Preview

Problems of Endocrinology

Advanced search

Сushing’s syndrome in early infancy due to МcCune—Albright syndrome

https://doi.org/10.14341/probl20166239-15

Abstract

McCune—Albright syndrome (MAS) is a rare multisystem disorder, classically defined by the clinical triad of fibrous dysplasia of bones (FD), café-au-lait skin spots, precocious puberty (PP) and other hyperfunctioning endocrinopathies. Diagnosis can be made if there are at least 2 of the 3 classical features. It is caused by somatic mutations of the GNAS gene encodes stimulate α-subunit of G protein (Gas). Gas is crucial for mediating effects of the lot of peptide hormones. Increased activity of Gas leads to multisystem hyperfunction. Some features are common (such as gonadotropin-independent precocious puberty) and another signs occur seldom. The clinical presentation of MAS is variable, the features occur at the different age. One of the rare feature of the MAS is Cushing’s syndrome due to bilateral adrenal hyperplasia, which usually occurs in the neonatal period. We describe clinical case of ACTH-independent hypercortisolism in the boy with MAS.

About the Authors

Nadezhda V. Makazan
Endocrinology Research Centre
Russian Federation
MD


Elizaveta M. Orlova
Endocrinology Research Centre
Russian Federation
MD, PhD


Maria A. Kareva
Endocrinology Research Centre
Russian Federation
MD, PhD


Igor V. Poddybnyi
Moscow State University of Medicine and Dentistry im. A.I. Evdokimova
Russian Federation
MD, PhD, Professor


Kirill N. Tolstov
Central Pediatric Clinical Hospital
Russian Federation
MD, PhD


Galina A. Polyakova
Moscow Regional Scientific and Research Institute named after M.F. Vladimirsky
Russian Federation
MD, PhD, Professor


Polina S. Bogdanova
European Medical Center
Russian Federation
MD, PhD


Valentina A. Peterkova
Endocrinology Research Centre
Russian Federation
MD, PhD, Professor


Ivan I. Dedov
Endocrinology Research Centre
Russian Federation
MD, PhD, Professor


References

1. Брайцев В.Р. Osteodystrophia fibrosa localisata. Съезд российских хирургов, 19-й: Тезисы. — Л., 1927. — С. 301-315.

2. Mccune DJ, Bruch H. Osteodystrophia Fibrosa. Am J Dis Child. 1937;54:806-848.

3. Albright F, Butler AM, Hampton AO, Smith P. Syndrome characterized by osteitis fibrosa disseminata, areas of pigmentation and endocrine dysfunction, with precocious puberty in females. N Engl J Med. 1937;216(17):727-746. doi: 10.1056/nejm193704292161701

4. Cоколов Д.Д., Иоффе Б.М. К вопросу о синдроме фиброзной дисплазии костей с ранним половым созреванием и пигментацией кожи. // Проблемы эндокринологии и гормонотерапии. — 1955. — Т. 6. — №1. — С. 88-94. [Sokolov DD, Ioffe BM. K voprosu o sindrome fibroznoy displazii kostey s roannim polovym sozrevaniem i pigmentatsiey kozhi. // Probl Endokrinol (Mosk). 1955;6(1):88-94. (In Russ.)].

5. Dumitrescu CE, Collins MT. Mccune—Albright syndrome. Orphanet J Rare Dis. 2008;3(1):12. doi: 10.1186/1750-1172-3-12

6. Collins MT, Singer FR, Eugster E. Mccune—Albright syndrome and the extraskeletal manifestations of fibrous dysplasia. Orphanet J Rare Dis. 2012;7(Suppl 1):S4. doi: 10.1186/1750-1172-7-s1-s4

7. Weinstein LS, Shenker A, Gejman PV, et al. Activating mutations of the stimulatory G protein in the Mccune—Albright syndrome. N Engl J Med. 1991;325(24):1688-1695. doi: 10.1056/nejm199112123252403

8. Spiegel AM. Receptor-effector coupling by G proteins: implications for normal and abnormal signal transduction. Endocr Rev. 1992;13(3):536-565. doi: 10.1210/Edrv-13-3-536

9. Carney JA, Young WF, Stratakis CA. Primary bimorphic adrenocortical disease: cause of hypercortisolism in Mccune—Albright syndrome. Am J Surg Pathol. 2011;35(9):1311-1326. doi: 10.1097/pas.0b013e31821ec4ce

10. Halioui-Louhaichi S, Dridi Y, Azzabi O, et al. Guérison d’un syndrome de Cushing révélateur d’un Syndrome De Mccune—Albright. Arch Pediatr. 2016;23(1):61-65. doi: 10.1016/j.arcped.2015.09.018

11. Coutant R, Lumbroso S, Rey R, et al. Macroorchidism due to autonomous hyperfunction of sertoli cells and G(S)alpha gene mutation: an unusual expression of Mccune—Albright syndrome in a prepubertal boy. J Clin Endocrinol Metab. 2001;86(4):1778-1781. doi: 10.1210/jcem.86.4.7391

12. Mamkin I, Philibert P, Anhalt H, et al. Unusual phenotypical variations in a boy with Mccune—Albright syndrome. Horm Res Paediatr. 2010;73(3):215-222. doi: 10.1159/000284365

13. Schmidt H, Kiess W. Secondary central precocious puberty in a girl with Mccune—Albright syndrome responds to treatment with GnRH analogue. J Pediatr Endocrinol Metab. 1998;11(1):77-81.

14. Cutler CM, Lee JS, Butman JA, et al. Long-term outcome of optic nerve encasement and optic nerve decompression in patients with fibrous dysplasia: risk factors for blindness and safety of observation. Neurosurgery. 2006;59(5):1011-1017; Discussion 1017-1018. doi: 10.1227/01.NEU.0000254440.02736.E3

15. Tolis G, Angelopoulos NG, Katounda E, et al. Medical treatment of acromegaly: comorbidities and their reversibility by somatostatin analogs. Neuroendocrinology. 2006;83(3-4):249-257. doi: 10.1159/000095535

16. Neggers SJ, Van Der Lely AJ. Somatostatin analog and pegvisomant combination therapy for acromegaly. Nat Rev Endocrinol. 2009;5(10):546-552. doi: 10.1038/nrendo.2009.175


Supplementary files

1. Рисунки к статье
Subject
Type Исследовательские инструменты
Download (759KB)    
Indexing metadata ▾

Review

For citations:


Makazan N.V., Orlova E.M., Kareva M.A., Poddybnyi I.V., Tolstov K.N., Polyakova G.A., Bogdanova P.S., Peterkova V.A., Dedov I.I. Сushing’s syndrome in early infancy due to МcCune—Albright syndrome. Problems of Endocrinology. 2016;62(3):9-15. https://doi.org/10.14341/probl20166239-15

Views: 769


ISSN 0375-9660 (Print)
ISSN 2308-1430 (Online)