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Landscape of Familial Isolated and Young-Onset Pituitary Adenomas: Prospective Diagnosis in AIP Mutation Carriers.

AbstractCONTEXT:
Familial isolated pituitary adenoma (FIPA) due to aryl hydrocarbon receptor interacting protein (AIP) gene mutations is an autosomal dominant disease with incomplete penetrance. Clinical screening of apparently unaffected AIP mutation (AIPmut) carriers could identify previously unrecognized disease.
OBJECTIVE:
To determine the AIP mutational status of FIPA and young pituitary adenoma patients, analyzing their clinical characteristics, and to perform clinical screening of apparently unaffected AIPmut carrier family members.
DESIGN:
This was an observational, longitudinal study conducted over 7 years.
SETTING:
International collaborative study conducted at referral centers for pituitary diseases.
PARTICIPANTS:
FIPA families (n 216) and sporadic young-onset (30 y) pituitary adenoma patients (n 404) participated in the study.
INTERVENTIONS:
We performed genetic screening of patients for AIPmuts, clinical assessment of their family members, and genetic screening for somatic GNAS1 mutations and the germline FGFR4 p.G388R variant.
MAIN OUTCOME MEASURE(S):
We assessed clinical disease in mutation carriers, comparison of characteristics of AIPmut positive and negative patients, results of GNAS1, and FGFR4 analysis.
RESULTS:
Thirty-seven FIPA families and 34 sporadic patients had AIPmuts. Patients with truncating AIPmuts had a younger age at disease onset and diagnosis, compared with patients with nontruncating AIPmuts. Somatic GNAS1 mutations were absent in tumors from AIPmut-positive patients, and the studied FGFR4 variant did not modify the disease behavior or penetrance in AIPmut-positive individuals. A total of 164 AIPmut-positive unaffected family members were identified; pituitary disease was detected in 18 of those who underwent clinical screening.
CONCLUSIONS:
A quarter of the AIPmut carriers screened were diagnosed with pituitary disease, justifying this screening and suggesting a variable clinical course for AIPmut-positive pituitary adenomas.
AuthorsLaura C Hernández-Ramírez, Plamena Gabrovska, Judit Dénes, Karen Stals, Giampaolo Trivellin, Daniel Tilley, Francesco Ferrau, Jane Evanson, Sian Ellard, Ashley B Grossman, Federico Roncaroli, Mónica R Gadelha, Márta Korbonits, International FIPA Consortium
JournalThe Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 100 Issue 9 Pg. E1242-54 (Sep 2015) ISSN: 1945-7197 [Electronic] United States
PMID26186299 (Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
Chemical References
  • Intracellular Signaling Peptides and Proteins
  • aryl hydrocarbon receptor-interacting protein
Topics
  • Adenoma (diagnosis, genetics, pathology)
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Female
  • Genetic Testing
  • Germ-Line Mutation
  • Growth Hormone-Secreting Pituitary Adenoma (diagnosis, genetics, pathology)
  • Humans
  • Intracellular Signaling Peptides and Proteins (genetics)
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Mutation
  • Pituitary Neoplasms (diagnosis, genetics, pathology)
  • Prospective Studies
  • Young Adult

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