3-M syndrome associated with growth hormone deficiency: 18 year follow-up of a patient

Cristina Meazza,Margherita Silengo,Andrea Superti-Furga,Ekkehard Lausch,Mauro Bozzola,Elena Bozzola,Sara Pagani,Valeria Calcaterra

doi:10.1186/1824-7288-39-21

Abstract

3-M syndrome is a rare autosomal recessive disorder that causes short stature, unusual facial features and skeletal abnormalities. Mutations in the CUL7, OBSL1 and CCDC8 genes could be responsible for 3-M syndrome.Here we describe the growth and evolution of dismorphic features of an Italian boy with 3-M syndrome and growth hormone deficiency (GHD) from birth until adulthood. He was born full term with a very low birth weight (2400 g=−3.36 standard deviation score, SDS) and length (40.0 cm =−6.53 SDS). At birth he presented with a broad, fleshy nose with anteverted nostrils, thick and patulous lips, a square chin, curvilinear shaped eyebrows without synophrys, short thorax and long slender bones. Then, during childhood tall vertebral bodies, hip dislocation, transverse chest groove, winged scapulae and hyperextensible joints became more evident and the diagnosis of 3-M syndrome was made; this was also confirmed by the finding of a homozygous deletion in exon 18 of the CUL7 gene, which has not been previously described.The patient also exhibited severe GHD (GH <5 ng/ml) and from the age of 18 months was treated with rhGH. Notwithstanding the early start of therapy and good compliance, his growth rate was always very low, except for the first two years of treatment and he achieved a final height of 132 cm (−6.42 SDS).

Highlights

3-M syndrome is a rare autosomal recessive disorder that causes short stature, unusual facial features and skeletal abnormalities
Since CUL7 is involved in chondrocyte growth and proliferation, in 3-M syndrome, reduced cell mitosis during the early gestation period could be the cause of retarded growth
We describe a patient with 3-M syndrome and Growth hormone (GH) deficiency, who was followed from the age of two years to adulthood

Summary

Introduction

3-M syndrome is a rare autosomal recessive disorder that causes short stature, unusual facial features and skeletal abnormalities. We describe a patient with 3-M syndrome and GH deficiency, who was followed from the age of two years to adulthood. Even though rhGH therapy was started early in infancy (18 months of age) with good compliance, no catch-up growth was observed.

Results

Conclusion