Adult and paediatric patients with pathogenic variants in the gene encoding succinate dehydrogenase (SDH) subunit B (SDHB) often have locally aggressive, recurrent or metastatic phaeochromocytomas and paragangliomas (PPGLs). Furthermore, SDHB PPGLs have the highest rates of disease-specific morbidity and mortality compared with other hereditary PPGLs. PPGLs with SDHB pathogenic variants are often less differentiated and do not produce substantial amounts of catecholamines (in some patients, they produce only dopamine) compared with other hereditary subtypes, which enables these tumours to grow subclinically for a long time. In addition, SDHB pathogenic variants support tumour growth through high levels of the oncometabolite succinate and other mechanisms related to cancer initiation and progression. As a result, pseudohypoxia and upregulation of genes related to the hypoxia signalling pathway occur, promoting the growth, migration, invasiveness and metastasis of cancer cells. These factors, along with a high rate of metastasis, support early surgical intervention and total resection of PPGLs, regardless of the tumour size. The treatment of metastases is challenging and relies on either local or systemic therapies, or sometimes both. This Consensus statement should help guide clinicians in the diagnosis and management of patients with SDHB PPGLs.

• MeSH
• dítě MeSH
• dospělí MeSH
• feochromocytom * genetika   terapie   diagnóza   MeSH
• lidé MeSH
• nádory nadledvin * genetika   terapie   diagnóza   MeSH
• paragangliom * genetika   terapie   MeSH
• sukcinátdehydrogenasa genetika   MeSH
• zárodečné mutace genetika   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• SDHB protein, human MeSH Prohlížeč
• sukcinátdehydrogenasa MeSH

BACKGROUND: Pituitary development and GH secretion are orchestrated by multiple genes including GH1, GHRHR, GLI2, HESX1, LHX3, LHX4, PROP1, POU1F1, and SOX3. We aimed to assess their mutation frequency and clinical relevance in children with severe GH deficiency (GHD). METHODS: The Genetics and Neuroendocrinology of Short Stature International Study (GeNeSIS; Clinical Trial Registry Number: NCT01088412) was a prospective, open-label, observational research program for pediatric patients receiving GH treatment, conducted in 30 countries between 1999 and 2015. The study included a sub-study to investigate mutations in the genes listed above. PCR products from genomic blood cell DNA were analyzed by Sanger sequencing. DNA variants were classified as pathogenic according to the recommendations of the American College of Medical Genetics and Genomics. Demographic, auxologic, and endocrine data at baseline and during GH treatment were documented and related to the genotyping results. FINDINGS: The analysis comprised 917 patients. In 92 patients (10%) 33 mutations were found, 16 previously described and 17 novel (52%). Mutation carriers were significantly younger, shorter, and more slowly growing than non-carriers. In general, their peak values in GH stimulation tests were very low; however, in 15/77 (20%) patients with GH1, PROP1, and SOX3 mutations they were only moderately diminished (3-6 μg/L). Two patients with a GH1 mutation developed TSH deficiency and one ADH deficiency. Using logistic multi-regression analysis, significant indicators of a mutation were combined pituitary hormone deficiency, greater patient-parent height difference (SDS), low GH peak, and young age. Final height SDS gain in mutation carriers (mean ± SD 3.4 ± 1.4) was greater than in non-carriers (2.0 ± 1.4; P < .001) and in patients with non-GHD short stature. INTERPRETATION: DNA testing for mutations in children with severe GHD shows a positive finding in approximately 10%. Phenotypes of mutation carriers can be variable. The benefit for clinical practice justifies DNA testing as an important component in the diagnostic work-up of patients with severe GHD. FUND: Eli Lilly and Company, Indianapolis, IN, USA. ClinicalTrials.com registration: NCT01088412.

• Klíčová slova
• Genetics, Growth hormone deficiency, Hypopituitarism, Pituitary, Short stature,
• MeSH
• dítě MeSH
• fenotyp MeSH
• homeodoménové proteiny genetika   MeSH
• hypofýza růst a vývoj   metabolismus   MeSH
• hypofyzární nanismus genetika   metabolismus   patofyziologie   MeSH
• jaderné proteiny genetika   MeSH
• lidé MeSH
• lidský růstový hormon genetika   MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mutace * MeSH
• mutační analýza DNA MeSH
• předškolní dítě MeSH
• prospektivní studie MeSH
• protein Gli2 s motivem zinkových prstů genetika   MeSH
• proteiny s homeodoménou LIM genetika   MeSH
• receptory hormonů regulujících hypofyzární hormony MeSH
• receptory neuropeptidů MeSH
• transkripční faktor Pit-1 genetika   MeSH
• transkripční faktory SOXB1 genetika   MeSH
• transkripční faktory genetika   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• pozorovací studie MeSH
• Názvy látek
• GHRHR protein, human MeSH Prohlížeč
• GLI2 protein, human MeSH Prohlížeč
• HESX1 protein, human MeSH Prohlížeč
• homeodoménové proteiny MeSH
• jaderné proteiny MeSH
• Lhx3 protein MeSH Prohlížeč
• LHX4 protein, human MeSH Prohlížeč
• lidský růstový hormon MeSH
• POU1F1 protein, human MeSH Prohlížeč
• Prophet of Pit-1 protein MeSH Prohlížeč
• protein Gli2 s motivem zinkových prstů MeSH
• proteiny s homeodoménou LIM MeSH
• receptory hormonů regulujících hypofyzární hormony MeSH
• receptory neuropeptidů MeSH
• SOX3 protein, human MeSH Prohlížeč
• transkripční faktor Pit-1 MeSH
• transkripční faktory SOXB1 MeSH
• transkripční faktory MeSH