Pituitary

Molecular analysis and genotype-phenotype correlations in patients with Congenital Hypopituitarism and related disorders

Investigators:

Mehul Dattani m.dattani@ucl.ac.uk

Summary:

Congenital hypopituitarism (CH) is a rare but life-threatening condition that is associated with significant morbidity and mortality. It occurs in 1 in 4000 to 1 in 10000 live births, and may present variably. The condition includes GH, ACTH, TSH and gonadotrophin deficiencies; diabetes insipidus is usually rare unless midline abnormalities are present, as is the case with Septo-Optic Dysplasia (SOD). Recently, a number of genetic causes have been identified for these conditions by our research group as well as others. However, the vast majority (>85%) of cases remain unexplained in terms of their cause. We have an ongoing research programme to identify the genetic cause in children with congenital hypopituitarism and SOD using novel genetic technologies including whole exome and whole genome sequencing. We are interested in recruiting patients with Combined Pituitary Hormone Deficiencies (CPHD), SOD, growth hormone deficiency (GHD), and Kallmann syndrome as well as hypogonadotrophic hypogonadism. Phenotypes, inheritance and penetrance can be variable, and much remains to be learned about the molecular basis of these conditions.

Start Date: Ongoing
End Date: --/--/----

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Markers of Hypothalamic Dysfunction in Children with Hypothalamo-Pituitary-Axis Tumours (HPAT) or Pituitary Maldevelopment - Hormonal, Anatomical and Clinical Correlates to Guide Treatment and Improve Outcomes

Investigators:

Mehul Dattani m.dattani@ucl.ac.uk

Summary:
The hypothalamus is a small but vital structure of the brain regulating multiple essential functions of the body such as thirst, hunger-satiety, sleep-wake cycle, blood pressure, heart rate, behaviour and thermoregulation. The hypothalamus is also tightly connected with another vital structure of the brain, the pituitary gland, which represents the master regulatory gland of the endocrine system. The hypothalamo-pituitary system regulates growth, puberty, reproduction, salt and water balance and stress response. Hypothalamic dysfunction (HD) is a rare, complex, highly variable and poorly understood life-limiting disorder significantly compromising quality of life, increasing disability and causing premature mortality from its secondary life-threatening complications. Current diagnostic tools are do not allow clear differentiation between hypothalamic and more manageable pituitary disorders and conventional qualitative neuroimaging techniques are unable to accurately anatomically define the hypothalamus. As a result, the endocrine phenotypes of these children are highly unpredictable and targeted interventions are lacking. The proposed project aims to identify, with the help of advanced quantitative MRI, structural and functional hypothalamic abnormalities and to correlate anatomical findings with specific hormonal patterns and clinical symptoms. The ultimate aim is to develop prediction models directly translatable into clinical practice. We will be studying hypothalamic dysfunction in children with congenital midline brain lesions as well as in children surviving brain tumours. The proposed study is directly relevant to any children with acquired or congenital lesions of the hypothalamo-pituitary axis, for whom current therapies are inadequate to ameliorate life-limiting obesity, risk of secondary type 2 diabetes mellitus and neuro-behavioural disorders, or improve health-related quality of life.

Start Date: --/04/2018
End Date: --/03/2021

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