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Mitrovic K.,Institute for Mother and Child Healthcare of Serbia Dr Vukan Cupic | Milenkovic T.,Institute for Mother and Child Healthcare of Serbia Dr Vukan Cupic | Todorovic S.,Institute for Mother and Child Healthcare of Serbia Dr Vukan Cupic | Vukovic R.,Institute for Mother and Child Healthcare of Serbia Dr Vukan Cupic | And 3 more authors.
Srpski Arhiv za Celokupno Lekarstvo | Year: 2013

Introduction Growth hormone deficiency (GHD) can be isolated or associated with deficiency of other pituitary gland hormones. According to age at diagnosis, causes of GHD are divided into congenital or acquired, and according to etiology into recognized and unknown. Objective We analyzed etiology and prevalence of GHD, demographic data at birth, age, body height (BH) and bone age at diagnosis as well as the frequency of other pituitary hormone deficiencies. Methods The study involved 164 patients (109 male). The main criterion for the diagnosis of GHD was inadequate response of GH after two stimulation tests. The patients were classified into three groups: idiopathic, congenital and acquired GHD. Results Idiopathic GHD was confirmed in 57.9% of patients, congenital in 11.6% and acquired in 30.5%. The mean age at diagnosis of GHD was 10.1±4.5 years. The patients with congenital GHD had most severe growth retardation (-3.4±1.4 SDS), while the patients with idiopathic GHD showed most prominent bone delay (-3.6±2.3 SDS). The prevalence of multiple pituitary hormone deficiency was 56.1%, in the group with congenital GHD 73.7%, acquired GHD 54.0% and idiopathic GHD 53.7%. The frequency of thyrotropin deficiency ranged from 88.2-100%, of adrenocorticotrophin 57.1-68.8% and of gonadotrophins deficiency 57.1- 63.0%, while deficiency of antidiuretic hormone was 2.0-25.0%. Conclusion Although regular BH measurements enable early recognition of growth retardation, patients' mean age and degree of growth retardation indicate that GHD is still diagnosed relatively late. A high incidence of other pituitary hormone deficiencies requires a detailed investigation of the etiology of disorders and evaluation of all pituitary functions in each child with confirmed GHD. Source


Mitrovic K.,Institute for Mother and Child Healthcare of Serbia Dr Vukan Cupic | Vukovic R.,Institute for Mother and Child Healthcare of Serbia Dr Vukan Cupic | Milenkovic T.,Institute for Mother and Child Healthcare of Serbia Dr Vukan Cupic | Todorovic S.,Institute for Mother and Child Healthcare of Serbia Dr Vukan Cupic | And 3 more authors.
European Journal of Pediatrics | Year: 2016

Congenital hypothyroidism (CH) is the most frequent congenital endocrine disorder. The purpose of the present study was to determine the incidence of CH in Central Serbia from 1983 to 2013. Newborn screening for CH was based on measuring neonatal thyroid-stimulating hormone (TSH) using a 30 mU/l cutoff (CO) until 12/1987 (P1), 15 mU/l until 12/1997 (P2), 10 mU/l until 12/2006 (P3), and 9 mU/l thereafter (P4). During the study period, there were 1,547,122 live births screened for CH. Primary CH was detected in 434 newborns, with incidence of 1:3728. With gradual lowering of the CO, the incidences of CH increased from 1:5943 in P1 to 1:1872 in P4 (p < 0.001). Incidence of CH with ectopic and enlarged gland doubled (p < 0.001), while prevalence of athyreosis remained relatively constant. The most prominent finding was the increase in the transient CH from none in P1 to 35 % of all CH patients in P4. Conclusion: The overall incidence of CH in Central Serbia during study period nearly tripled, with a significant increase in almost all etiological categories, and was associated with lowering TSH cutoffs as well as other yet unidentified factors. Further studies are needed to identify other factors associated with increasing incidence of CH.What is Known:• Congenital hypothyroidism (CH) is the main cause of preventable mental retardation.• Recent reports have indicated a progressive increase in the incidence of primary CH throughout the world, partially explained by lowering of the TSH cutoff values.What is New:• During the study period associated with lowering of the TSH cutoffs, the overall incidence of CH in Serbia tripled, including transient CH, ectopy, and dyshormonogenesis, while prevalence of athyreosis remained stable during 30 years.• Significant increase in the incidence of both permanent and transient CH was observed, associated with lowering of TSH cutoffs as well as other yet unidentified factors. © 2015, Springer-Verlag Berlin Heidelberg. Source


Milenkovic T.,Institute for Mother and Child Healthcare of Serbia Dr Vukan Cupic | Guc-Scekic M.,Institute for Mother and Child Healthcare of Serbia Dr Vukan Cupic | Zdravkovic D.,Institute for Mother and Child Healthcare of Serbia Dr Vukan Cupic | Zdravkovic D.,University of Belgrade | And 5 more authors.
Balkan Journal of Medical Genetics | Year: 2011

Ring Y chromosome is a very rare chromosomal aberration. The published mixed gonadal dysgenesis (MGD) patients with a ring Y chromosome are short in stature, but are not growth hormone (GH) deficient. We present the molecular cytogenetic and molecular characterization of ring Y chromosome mosaicism in a 10-year-old boy with MGD whose short stature could be explained by the high percentage of cells monosomic for the X-chromosome, but also by the presence of severe GH deficiency. The ring Y chromosome in our patient is a de novo structural aberration. The father's karyotype was normal. Source


Kravljanac R.,Institute for Mother and Child Healthcare of Serbia Dr Vukan Cupic | Kravljanac R.,University of Belgrade | Djuric M.,Institute for Mother and Child Healthcare of Serbia Dr Vukan Cupic | Djuric M.,University of Belgrade
Srpski Arhiv za Celokupno Lekarstvo | Year: 2012

Introduction: Paroxismal events can resemble epileptic seizures, however, some epileptic seizures, especially benign occipital childhood epilepsies can imitate migraine, cycling vomiting or encephalitis. Objective: The aim of this study was evaluation of clinical and electroencephalographic (EEG) features and outcome in children with benign occipital childhood epilepsies. Methods: Investigation included 18 patients with benign occipital childhood epilepsies hospitalized in the period from 2007 to 2010. The diagnosis was based on clinical and EEG characteristics of seizures, while treatment included acute therapy for seizures and chronic antiepileptic drugs. Prognosis was analyzed in terms of neurological outcome and seizure recurrence rate. Results: Benign occipital childhood epilepsy with early onset was diagnosed in 15 children. Vegetative symptoms, mostly ictal vomiting (13), eye deviation and loss of consciousness (13) dominated in the clinical presentation. The most frequent EEG findings showed occipital epileptic discharges. Benign occipital childhood epilepsy with late onset was diagnosed in three cases. Seizures were manifested by visual hallucinations, headache and secondary generalized convulsions. All three patients were administered chronic antiepileptic drugs and had good outcome. Conclusion: In our patients, clinical manifestations of benign occipital epilepsies had some similarities with clinical features of migraine and encephalitis. It could explain misdiagnosis in some of them. Knowledge about main features and differences between each of these disorders is crucial for making appropriate diagnosis. Source

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