Comparison of the clinical characteristics of children with Silver-Russell syndrome genetically confirmed or not and their response to growth hormone therapy: a national multicenter study

J Pediatr Endocrinol Metab. 2025 May 28;38(8):830-837. doi: 10.1515/jpem-2024-0587. Print 2025 Aug 26.

Abstract

Objectives: Silver-Russell syndrome (SRS) is a rare imprinting disorder characterized by intrauterine and postnatal growth retardation. Its genetic etiology shows a heterogeneous distribution. This study aimed to evaluate the clinical characteristics of children diagnosed with SRS, their response to growth hormone therapy, and compare the data of genetically confirmed and clinically diagnosed SRS cases.

Methods: A total of 69 patients were included in the study. Genetically confirmed cases were considered Group 1, and cases with a clinical diagnosis according to the Netchine-Harbison scoring system were considered Group 2. The anthropometric data of the patients at birth, at the time of diagnosis, before and during the first year of growth hormone (GH) treatment, final height-SDS values of patients who reached final height, and accompanying comorbidities were recorded.

Results: In Group 1, 75.8 % had hypomethylation in the ICR1 region, 13.7 % had maternal uniparental disomy 7, 6.8 % had an IGF-2 mutation, and 3 % had a duplication in the 11p15 region. Central precocious puberty, gastroenterological, and neurologic comorbidities were found to be more frequent than those from other systems. Final height-SDS was -2.32 ± 1.57 (n=5) in Group 1 and -2.41 ± 0.86 (n=5) in Group 2.

Conclusions: 11p15 LOM was the most common genetic disorder in children with SRS in our case series. Gastroenterological problems and neurologic complications were observed frequently in these cases. Central precocious puberty was more commonly observed compared to the general population. The duration of treatment was the most critical factor in the success of GH therapy.

Keywords: Silver Russel syndrome; clinical characteristics; complications; growth hormone.

Publication types

  • Multicenter Study
  • Comparative Study

MeSH terms

  • Adolescent
  • Body Height / drug effects
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Human Growth Hormone* / therapeutic use
  • Humans
  • Infant
  • Infant, Newborn
  • Insulin-Like Growth Factor II / genetics
  • Male
  • Mutation*
  • Prognosis
  • Retrospective Studies
  • Silver-Russell Syndrome* / drug therapy
  • Silver-Russell Syndrome* / genetics
  • Silver-Russell Syndrome* / pathology

Substances

  • Human Growth Hormone
  • Insulin-Like Growth Factor II