Abstract
Introduction
Williams-Beuren Syndrome (WBS) is a rare chromosomal disorder caused by a 7q11.23 deletion, featuring dysmorphic findings, cardiovascular anomalies, neurodevelopmental problems, and endocrine disorders. This study evaluated endocrine manifestations, diagnostic delays, and the importance of multidisciplinary follow-up.
Materials and Methods
Fourteen WBS patients followed at a tertiary pediatric endocrinology clinic between 2018-2023 were retrospectively analyzed. As the cohort comprised patients referred to endocrinology, the reported ratesreflect the frequencies observed in our series rather than population prevalence.
Results
Six patients (42.9%) were female, eight (57.1%) male. Mean birth weight was 2496.8 ± 581.4 g. Median diagnostic delay from first presentation to genetic diagnosis was 3.6 months (range: 0-167.9 months); 5 patients (35.7%) experienced delays exceeding 12 months. Cardiovascular anomalies were found in 11 (78.6%), hypothyroidism in 5 (35.7%), hypercalcemia in 8 (57.1%), short stature in 3 of 8 patients with available height SDS, cryptorchidism in 4/8 males (50%), and neurodevelopmental problems in 13 (92.9%). Only one patient (7.1%) first presented to endocrinology.
Conclusion
Diagnostic delay remains a significant problem in WBS. Endocrine problems, particularly hypercalcemia, hypothyroidism, and cryptorchidism, must be recognized and treated early. Increasing disease awareness for earlier diagnosis and a multidisciplinary approach are important.
Keywords:
Williams-Beuren syndrome, endocrinology, hypercalcemia, hypothyroidism, diagnostic delay, multidisciplinary
References
1Morris CA. Williams syndrome. 1999 Apr 9 [Updated 2023 Apr 13]. In: Adam MP, Feldman J, Mirzaa GM, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2024.
2Osborne LR. Williams-Beuren syndrome: unraveling the mysteries of a microdeletion disorder. Mol Genet Metab. 1999;67.
3Pober BR. Williams-Beuren syndrome. N Engl J Med. 2010;362:239-52.
4Cagle AP, Waguespack SG, Buckingham BA, Shankar RR, DiMeglio LA. Severe infantile hypercalcemia associated with Williams syndrome successfully treated with intravenously administered pamidronate. Pediatrics. 2004;114:1091-5.
5Selicorni A, Fratoni A, Pavesi MA, Bottigelli M, Arnaboldi E, Milani D. Thyroid anomalies in Williams syndrome: investigation of 95 patients. Am J Med Genet A. 2006;140:1098-1101.
6Kozel BA, Barak B, Kim CA, Mervis CB, Osborne LR, Porter M, et al. Williams syndrome. Nat Rev Dis Primers. 2021;7:42.
7Stanley TL, Leong A, Pober BR. Growth, body composition, and endocrine issues in Williams syndrome. Curr Opin Endocrinol Diabetes Obes. 2021;28:64-74
8de Sousa Lima Strafacci A, Fernandes Camargo J, Bertapelli F, Guerra Júnior G. Growth assessment in children with Williams-Beuren syndrome: a systematic review. J Appl Genet. 2020;61:205-12.
9Güven A. Seven cases with Williams-Beuren syndrome: endocrine evaluation and long-term follow-up. J Pediatr Endocrinol Metab. 2017;30:159-65.
10Kim YM, Cho JH, Kang E, Kim GH, Seo EJ, Lee BH, et al. Endocrine dysfunctions in children with Williams-Beuren syndrome. Ann Pediatr Endocrinol Metab. 2016;21:15-20.
11Stagi S, Bindi G, Neri AS, Lapi E, Losi S, Jenuso R, et al. Thyroid function and morphology in patients affected by Williams syndrome. Clin Endocrinol (Oxf). 2005;63:456-60.
12Cammareri V, Vignati G, Nocera G, Beck-Peccoz P, Persani L. Thyroid hemiagenesis and elevated thyrotropin levels in a child with Williams syndrome. Am J Med Genet. 1999;85:491-4.
13Cherniske EM, Carpenter TO, Klaiman C, Young E, Bregman J, Insogna K, et al. Multisystem study of 20 older adults with Williams syndrome. Am J Med Genet A. 2004;131:255-64.