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Should patients with Phosphomannomutase 2-CDG (PMM2-CDG) be screened for adrenal insufficiency
A. Čechová, T. Honzík, AC. Edmondson, C. Ficicioglu, M. Serrano, R. Barone, P. De Lonlay, M. Schiff, P. Witters, C. Lam, M. Patterson, MCH. Janssen, J. Correia, D. Quelhas, J. Sykut-Cegielska, H. Plotkin, E. Morava, K. Sarafoglou
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, pozorovací studie, Research Support, N.I.H., Extramural, práce podpořená grantem
Grantová podpora
U54 NS115198
NINDS NIH HHS - United States
- MeSH
- adrenální insuficience diagnóza etiologie patofyziologie MeSH
- dítě MeSH
- dospělí MeSH
- fosfotransferasy (fosfomutasy) krev genetika MeSH
- glykosylace MeSH
- kojenec MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- předškolní dítě MeSH
- prospektivní studie MeSH
- rizikové faktory MeSH
- systém hypofýza - nadledviny fyziologie MeSH
- vrozené poruchy glykosylace MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- kojenec MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
PMM2-CDG is the most common congenital disorder of glycosylation (CDG) accounting for almost 65% of known CDG cases affecting N-glycosylation. Abnormalities in N-glycosylation could have a negative impact on many endocrine axes. There is very little known on the effect of impaired N-glycosylation on the hypothalamic-pituitary-adrenal axis function and whether CDG patients are at risk of secondary adrenal insufficiency and decreased adrenal cortisol production. Cortisol and ACTH concentrations were simultaneously measured between 7:44 am to 1 pm in forty-three subjects (20 female, median age 12.8 years, range 0.1 to 48.6 years) participating in an ongoing international, multi-center Natural History study for PMM2-CDG (ClinicalTrials.gov Identifier: NCT03173300). Of the 43 subjects, 11 (25.6%) had cortisol below 5 μg/dl and low to normal ACTH levels, suggestive of secondary adrenal insufficiency. Two of the 11 subjects have confirmed central adrenal insufficiency and are on hydrocortisone replacement and/or stress dosing during illness; 3 had normal and 1 had subnormal cortisol response to ACTH low-dose stimulation test but has not yet been started on therapy; the remaining 5 have upcoming stimulation testing planned. Our findings suggest that patients with PMM2-CDG may be at risk for adrenal insufficiency. Monitoring of morning cortisol and ACTH levels should be part of the standard care in patients with PMM2-CDG.
Center for Integrative Brain Research Seattle Children's Research Institute Seattle WA 98101 USA
Centro Hospitalar Universitário do Porto Porto Portugal
Department of Clinical Genomics Department of Laboratory Medicine and Pathology Mayo Clinic MN USA
Department of Pediatrics University of Nebraska Medical Center Omaha NE USA
Division of Human Genetics Department of Pediatrics Children's Hospital of Philadelphia USA
Glycomine Inc San Francisco CA USA
Inserm UMR_S1163 Institut Imagine Paris France
Radboud University Medical Centre Department of Internal Medicine Nijmegen the Netherlands
U 703 Centre for Biomedical Research on Rare Diseases Instituto de Salud Carlos 3 Spain
Citace poskytuje Crossref.org
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- $a Čechová, Anna $u Department of Pediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
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- $a Should patients with Phosphomannomutase 2-CDG (PMM2-CDG) be screened for adrenal insufficiency / $c A. Čechová, T. Honzík, AC. Edmondson, C. Ficicioglu, M. Serrano, R. Barone, P. De Lonlay, M. Schiff, P. Witters, C. Lam, M. Patterson, MCH. Janssen, J. Correia, D. Quelhas, J. Sykut-Cegielska, H. Plotkin, E. Morava, K. Sarafoglou
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- $a PMM2-CDG is the most common congenital disorder of glycosylation (CDG) accounting for almost 65% of known CDG cases affecting N-glycosylation. Abnormalities in N-glycosylation could have a negative impact on many endocrine axes. There is very little known on the effect of impaired N-glycosylation on the hypothalamic-pituitary-adrenal axis function and whether CDG patients are at risk of secondary adrenal insufficiency and decreased adrenal cortisol production. Cortisol and ACTH concentrations were simultaneously measured between 7:44 am to 1 pm in forty-three subjects (20 female, median age 12.8 years, range 0.1 to 48.6 years) participating in an ongoing international, multi-center Natural History study for PMM2-CDG (ClinicalTrials.gov Identifier: NCT03173300). Of the 43 subjects, 11 (25.6%) had cortisol below 5 μg/dl and low to normal ACTH levels, suggestive of secondary adrenal insufficiency. Two of the 11 subjects have confirmed central adrenal insufficiency and are on hydrocortisone replacement and/or stress dosing during illness; 3 had normal and 1 had subnormal cortisol response to ACTH low-dose stimulation test but has not yet been started on therapy; the remaining 5 have upcoming stimulation testing planned. Our findings suggest that patients with PMM2-CDG may be at risk for adrenal insufficiency. Monitoring of morning cortisol and ACTH levels should be part of the standard care in patients with PMM2-CDG.
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