum MC, Christesen HT
J Clin Endocrinol Metab 2023 Sep 18;108(10):2475-2485. doi: 10.1210/clinem/dgad198. PMID: 37043518Free PMC Article
Lauffer P, Zwaveling-Soonawala N, Naafs JC, Boelen A, van Trotsenburg ASP
Front Endocrinol (Lausanne) 2021;12:686317. Epub 2021 Sep 9 doi: 10.3389/fendo.2021.686317. PMID: 34566885Free PMC Article
Cerbone M, Dattani MT
Growth Horm IGF Res 2017 Dec;37:19-25. Epub 2017 Oct 19 doi: 10.1016/j.ghir.2017.10.005. PMID: 29107171
Shi T, McAllister DA, O'Brien KL, Simoes EAF, Madhi SA, Gessner BD, Polack FP, Balsells E, Acacio S, Aguayo C, Alassani I, Ali A, Antonio M, Awasthi S, Awori JO, Azziz-Baumgartner E, Baggett HC, Baillie VL, Balmaseda A, Barahona A, Basnet S, Bassat Q, Basualdo W, Bigogo G, Bont L, Breiman RF, Brooks WA, Broor S, Bruce N, Bruden D, Buchy P, Campbell S, Carosone-Link P, Chadha M, Chipeta J, Chou M, Clara W, Cohen C, de Cuellar E, Dang DA, Dash-Yandag B, Deloria-Knoll M, Dherani M, Eap T, Ebruke BE, Echavarria M, de Freitas Lázaro Emediato CC, Fasce RA, Feikin DR, Feng L, Gentile A, Gordon A, Goswami D, Goyet S, Groome M, Halasa N, Hirve S, Homaira N, Howie SRC, Jara J, Jroundi I, Kartasasmita CB, Khuri-Bulos N, Kotloff KL, Krishnan A, Libster R, Lopez O, Lucero MG, Lucion F, Lupisan SP, Marcone DN, McCracken JP, Mejia M, Moisi JC, Montgomery JM, Moore DP, Moraleda C, Moyes J, Munywoki P, Mutyara K, Nicol MP, Nokes DJ, Nymadawa P, da Costa Oliveira MT, Oshitani H, Pandey N, Paranhos-Baccalà G, Phillips LN, Picot VS, Rahman M, Rakoto-Andrianarivelo M, Rasmussen ZA, Rath BA, Robinson A, Romero C, Russomando G, Salimi V, Sawatwong P, Scheltema N, Schweiger B, Scott JAG, Seidenberg P, Shen K, Singleton R, Sotomayor V, Strand TA, Sutanto A, Sylla M, Tapia MD, Thamthitiwat S, Thomas ED, Tokarz R, Turner C, Venter M, Waicharoen S, Wang J, Watthanaworawit W, Yoshida LM, Yu H, Zar HJ, Campbell H, Nair H; RSV Global Epidemiology Network
Lancet 2017 Sep 2;390(10098):946-958. Epub 2017 Jul 7 doi: 10.1016/S0140-6736(17)30938-8. PMID: 28689664Free PMC Article
Heidelbaugh JJ
FP Essent 2016 Dec;451:25-30. PMID: 27936532

Clinical prediction guides

Jakobsen LK, Jensen RB, Birkebæk NH, Hansen D, Christensen AR, Bjerrum MC, Christesen HT
J Clin Endocrinol Metab 2023 Sep 18;108(10):2475-2485. doi: 10.1210/clinem/dgad198. PMID: 37043518Free PMC Article
Voutetakis A
Handb Clin Neurol 2021;181:9-27. doi: 10.1016/B978-0-12-820683-6.00002-6. PMID: 34238482
Firouzi M, Sherkatolabbasieh H, Shafizadeh S
Endocr Metab Immune Disord Drug Targets 2021;21(2):288-297. doi: 10.2174/1871530320666200704144912. PMID: 32621723
Correa FA, Nakaguma M, Madeira JLO, Nishi MY, Abrão MG, Jorge AAL, Carvalho LR, Arnhold IJP, Mendonça BB
Arch Endocrinol Metab 2019 May 13;63(2):167-174. doi: 10.20945/2359-3997000000139. PMID: 31090814Free PMC Article
Persani L
J Clin Endocrinol Metab 2012 Sep;97(9):3068-78. Epub 2012 Jul 31 doi: 10.1210/jc.2012-1616. PMID: 22851492

Recent systematic reviews

Pérez-Gerdel T, Camargo M, Alvarado M, Ramírez JD
Adv Biol (Weinh) 2023 Aug;7(8):e2200337. Epub 2023 Mar 22 doi: 10.1002/adbi.202200337. PMID: 36950759
Chang R, Elhusseiny KM, Yeh YC, Sun WZ
PLoS One 2021;16(2):e0246318. Epub 2021 Feb 11 doi: 10.1371/journal.pone.0246318. PMID: 33571301Free PMC Article
Ganeshkumar P, Murhekar MV, Poornima V, Saravanakumar V, Sukumaran K, Anandaselvasankar A, John D, Mehendale SM
PLoS Negl Trop Dis 2018 Jul;12(7):e0006618. Epub 2018 Jul 16 doi: 10.1371/journal.pntd.0006618. PMID: 30011275Free PMC Article
Jones NL, Koletzko S, Goodman K, Bontems P, Cadranel S, Casswall T, Czinn S, Gold BD, Guarner J, Elitsur Y, Homan M, Kalach N, Kori M, Madrazo A, Megraud F, Papadopoulou A, Rowland M; ESPGHAN, NASPGHAN
J Pediatr Gastroenterol Nutr 2017 Jun;64(6):991-1003. doi: 10.1097/MPG.0000000000001594. PMID: 28541262
Canavan TN, Mathes EF, Frieden I, Shinkai K
J Am Acad Dermatol 2015 Feb;72(2):239-45. doi: 10.1016/j.jaad.2014.06.026. PMID: 25592340

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