New Features in a Rare Monogenic Obesity: Carboxypeptidase E Deficiency


Emet D. C., HELHEL E., PORTAKAL AKÇİN O., Gonc N.

HORMONE RESEARCH IN PAEDIATRICS, 2025 (SCI-Expanded, Scopus) identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2025
  • Doi Number: 10.1159/000543524
  • Journal Name: HORMONE RESEARCH IN PAEDIATRICS
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, Chemical Abstracts Core, EMBASE, Food Science & Technology Abstracts, MEDLINE, SportDiscus
  • Hacettepe University Affiliated: Yes

Abstract

Introduction: Carboxypeptidase E (CPE) is an enzyme involved in the neuropeptides/hormones processing. Its deficiency is associated with endocrinopathies comparable to those caused by proprotein convertase 1/3(PC1/3) deficiency. In this case report, we expand the clinical features of CPE deficiency by examining the index case's clinical/laboratory results, which are also indicative of PC1/3 deficiency. Case Presentation: The index case, 13.5 years old, had obesity, central hypothyroidism, developmental delay, hypogonadotropic hypogonadism, enuresis. A 4-hour oral glucose tolerance test revealed glucose intolerance with a partial insulin deficiency and postprandial hypoglycemia. Proinsulin level was high. Partial central diabetes insipidus was verified with a water deprivation test. Administration of desmopressin successfully alleviated the symptoms of polyuria-polydipsia and enuresis. Brain-derived-neurotrophic-factor level, which might be linked to ID, was low. The 8-month-old sibling had central hypothyroidism and hypotonicity but has not yet developed obesity. Conclusion: Patients with CPE deficiency should undergo evaluation not only for hypothyroidism and hypogonadism but also for glucose and water metabolism disorders. The presentation of new cases may lead to the discovery of novel findings, and the identification of other pituitary hormone deficiencies. (c) 2025 S. Karger AG, Basel