Neuroimaging findings and severity of hypopituitarism in a cohort of 78 children

Abstract

Objectives: To evaluate neuroimaging abnormalities in children with hypopituitarism and correlate with the number of pituitary hormone deficiencies, age at diagnosis, severity of growth hormone deficiency and response in the first year of treatment with recombinant human growth hormone. Material and methods: It was a cross-sectional descriptive study. Children with hypopituitarism followed at a pediatric university hospital over a 10-year period were included. All neuroimaging were reviewed by the researcher and classified as: normal, with hypoplastic adenohypophysis, absent pituitary stalk, ectopic neurohypophysis or empty sella. The Fisher-exact and the Mann-Whitney tests were applied for categorical and numerical data, respectively. The distribution of numerical variables was assessed by Shapiro-Wilks test. The significance level adopted was 5%. Results: Seventy-eight patients aged between 0.5 and 17.82 years were included in the study. We found male predominance. Only 29.5% of patients had normal magnetic imaging resonance, with hypoplastic adenohypophysis being the most frequent abnormality. Half of the patients had neonatal complications history. The same proportion of isolated growth hormone deficiency and multiple pituitary hormones deficiencies were found. Severe growth hormone deficiency was found in 82% of patients with neuroimaging abnormalities. Appropriate response to therapy was observed in 76.6% of patients, being more prevalent in those with multiple pituitary hormones deficiencies. Conclusions: The presence of neuroimaging abnormalities was related to multiple pituitary hormones deficiencies, severe growth hormone deficiency and neonatal abnormalities, without however having relation to early-onset of disease.