MRI features of growth hormone deficiency in children with short stature caused by pituitary lesions

Xu, Chao; Zhang, Xinxian; Dong, Lina; Zhu, Bin; Tao, Xiaofeng

doi:10.3892/etm.2017.4377

Cited by 22 publications

(12 citation statements)

References 19 publications

(19 reference statements)

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“…Therefore, PSIS may be the most common etiology of MPHD in children and adolescents, which is different from adults [24]. Among all the non-tumor reasons, PSIS was the most common pituitary dysplasia associated with MPHD, as supported by a previous study [25]. More than 50% of the PSIS children and adolescents (61/93) had abnormal fetal positions and anoxia/asphyxia due to difficult labor.…”

Section: Discussionmentioning

confidence: 86%

Distinct pituitary hormone levels of 184 Chinese children and adolescents with multiple pituitary hormone deficiency: a single-centre study

et al. 2019

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BackgroundPituitary tumors and/or their treatment are associated with multiple pituitary hormone deficiency (MPHD) in adults, but the distinct pituitary hormone profile of MPHD in Chinese children and adolescents remains unclear.MethodsPatients with MPHD were divided into four groups according to their MRI results: 1) pituitary stalk interruption syndrome (PSIS); 2) hypoplasia; 3) normal; and 4) tumor survivor.ResultsAmong the 184 patients, 93 patients (50.5%) were with PSIS, 24 (13.0%) had hypoplastic pituitary gland, 10 (5.4%) patients were normal, and 57 (31.0%) were tumor survivors. There was an association between abnormal fetal position and PSIS (P ≤ 0.001). The CA/BA in PSIS, hypoplasia, normal, tumor survivor groups were 2.27 ± 1.05, 1.48 ± 0.39, 1.38 ± 0.57, 1.49 ± 0.33, and HtSDS were − 3.94 ± 1.39, − 2.89 ± 1.09, − 2.50 ± 1.05, − 1.38 ± 1.63. Patients in PSIS group had the largest CA/BA (P ≤ 0.001 vs. hypoplasia group, P = 0.009 vs. normal group, P ≤ 0.001 vs. tumor survivors) and lowest HtSDS (P ≤ 0.001 vs. hypoplasia group, P = 0.003 vs. normal group, P ≤ 0.001 vs. tumor survivors). The levels of TSH in the PSIS, hypoplasia, normal, and tumor survivor groups were 1.03 ± 1.08 (P = 0.149 vs. tumor survivors), 1.38 ± 1.47 (P = 0.045 vs. tumor survivors), 2.49 ± 1.53 (P < 0.001 vs. tumor survivors), and 0.76 ± 1.15 μIU/ml. The levels of GH peak in PSIS, hypoplasia, normal, tumor survivor groups were 1.37 ± 1.78, 1.27 ± 1.52, 3.36 ± 1.79, 0.53 ± 0.52 ng/ml and ACTH were 27.50 ± 20.72, 25.05 ± 14.64, 34.61 ± 59.35, 7.19 ± 8.63 ng/ml. Tumor survivors had the lowest levels of GH peak (P ≤ 0.001 vs. PSIS group, P = 0.002 vs. hypoplasia group, P ≤ 0.001 vs. normal group) and ACTH (all the P ≤ 0.001 vs. the other three groups).ConclusionThe frequency of PSIS is high among children and adolescents with MPHD. The severity of hormone deficiencies in patients with MPHD was more important in the tumor survivor group compared with the other groups.

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Section: Discussionmentioning

confidence: 86%

Distinct pituitary hormone levels of 184 Chinese children and adolescents with multiple pituitary hormone deficiency: a single-centre study

et al. 2019

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“…Interestingly, considerable variation in height has been pointed out for patients who did not receive any GH supplementation treatment (51), and some children maintain normal linear growth despite abnormal GH secretion (56). Among nearly 600 GHD patients with short stature caused by pituitary lesions, 7.8% cases of PSIS were identified in a recent study (57). In terms of treatment, growth response to GH substitution was better in the context of a pituitary defect than for isolated idiopathic GHD without any MRI abnormality (58); the most significant catch-up growth occurred before 3 years of treatment, especially during the first year of GH initiation (50).…”

Section: Hormonal Presentationmentioning

confidence: 99%

DIAGNOSIS OF ENDOCRINE DISEASE: Pituitary stalk interruption syndrome: etiology and clinical manifestations

Vergier

Castinetti

Saveanu

et al. 2019

European Journal of Endocrinology

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Pituitary stalk interruption syndrome (PSIS) is a congenital pituitary anatomical defect. This syndrome is an antenatal developmental defect belonging to the holoprosencephaly phenotype spectrum. It is heterogeneous regarding clinical, biological and radiological presentation and is characterized by the following triad: thin (<1 mm) or interrupted pituitary stalk connecting the hypothalamus to the pituitary gland, no eutopic posterior lobe, and hypoplasia or aplasia of the anterior lobe. This review reports current knowledge about the composite pathogenesis, for which underlying mechanisms remain unclear. Current data suggest genetic origins involving early developmental gene mutations with complex inheritance patterns and environmental influence, placing PSIS at the crossroads between Mendelian and multifactorial diseases. The phenotype associated with PSIS is highly heterogeneous with a high incidence of various combinations of hormonal deficiencies, sometimes associated with extra-pituitary birth defects. The age at onset is variable, but typical presentation is evolutive combined anterior pituitary hormone deficiencies at pediatric age, which progress even during adulthood to panhypopituitarism. Therefore, patients’ follow-up throughout life is essential for adequate management.

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“…There is no data regarding the exact prevalence of PSIS. However, Xu et al observed PSIS in 7.8% (45/577) of cases with confirmed growth hormone deficiency (GHD) [ 16 ], while other studies have reported the condition in 4–8% of patients with hypopituitarism [ 17 , 18 ]. A male predominance is consistent with previous observations [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Diversity of Pathological Conditions Affecting Pituitary Stalk

Kluczyński

Godlewska

Wójcik

et al. 2021

JCM

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Pituitary stalk lesions (PSL) are a very rare pathology. The majority of conditions affecting the infundibulum do not present with clinically apparent symptoms, what makes the diagnosis difficult. The recognition might be also complicated by the non-specific and transient characteristics of hormonal insufficiencies. In our study, we retrospectively analysed demographic, biochemical, and clinical long-term data of 60 consecutive, unselected adult patients (34 women and 26 men) with PSL diagnosed in the Department of Endocrinology, Jagiellonian University in Krakow. The diagnosis of PSL were categorized as confirmed, probable, or undetermined in 26, 26 and 8 patients, accordingly. Given the possible aetiology congenital, inflammatory, and neoplastic stalk lesions were diagnosed in 17, 15 and 20 patients, accordingly. In eight cases the underlying pathology remained undetermined. The most common pituitary abnormality was gonadal insufficiency diagnosed in 50.8% of cases. Diabetes insipidus was detected in 23.3% of cases. In 5% of patients the pituitary function recovered partially over time. Stalk lesions were extensively discussed in the context of the current literature. Based on the published data and our own experience a diagnostic algorithm has been proposed to help physicians with the management of patients with this challenging condition.

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MRI features of growth hormone deficiency in children with short stature caused by pituitary lesions

Cited by 22 publications

References 19 publications

Distinct pituitary hormone levels of 184 Chinese children and adolescents with multiple pituitary hormone deficiency: a single-centre study

Distinct pituitary hormone levels of 184 Chinese children and adolescents with multiple pituitary hormone deficiency: a single-centre study

DIAGNOSIS OF ENDOCRINE DISEASE: Pituitary stalk interruption syndrome: etiology and clinical manifestations

Diversity of Pathological Conditions Affecting Pituitary Stalk

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