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Endocrine Abstracts (2018) 58 OC5.8 | DOI: 10.1530/endoabs.58.OC5.8

1Centre for Endocrinology, William Harvey Research Institute, Barts and The London School of Medicine, Queen Mary University London, London, UK; 2Great Ormond Street Institute of Child Health, University College London, London, UK; 3University Hospitals of Leicester NHS Trust, Leicester, UK; 4Sheffield Children’s Hospital, Sheffield, UK; 5Medical University of Bialystok, Bialystok, Poland; 6Al Mafraq Hospital, Abu Dhabi, UAE; 7Mubarak Al-kabeer Hospital, Jabriya, Kuwait; 8Birmingham Heartlands Hospital, Birmingham, UK; 9Royal Hospital for Children, Glasgow, UK; 10Guy’s and St Thomas’ NHS Foundation Trust, London, UK; 11Viapath, Guy’s Hospital, London, UK.


Introduction: Our Centre receives international referrals for genetic analysis of children with short stature (SS) and features of GH/IGF-1 insensitivity. Copy number variation (CNV) hasn’t previously been investigated in GH/IGF-1 insensitivity. We hypothesised CNVs contribute to the phenotype in our undiagnosed cohort.

Experimental design/methodology: CGH was performed with oligonucleotide array using ~60,000 probes in 60 patients (38 M, mean age 7.0 yrs (range 1.1–16.5), mean height SDS −3.87 (range −1.58 to −7.44)).

Results: We identified CNVs in 10/60 (17%) patients (8M), mean height SDS −3.70 (range −1.6 to −5.7). 7/10 and 3/10 patients had likely pathogenic CNVs and CNVs of uncertain significance, respectively. Patients 1–7 have features of Silver-Russell Syndrome (SRS), scoring 2–3/6 on the Netchine-Harbison Clinical Scoring System. Patients 1–6 have CNVs previously associated with SRS phenotypes. Causative genes within many CNV regions below have yet to be established.

Table 1 CNVs identified in our patients
Patient Age (years)Height SDSClinical detailsCNV
112.8−3.6Small triangular face, high arched palate, feeding difficulties1q21 deletion
210.1−1.6Feeding difficulties, dyslexia1q21 deletion
39.1−3.7Clinodactly, feeding difficulties1q21 deletion
411.3−5.1Triangular face, high pitched voice12q14 deletion
51.9−5.7Low set ears, triangular face, SGA7q21 deletion, 7q31 deletion
614.4−2.7SGA7q21 duplication, Xp22 duplication
72.8−4.9Triangular face, frontal bossing, feeding difficulties15q11 deletion
817.0−4.0Learning difficulties, delayed puberty5q12 deletion
92.7−2.0Adrenal insufficiency, SGA7q36 duplication
102.5−3.6Short limbs3p22 deletion, 15q13 duplication

Conclusion: Our cohort was enriched for rare CNVs. Interestingly, 7/10 patients with CNVs had features of SRS, a heterogeneous syndrome with no genetic cause identified in 40% patients. Consistent with previous reports, the SRS phenotype in our CNV patients appears milder than classic 11p15LOM/upd(7)mat cases and only 2/7 with SRS features were born SGA. Our study is the first to report CNVs in GH/IGF-1 insensitivity patients and contributes to the emerging SRS-like phenotype. Our findings emphasise the importance of CNV testing in SS patients, especially those with SRS features.

Volume 58

46th Meeting of the British Society for Paediatric Endocrinology and Diabetes

Birmingham, UK
07 Nov 2018 - 09 Nov 2018

British Society for Paediatric Endocrinology and Diabetes 

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