Successful Growth Hormone Therapy in Cornelia de Lange Syndrome

J Clin Res Pediatr Endocrinol. 2017 Dec 15;9(4):366-370. doi: 10.4274/jcrpe.4349. Epub 2017 Jun 7.

Abstract

Cornelia de Lange syndrome (CdLS) is a both clinically and genetically heterogeneous syndrome. In its classical form, it is characterised by distinctive facial features, intra-uterine growth retardation, short stature, developmental delay, and anomalies in multiple organ systems. NIPBL, SMC1A, SMC3, RAD21 and HDAC8, all involved in the cohesin pathway, have been identified to cause CdLS. Growth hormone (GH) secretion has been reported as normal, and to our knowledge, there are no reports on the effect of recombinant human GH treatment in CdLS patients. We present a patient born small for gestational age with persistent severe growth retardation [height -3.4 standard deviation score (SDS)] and mild dysmorphic features, who was treated with GH from 4.3 years of age onward and was diagnosed 6 years later with CdLS using whole-exome sequencing. Treatment led to a height gain of 1.6 SDS over 8 years. Treatment was interrupted shortly due to high serum insulin-like growth factor-1 serum values. In conclusion, GH therapy may be effective and safe for short children with CdLS.

Keywords: Cornelia de Lange syndrome; NIPBL whole-exome sequencing.; growth hormone; small for gestational age.

Publication types

  • Case Reports

MeSH terms

  • Body Height / drug effects
  • Child
  • De Lange Syndrome / complications
  • De Lange Syndrome / drug therapy*
  • Dwarfism / drug therapy
  • Dwarfism / etiology
  • Hormone Replacement Therapy
  • Human Growth Hormone / therapeutic use*
  • Humans
  • Infant, Small for Gestational Age / growth & development
  • Male
  • Treatment Outcome

Substances

  • Human Growth Hormone