Mustafa Ali AKIN, Selim KURTOĞLU, Dilek SARICI, Leyla AKIN, Nihal HATİPOĞLU

Endocrine abnormalities of patients with cleft lip and/or cleft palate during the neonatal period

There are close interactions among the developing oral cavity, pituitary gland, and central nervous system (CNS) in early embryonic life. In this study we aimed to screen endocrine abnormalities in patients with orofacial clefts in the neonatal period. Materials and methods: Thirty-one patients with isolated orofacial median clefts were included in the study. Pituitary, thyroid, and adrenal hormones were measured at the first week and remeasured in the third or fourth weeks. Imaging studies were done for detection of CNS anomalies in all patients. Results: Endocrine abnormality was detected in 22 (70.9%) patients. The number of patients with single and multiple endocrine abnormalities were 13 (41.9%) and 9 (29%), respectively. Thyroid hormone-related disorders were detected in 10 (32.3%) patients. Growth hormone deficiency was detected in 4 (12.9%) patients. Adrenocorticotrophic hormone and/or glucocorticoid deficiency was detected in 5 (16.1%) patients. Neonatal hypoglycemia due to endocrinological abnormalities was detected in 6 (19.4%) patients. Defected mini-puberty was seen in 2 (15.4%) patients. There was no relationship between the types of orofacial cleft and endocrine abnormalities. Conclusion: Endocrinological evaluation of the patients with orofacial clefts in the neonatal period is a worthwhile endeavor to detect hormone deficiencies regardless of the type of the cleft.

Anahtar Kelimeler:

Key words: Endocrine system diseases, cleft lip and palate, newborn

Endocrine abnormalities of patients with cleft lip and/or cleft palate during the neonatal period

Keywords:

Key words: Endocrine system diseases, cleft lip and palate, newborn,

PDF

___

Cox TC. Taking it to the max: the genetic and developmental mechanisms coordinating midfacial morphogenesis and dysmorphology. Clin Genet 2004; 65: 163–176.
Lowe LH, Booth TN, Joglar JM, Rollins NK. Midface anomalies in children. Radiographics 2000; 20: 907–922.
Mossey PA, Little J, Munger RG, Dixon MJ, Shaw WC. Cleft lip and palate. Lancet 2009; 374: 1773–1785.
Tuncbilek E. Türkiye’de konjenital malformasyon sikliği, dagilimi, risk faktörleri ve yenidoganlarin antropometrik degerlendirmesi. Ankara, Turkey: TÜBİTAK Matbaası; 1994 (in Turkish).
Juriloff DM, Harris MJ. Mouse genetic models of cleft lip with or without cleft palate. Birth Defects Res A Clin Mol Teratol 2008; 82: 63–77.
Osman M, Allan JC, Kramer B. A pharyngeal and ectopic hypophysis in a neonate with craniofacial abnormalities: a case report and review of development and structure. Cleft Palate Craniofac J 2006; 43: 117–122.
Kjaer I. Human prenatal craniofacial development related to brain development under normal and pathologic conditions. Acta Odontol Scand 1995; 53: 135–143.
Roitman A, Laron Z. Hypothalamo-pituitary hormone insufficiency associated with cleft lip and palate. Arch Dis Child 1978; 53: 952–955.
Laron Z, Taube E, Kaplan I. Pituitary growth hormone insufficiency associated with cleft lip and palate. An embryonal developmental defect. Helv Paediatr Acta 1969; 24: 576–581.
Azcona C, Stanhope R. Height and weight achievement in cleft lip and palate. Arch Dis Child 1997; 77: 187–188.
Montagnoli LC, Barbieri MA, Bettiol H, Marques IL, de Souza L. Growth impairment of children with different types of lip and palate clefts in the first 2 years of life: a cross-sectional study. J Pediatr (Rio J) 2005; 81: 461–465.
Marques IL, Nackashi JA, Borgo HC, Martinelli AP, PegoraroKrook MI, Williams WN, Dutka JC, Seagle MB, Souza TV, Garla LA et al. Longitudinal study of growth of children with unilateral cleft-lip palate from birth to two years of age. Cleft Palate Craniofac J 2009; 46: 603–609.
McHeik JN, Levard G. Growth in infants in the first two years of life after neonatal repair for unilateral cleft lip and palate. Int J Pediatr Otorhinolaryngol 2010; 74: 465–468.
Traggiai C, Stanhope R. Endocrinopathies associated with midline cerebral and cranial malformations. J Pediatr 2002; 140: 252–255.
Rudman D, Davis T, Priest JH, Patterson JH, Kutner MH, Heymsfield SB, Bethel RA. Prevalence of growth hormone deficiency in children with cleft lip or palate. J Pediatr 1978; 93: 378–382.
Lipman T, Rezvani I, Mitra A, Mastropieri C. Assessment of stature in children with orofacial clefting. MCN Am J Matern Child Nurs 1999; 24: 252–256.
Felixschollaart B, Hoeksma JB, Prahlandersen B. Growth comparisons between children with cleft lip and/or palate and controls. Cleft Palate Craniofac J 1992; 29: 475–480.
Cunningham ML, Jerome JT. Linear growth characteristics of children with cleft lip and palate. J Pediatr 1997; 131: 707–711.
Smedegaard LHV, Marxen DRN, Moes JHV, Glassou EN, Scientsan C. Hospitalization, breast-milk feeding, and growth in infants with cleft palate and cleft lip and palate born in Denmark. Cleft Palate Craniofac J 2008; 45: 628–632.
Turner L, Jacobsen C, Humenczuk M, Singhal VK, Moore D, Bell H. The effects of lactation education and a prosthetic obturator appliance on feeding efficiency in infants with cleft lip and palate. Cleft Palate Craniofac J 2001; 38: 519–524.
Sandell EB, Kolthoff IM. Micro determination of iodine by a catalytic method. Mikrochemica Acta 1937; 1: 9–25.
Dunn JT, Myers HE, Dunn A. Simple methods for assessing urinary iodine, including preliminary description of a new rapid technique (“Fast B”). Exp Clin Endocrinol Diabetes 1998; 106 (Suppl. 3): 10–12.
Kapelari K, Kirchlechner C, Hogler W, Schweitzer K, Virgolini I, Moncayo R. Pediatric reference intervals for thyroid hormone levels from birth to adulthood: a retrospective study. BMC Endocr Disord 2008; 8: 15.
Kurtoğlu S, Kondolot M, Mazicioğlu MM, Hatipoğlu N, Akin MA, Akyildiz B. Growth hormone, insulin like growth factor-1, and insulin-like growth factor-binding protein-3 levels in the neonatal period: a preliminary study. J Pediatr Endocrinol Metab 2010; 23: 885–889.
Schmidt H, Schwarz HP. Serum concentrations of LH and FSH in the healthy newborn. Eur J Endocrinol 2000; 143: 213–215.
Hochberg Z. Infancy. In: Hochberg Z, editor. Evo-Devo of Child Growth: Treatise on Child Growth and Human Evolution. 1st ed. Hoboken, NJ, USA: Wiley-Blackwell; 2010. pp. 67–90.
Burger HG, Yamada Y, Bangah ML, McCloud PI, Warne GL. Serum gonadotropin, sex steroid, and immunoreactive inhibin levels in the first two years of life. J Clin Endocrinol Metab 1991; 72: 682–686.
Esoterix Laboratory Services. Endocrinology Expected Values & S.I. Unit Conversion Tables. Austin, TX, USA: Esoterix Laboratory Services Endocrine Sciences; 2009.
Coşkun A, Yıkılmaz A, Doğanay S. Yenidoğanda endokrinolojik hastaliklarin radyolojik değerlendirilmesi In: Kurtoğlu S, editor. Yenidoğan Dönemi Endokrin Hastalıkları. 1st ed. Istanbul, Turkey: Nobel Tıp Kitapevleri; 2011. pp. 599–611 (in Turkish).
Argryropoulou M, Perignon F, Brunelle F, Brauner R, Rappaport R. Height of normal pituitary gland as a function of age evaluated by magnetic resonance imaging children. Pediatr Radiol 1991; 21: 247–249.
Yu W, Serrano M, Miguel SS, Ruest LB, Svoboda KK. Cleft lip and palate genetics and application in early embryological development. Indian J Plast Surg 2009; 42: 35–50.
Mehta A, Dattani MT. Developmental disorders of the hypothalamus and pituitary gland associated with congenital hypopituitarism. Best Pract Res Clin Endocrinol Metab 2008; 22: 191–206.
Nagel BH, Palmbach M, Petersen D, Ranke MB. Magnetic resonance images of 91 children with different causes of short stature: pituitary size reflects growth hormone secretion. Eur J Pediatr 1997; 156: 758–763.
Lipinski RJ, Song C, Sulik KK, Everson JL, Gipp JJ, Yan D, Bushman W, Rowland IJ. Cleft lip and palate results from Hedgehog signaling antagonism in the mouse: phenotypic characterization and clinical implications. Birth Defects Res A Clin Mol Teratol 2010; 88: 232–240.
Aydin K, Bideci A, Kendirci M, Cinaz P, Kurtoglu S. Insulinlike growth factor-I and insulin-like growth factor binding protein-3 levels of children living in an iodine- and seleniumdeficient endemic goiter area. Biol Trace Elem Res 2002; 90: 25–
Bamforth JS, Hughes IA, Lazarus JH, Weaver CM, Harper PS. Congenital hypothyroidism, spiky hair, and cleft palate. J Med Genet 1989; 26: 49–51.
Bell JJ, August GP, Blethen SL, Baptista J. Neonatal hypoglycemia in a growth hormone registry: incidence and pathogenesis. J Pediatr Endocrinol Metab 2004; 17: 629–635.
Buntincx IM, Van Overmeire B, Desager K, Van Hauwaert J. Syndromic association of cleft palate, bilateral choanal atresia, curly hair, and congenital hypothyroidism. J Med Genet 1983; 30: 427–428.
Hadziselimovic F, Zivkovic D, Bica DT, Emmons LR. The importance of mini-puberty for fertility in cryptorchidism. J Urol 2005; 174: 1536–1539.
Kurtoğlu S, Akcakuş M, Kocaoğlu C, Güneş T, Karaküçük I, Kula M, Kocakoç E. Iodine deficiency in pregnant women and in their neonates in the central Anatolian region (Kayseri) of Turkey. Turk J Pediatr 2004; 46: 11–15.
Sheahan P, Miller I, Sheahan JN, Earley MJ, Blayney AW. Incidence and outcome of middle ear disease in cleft lip and/or cleft palate. Int J Pediatr Otorhinolaryngol 2003; 67: 785–793.
Tonacchera M, Banco M, Lapi P, Di Cosmo C, Perri A, Montanelli L, Moschini L, Gatti G, Gandini D, Massei A et al. Genetic analysis of TTF-2 gene in children with congenital hypothyroidism and cleft palate, congenital hypothyroidism, or isolated cleft palate. Thyroid 2004; 14: 584–588. van der Plas E, Caspell CJ, Aerts AM, Tsalikian E, Richman LC, Dawson JD, Nopoulos P. Height, BMI, and pituitary volume in individuals with and without isolated cleft lip and/or palate. Pediatr Res 2012; 71: 612–618.