Abstract
Background A 23-year-old male was referred to our clinic with diagnosis of idiopathic isolated
growth hormone deficiency. A detailed family history revealed short stature and swelling
of legs which only affected females in four generations of his family.
Methods Combined pituitary function tests revealed growth hormone deficiency, secondary hypothyroidism
and hypoprolactinemia in the proband. His mother had hypoprolactinemia and growth
hormone deficiency. A diagnosis of inherited combined pituitary deficiency due to
a PIT-1 mutation was suspected in view of the short stature with associated multiple
pituitary hormone deficiencies.
Results A mutation was identified in PIT-1 (POU1F1), 196C>T, which produces the amino acid
change P24L in exon 1. The mutation was also found in the mother of the proband but
not in his phenotypically normal half-sister.
Conclusion The case shows a novel association of two rare conditions Pit-1 mutation and lipoedema
in a family that has not been described before. It also allows formulation of hypothesis
on the interaction of growth hormone and sex steroids resulting in abnormal fat distribution
in predisposed subjects at the time of puberty
Key words
estrogens - hypopituitarism - leptin - obesity
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Correspondence
Dr. G. BanoMBBS, MD, FRCP
St George's NHS Trust
Thomas Addison unit
Blackshaw Road
London
United Kingdom
SW17 0QT
Telefon: 004/420/87 25 10 27
Fax: 004/420/87 25 02 40
eMail: gbano@sgul.ac.uk