Growth hormone deficiency in children: Role of magnetic resonance imaging in assessing aetiopathogenesis and prognosis in idiopathic hypopituitarism

Pellini, C; Natale, B. Di; Angelis, Riccardo De; Bressani, N.; Scotti, Giuseppe; Triulzi, Fabio; Chiumello, G

doi:10.1007/bf01957687

Cited by 41 publications

(21 citation statements)

References 26 publications

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“…Overall, 33% of the children were deficient in 1 or more hormones other than GH, but it was not noted if any of the children with an ACTH deficiency had normal thyroid function. Smaller studies of children with IGHD have reported TSH deficiency rates of 11–50% and ACTH deficiency rates of 6–26% [4,11,12,13]. These studies did not report a cross-tabulation of the coincidence of ACTH and TSH deficiencies either.…”

Section: Discussionmentioning

confidence: 72%

Is Adrenocorticotropic Hormone Deficiency Really Rare in Patients with Idiopathic Growth Hormone Deficiency and Normal Thyroid Function Tests

et al. 2010

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Background/Aim: It was the aim of this study to evaluate subtle adrenocorticotropic hormone deficiencies in a group of patients with idiopathic growth hormone deficiency and without thyroid-stimulating hormone deficiency. Methods: Growth hormone and cortisol responses to an insulin tolerance test of 25 patients (15 males and 10 females) were evaluated at diagnosis (11.8 ± 2.5 years) and at the time of retesting (14.6 ± 1.6 years). A cortisol response <416, 416–555 and >555 nmol/l was defined as inadequate, blunted and normal, respectively. Results: Baseline cortisol responses to the insulin tolerance test were subnormal in 10 of the 25 patients (6 had blunted responses and 4 had inadequate responses). The mean ± SD of normal, blunted and inadequate cortisol response at diagnosis was 722.2 ± 127.8, 480.4 ± 37.4 and 317.7 ± 81.7 nmol/l, respectively. Five of these patients showed improved cortisol response at retesting. Three of the 15 patients who had a normal baseline cortisol response developed blunted cortisol response at re-evaluation. The mean ± SD of normal and blunted plus inadequate cortisol response at retesting was 668.1 ± 116.1 and 467.3 ± 64 nmol/l, respectively. All patients with a subnormal cortisol level were asymptomatic. Conclusion: Asymptomatic adrenocorticotropic hormone deficiency patients should be followed up closely, and treatment should be considered in a stress situation after re-evaluation of the hypothalamic-pituitary-adrenal axis.

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Section: Discussionmentioning

confidence: 72%

Is Adrenocorticotropic Hormone Deficiency Really Rare in Patients with Idiopathic Growth Hormone Deficiency and Normal Thyroid Function Tests

et al. 2010

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“…Magnetic resonance imaging (MRI) is a non-invasive technique that facilitates good visualization of both the hypophysis and the pituitary stalk (1)(2)(3)(4), thus improving our understanding of the pathophysiology of apparently idiopathic growth hormone deficiency (GHD) (5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Relationships between neuroradiological and clinical features in apparently idiopathic hypopituitarism

Arrigo

Luca

Maghnie

et al. 1998

European Journal of Endocrinology

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In this study, perinatal history, postnatal auxological and clinical evolution and endocrine features were retrospectively evaluated in 49 children, adolescents and young adults with apparently idiopathic hypopituitarism. They were divided into two groups according to magnetic resonance images: 32 patients with isolated pituitary hypoplasia (group A) and 17 with pituitary stalk interruption syndrome (group B). The aim of the study was to assess whether these neuroradiological pictures are associated with specific endocrine and clinical patterns. No significant difference in terms of gestational age, intrauterine growth and rates of adverse perinatal events was found between the two groups. Clinical signs documenting the existence of pituitary dysfunction in utero or shortly after birth were either slightly (micropenis, cryptorchidism, cholestatic jaundice) or significantly (hypoglycemia) more frequent in patients in group B. Although diagnosis of hypopituitarism was made significantly earlier in patients in group B, height deficiency at diagnosis was similar in both groups. Endocrine investigations revealed a more severe and widespread impairment of pituitary function among those in group B. The main conclusion is that the postnatal clinical course is more severe when growth hormone deficiency is associated with pituitary stalk interruption syndrome than when the pituitary is only reduced in height, probably because of the more severe and widespread impairment of pituitary function in the former cases.

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“…The gonadotropin deficit would be as common but difficult to confirm in children before puberty. More rarely diabetes insipidus can be observed (Pellini et al, 1990;Mariani, 1992).…”

Section: Discussionmentioning

confidence: 99%

Interruption Syndrome Pituitary Stalk: About 8O Cases

Fedala¹,

Chentli²,

Meskine³

et al. 2015

ijccr

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Summary We report the study of 80 patients (65 M, 15 F) with Interruption Syndrome Pituitary Stalk. They had consulted for delay stature n: 65 and polyuropolydipsic syndrome n: 2. The mean age at diagnosis was 7±2.8 years. Delivery dystocia was noted in 18.7%. Neonatal hypoxia has been reported in 5%. The average size of patients was -.3±DS/M (Sempe). Micropenis ± cryptorchidism was present in 50%. Pituitary hypoplasia represents 91.2% of abnormality. The post pituitary gland is ectopic in 37.5%: infundibular place (90%) Tubercinerum (10%). In 3.7%, it is not found. The number of ectopic and unseen post pituitary gland is significantly higher (p<10-6) when the stalk is discontinued (n: 28). Than when pituitary gland is normally (n=3). When the post pituitary gland is ectopic or unseen (n: 37), malformations of HH are associated generally (81, 08%).Pituitary is more severely reduced when the post pituitary gland is ectopic or invisible and that the stalk is interrupted than when it is normal: 1.5mm±0.6 vs. 1.8±3 mm (p: 0.01).Hormonal assessment revealed IGH in 100%. It was associated with others pituitary deficiencies in 68.7%. Diabetes insipidus was found in 05 cases.Multiple pituitary deficiencies are more common when there are at least two malformations anomalies. Reassessment revealed other hormonal deficiencies in 22, 5% of patients with a mean of 05 years.The genetic study performed showed no molecular defect (PROP 1 PIT1, LHX3, LHX4, HESX1).

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Growth hormone deficiency in children: Role of magnetic resonance imaging in assessing aetiopathogenesis and prognosis in idiopathic hypopituitarism

Cited by 41 publications

References 26 publications

Is Adrenocorticotropic Hormone Deficiency Really Rare in Patients with Idiopathic Growth Hormone Deficiency and Normal Thyroid Function Tests

Is Adrenocorticotropic Hormone Deficiency Really Rare in Patients with Idiopathic Growth Hormone Deficiency and Normal Thyroid Function Tests

Relationships between neuroradiological and clinical features in apparently idiopathic hypopituitarism

Interruption Syndrome Pituitary Stalk: About 8O Cases

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