Progression from isolated growth hormone deficiency to combined pituitary hormone deficiency

Growth hormone deficiency with late-onset hypothalamic hypoadrenocorticism associated with respiratory and renal dysfunction: a case report

“…In addition, the following have been shown to be risk factors for progression from isolated GHD to CPHD: 1) severe GHD; 2) female sex; 3) organic GHD etiology; 4) longer follow-up; 5) genetic defects; 6) structural abnormalities of the forebrain and hypothalamo-pituitary region (ectopic posterior pituitary, absent pituitary stalk, small anterior pituitary, abnormal corpus callosum, septo-optic dysplasia, empty sella turcica, optic nerve hypoplasia, holoprosencephaly, etc. ); 7) presence of extrapituitary malformations; and 8) delivery complications, breech delivery, and perinatal/neonatal adverse events [8]. This patient had an empty sella turcica, a 62-year period of follow-up, severe GHD, and female sex as risk factors.…”

“…In addition, they also reported that patients with various deficiencies presented at different times during followup: ADH deficiency at 3.1 ± 1 years; TSH deficiency at 7.5 ± 5.6 years; LH/FSH deficiencies at 8.3 ± 4 years; and ACTH deficiency at 9.3 ± 3.5 years [2]. Though these differences could be the result of differences in the age or follow-up period of the population studied, they may also be due to the variable endocrine phenotypes of CPHD patients [8]. In the majority of studies, the most frequent additional deficit was TSH deficiency, with the least frequent one being diabetes insipidus (DI); the prevalences of LH/FSH and ACTH deficiencies varied [8].…”

“…Patients with GHD can present with either an isolated deficiency or a combination of deficiencies of pituitary hormones [combined pituitary hormone deficiency (CPHD)] at any time from the neonatal period to adulthood. Additional endocrinopathies may develop in varying numbers and at various times [8]. It has been reported that additional hormone deficiencies were more frequent in the order of TSH, LH/FSH, ADH, and ACTH, and the median time interval from GHD diagnosis to the onset of other hormone deficiencies ranged from 1.9 years for TSH, to 2.4 years for ADH and ACTH, and 3.3 years for LH/FSH [9].…”

“…Though these differences could be the result of differences in the age or follow-up period of the population studied, they may also be due to the variable endocrine phenotypes of CPHD patients [8]. In the majority of studies, the most frequent additional deficit was TSH deficiency, with the least frequent one being diabetes insipidus (DI); the prevalences of LH/FSH and ACTH deficiencies varied [8]. In addition, the following have been shown to be risk factors for progression from isolated GHD to CPHD: 1) severe GHD; 2) female sex; 3) organic GHD etiology; 4) longer follow-up; 5) genetic defects; 6) structural abnormalities of the forebrain and hypothalamo-pituitary region (ectopic posterior pituitary, absent pituitary stalk, small anterior pituitary, abnormal corpus callosum, septo-optic dysplasia, empty sella turcica, optic nerve hypoplasia, holoprosencephaly, etc.…”

Growth and Adult Height during Human Growth Hormone Treatment in Chinese Children with Multiple Pituitary Hormone Deficiency Caused by Pituitary Stalk Interruption Syndrome: A Single Centre Study

“…Pituitary stalk interruption syndrome (PSIS) is characterized by the occurrence of a thin or absent pituitary stalk, hypoplasia of adenohypophysis, and ectopic neurohypophysis on magnetic resonance imaging (MRI) of the hypothalamopituitary region (1). It is a rare congenital disease associated with multiple pituitary hormone deficiencies (MPHD).…”