Growth and Clinical Characteristics of Children with Floating-Harbor Syndrome: Analysis of Current Original Data and a Review of the Literature

Horm Res Paediatr. 2019;92(2):115-123. doi: 10.1159/000503782. Epub 2019 Nov 12.

Abstract

Background: Floating-Harbor syndrome (FHS) is a rare condition characterized by dysmorphic facial features, short stature, and expressive language delay.

Objective: The aim of this study was to describe a cohort of patients with FHS and review the literature about the response to recombinant human growth hormone (rhGH) therapy.

Methods: Anthropometric and laboratory data from 7 patients with FHS were described. The molecular diagnosis was established by multigene analysis. Moreover, we reviewed the literature concerning patients with FHS treated with rhGH.

Results: All 7 patients were born small for gestational age. At first evaluation, 6 patients had a height standard deviation score (SDS) ≤-2 and 1 had short stature in relation to their target height. Bone age was usually delayed, which rapidly advanced during puberty. Nonspecific skeletal abnormalities were frequently noticed, and normal to elevated plasma IGF-I levels were observed in all except 1 patient with growth hormone deficiency. Information about 20 patients with FHS treated with rhGH was analyzed (4 from our cohort and 16 from the literature). The median height changes during the treatment period (approx. 2.9 years) were 1.1 SDS (range from -0.4 to 3.1). Nontreated patients had an adult height SDS of -4.1 ± 1.2 (n = 10) versus -2.6 ± 0.8 SDS (n = 7, p 0.012) for treated patients.

Conclusion: We observed a laboratory profile compatible with IGF-1 insensitivity in some patients with FHS. Nevertheless, our study suggests that children with FHS may be considered as candidates for rhGH therapy. Further studies are necessary to establish the real benefit and safety of rhGH therapy in these patients.

Keywords: Floating-Harbor syndrome; Growth; Growth hormone therapy; SRCAP; Short stature.

Publication types

  • Review

MeSH terms

  • Abnormalities, Multiple* / drug therapy
  • Abnormalities, Multiple* / metabolism
  • Abnormalities, Multiple* / pathology
  • Abnormalities, Multiple* / physiopathology
  • Adolescent
  • Adolescent Development / drug effects*
  • Body Height / drug effects
  • Child
  • Child Development / drug effects*
  • Child, Preschool
  • Craniofacial Abnormalities* / drug therapy
  • Craniofacial Abnormalities* / metabolism
  • Craniofacial Abnormalities* / pathology
  • Craniofacial Abnormalities* / physiopathology
  • Dwarfism, Pituitary* / drug therapy
  • Dwarfism, Pituitary* / metabolism
  • Dwarfism, Pituitary* / pathology
  • Dwarfism, Pituitary* / physiopathology
  • Female
  • Growth Disorders* / drug therapy
  • Growth Disorders* / metabolism
  • Growth Disorders* / pathology
  • Growth Disorders* / physiopathology
  • Heart Septal Defects, Ventricular* / drug therapy
  • Heart Septal Defects, Ventricular* / metabolism
  • Heart Septal Defects, Ventricular* / pathology
  • Heart Septal Defects, Ventricular* / physiopathology
  • Human Growth Hormone / therapeutic use*
  • Humans
  • Insulin-Like Growth Factor I / metabolism
  • Male
  • Puberty / drug effects*

Substances

  • IGF1 protein, human
  • Human Growth Hormone
  • Insulin-Like Growth Factor I

Supplementary concepts

  • Floating-harbor syndrome