tailieunhanh - Báo cáo khoa học: " Primary growth hormone insensitivity (Laron syndrome) and acquired hypothyroidism: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Primary growth hormone insensitivity (Laron syndrome) and acquired hypothyroidism: a case report. | Cotta et al. Journal of Medical Case Reports 2011 5 301 http content 5 1 301 JOURNALOF medical LrCASE REPORTS CASE REPORT Open Access Primary growth hormone insensitivity Laron syndrome and acquired hypothyroidism a case report 1 2 1 3 1-4 1 Oana R Cotta Libero Santarpia Lorenzo Curtò Gianluca Aimaretti Ginevra Cornell Francesco Trimarchi and Salvatore Cannavò1 Abstract Introduction Primary growth hormone resistance or growth hormone insensitivity syndrome also known as Laron syndrome is a hereditary disease caused by deletions or different types of mutations in the growth hormone receptor gene or by post-receptor defects. This disorder is characterized by a clinical appearance of severe growth hormone deficiency with high levels of circulating growth hormone in contrast to low serum insulin-like growth factor 1 values. Case presentation We report the case of a 15-year-old Caucasian girl who was diagnosed with Silver-Russell syndrome at the age of four and a half years. Recombinant growth hormone was administered for 18 months without an appropriate increase in growth velocity. At the age of seven years her serum growth hormone levels were high and an insulin-like growth factor 1 generation test did not increase insulin-like growth factor 1 levels baseline insulin-like growth factor 1 levels 52 pg L reference range 75 pg L to 365 pg L and peak 76 pg L and 50 pg L after 12 and 84 hours respectively from baseline . The genetic analysis showed that the patient was homozygous for the R217X mutation in the growth hormone receptor gene which is characteristic of Laron syndrome. On the basis of these results the diagnosis of primary growth hormone insensitivity syndrome was made and recombinant insulin-like growth factor 1 therapy was initiated. The patient s treatment was well tolerated but unexplained central hypothyroidism occurred at the age of years. At the age of 15 years when the patient s sexual development was almost completed and

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