Endocrine Disorders in Children with Primary Mitochondrial Diseases: Single Center Experience

Esra Deniz Papatya ��ak��r, Melike Ersoy, Nihan ��ak��r Bi��er, Asuman Gedikba����
Author Information
  1. Esra Deniz Papatya ��ak��r: University of Health Sciences T��rkiye, Bak��rk��y Dr. Sadi Konuk Training and Research Hospital, Clinic of Pediatric Endocrinology, ��stanbul, T��rkiye ORCID
  2. Melike Ersoy: University of Health Sciences T��rkiye, Bak��rk��y Dr. Sadi Konuk Training and Research Hospital, Clinic of Pediatric Metabolism, ��stanbul, T��rkiye ORCID
  3. Nihan ��ak��r Bi��er: Ac��badem Mehmet Ali Ayd��nlar University, Faculty of Health Sciences, Department of Nutrition and Dietetics, ��stanbul, T��rkiye ORCID
  4. Asuman Gedikba����: ��stanbul University Institute of Child Health, Department of Pediatric Basic Sciences, Division of Medical Genetics; ��stanbul University, ��stanbul Faculty of Medicine, Department of Pediatric Genetics, ��stanbul, T��rkiye ORCID

Abstract

Objective: Endocrine abnormalities may be the only clinical manifestation of primary mitochondrial disorders. The aim of this study was to evaluate the endocrinological characteristics of mitochondrial disease (MD) in a cohort from a single center.
Methods: Pediatric patients diagnosed with MD were categorized on the basis of their specific genetic abnormalities. The auxologic data, pubertal development, and, based on their clinical symptoms, hormonal profiles were obtained.
Results: Twelve of the cohort of 26 patients (46%) were female. In 15 (57.6%), the MD was caused by nuclear DNA mutations (nDNA group). Four patients had Leigh syndrome, two patients had Leber���s Hereditary Optic Neuropathy syndrome, two patients had Mitochondrial Encephalopathy Lactic Acidosis and Stroke Like episodes, and one patient had Kearns-Sayre syndrome clinical phenotype. The median age at diagnosis was 2.91 (0.59-16.8) years, and the median age at first endocrine evaluation was 4.62 (1.26-18) years. The mean height standard deviation score (SDS) was -1.34��2.12, and the mean body mass index SDS was -0.82��1.96 for all patients. Of the 26 patients, 6 (23%) had a range of hormonal deficits. Ovarian insufficiency, central adrenal insufficiency, central hypothyroidism, diabetes mellitus, and critical illness-related adrenal insufficiency were all observed. Three of the patients were initially monitored in the endocrine clinic for hormone deficiencies but it was later determined that the hormonal abnormalities were caused by underlying MD.
Conclusion: Individuals diagnosed with MD, particularly those with specific genetic abnormalities, are considered a high-risk group for developing hormonal deficits. Endocrine abnormalities may be one of the primary early warning symptoms for MD.

Keywords

References

  1. Minerva Cardioangiol. 2006 Jun;54(3):387-91 [PMID: 16733514]
  2. Clin Genet. 2018 Aug;94(2):276-277 [PMID: 29671881]
  3. Acta Neurol Scand Suppl. 2007;187:64-7 [PMID: 17419832]
  4. Nat Rev Endocrinol. 2019 Jul;15(7):417-427 [PMID: 30850749]
  5. Acta Paediatr. 2009 Mar;98(3):553-4 [PMID: 19120037]
  6. Pediatrics. 2020 Mar;145(3): [PMID: 32094289]
  7. J Clin Res Pediatr Endocrinol. 2012 Sep;4(3):132-9 [PMID: 22664362]
  8. Front Genet. 2023 Jun 12;14:1191159 [PMID: 37377599]
  9. Neurology. 1983 Oct;33(10):1288-93 [PMID: 6310438]
  10. Intern Med J. 2022 Jan;52(1):110-120 [PMID: 34505344]
  11. Mitochondrion. 2022 Sep;66:51-53 [PMID: 35901949]
  12. Endocr Rev. 2022 May 12;43(3):583-609 [PMID: 35552684]
  13. Am J Hum Genet. 2012 Oct 5;91(4):737-43 [PMID: 23022098]
  14. Ann Clin Transl Neurol. 2018 Feb 07;5(3):333-345 [PMID: 29560378]
  15. Hum Mol Genet. 2013 Jan 15;22(2):384-90 [PMID: 23077218]
  16. J Clin Res Pediatr Endocrinol. 2015 Dec;7(4):280-93 [PMID: 26777039]
  17. Genet Med. 2017 Dec;19(12): [PMID: 28749475]
  18. J Intern Med. 2020 Jun;287(6):609-633 [PMID: 32176382]
  19. PLoS Genet. 2016 Jan 07;12(1):e1005679 [PMID: 26741492]
  20. Pediatr Diabetes. 2015 Feb;16(1):1-9 [PMID: 25330715]
  21. J Endocr Soc. 2018 Feb 19;2(4):361-373 [PMID: 29594260]
  22. Ann Neurol. 2015 May;77(5):753-9 [PMID: 25652200]
  23. Curr Treat Options Neurol. 2009 Nov;11(6):414-30 [PMID: 19891905]
  24. J Med Genet. 2016 Nov;53(11):768-775 [PMID: 27412952]
  25. Diabetologia. 1996 Oct;39(10):1196-200 [PMID: 8897007]
  26. Nat Rev Endocrinol. 2017 Feb;13(2):92-104 [PMID: 27716753]
  27. J Pediatr Endocrinol Metab. 2017 Apr 1;30(4):479-481 [PMID: 28085676]
  28. Am J Hum Genet. 2012 Oct 5;91(4):729-36 [PMID: 23022099]
  29. Am J Clin Nutr. 2010 Dec;92(6):1369-77 [PMID: 20962155]
  30. Mol Cell Endocrinol. 2013 May 22;371(1-2):195-200 [PMID: 23279877]
  31. Brain. 2012 Nov;135(Pt 11):3392-403 [PMID: 23107649]
  32. Curr Opin Endocrinol Diabetes Obes. 2022 Feb 1;29(1):36-43 [PMID: 34839324]
  33. Eur J Endocrinol. 2023 Nov 8;189(5):485-494 [PMID: 37815532]
  34. Endocrinology. 2019 Oct 1;160(10):2353-2366 [PMID: 31393557]
  35. J Pediatr. 2003 Aug;143(2):208-12 [PMID: 12970634]
  36. Diabetologia. 2007 Oct;50(10):2085-9 [PMID: 17653689]

MeSH Term

Humans
Female
Child
Mitochondrial Diseases
Male
Endocrine System Diseases
Adolescent
Child, Preschool
Infant

Word Cloud

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