Growth, final height and endocrine sequelae in a UK population of patients with Hurler syndrome (MPS1H)

Research output: Contribution to journalArticle

  • External authors:
  • Chris J. Gardner
  • Nicola Robinson
  • Tim Meadows
  • Robert Wynn
  • Andrew Will
  • Jean Mercer
  • Heather J. Church
  • Karen Tylee
  • J. Edmond Wraith

Abstract

Objective: Hurler Syndrome, (MPSIH) is an inborn error of glycosaminoglycan metabolism. Haematopoietic stem cell transplantation (HSCT) has transformed the prognosis for these children. Prior to transplant patients receive chemotherapy or chemo-radiotherapy. Regular screening for the development of endocrine sequelae is therefore essential. We present for the first time data on final adult height and endocrine complications in children with MPSIH post HSCT. Design: Retrospective case note study and a prospective programme of growth and endocrine assessment. Patients: 22 patients were included, mean age at last assessment 12.2 (Range 6.3-21.6) years. Mean age at HSCT was 1.3 (SD 0.6) years. Conditioning included mostly busulphan and cyclophosphamide, with 5 patients receiving total body irradiation prior to second transplant. Results: Height SDS decreased over time. Final height (FH) was attained in seven patients with male FH SDS -4.3 (Range -3.8, -5.1) and female FH SDS -3.4 (Range -2.9, -5.6). Eight of 13 patients tested had evidence of high growth hormone (GH) levels, while one had GH deficiency. Adrenal and thyroid function was normal in all. 11 patients were pubertal or post pubertal. Two females had pubertal failure requiring intervention. All male patients had spontaneous, complete puberty; however three patients have reduced testicular volumes. Five out of 13 patients tested had an abnormal oral glucose tolerance test. Conclusion: Growth is impaired, primarily related to skeletal dysplasia, but also associated with GH resistance. Pubertal development may be compromised and abnormalities of glucose metabolism are common. We recommend a structured endocrine surveillance programme for these patients. © 2011 SSIEM and Springer.

Bibliographical metadata

Original languageEnglish
Pages (from-to)489-497
Number of pages8
JournalJournal of Inherited Metabolic Disease
Volume34
Issue number2
DOIs
Publication statusPublished - Apr 2011