Reduced Pituitary Volume in Children with Short Stature: Clinical and Radiological Correlates

Abstract

A retrospective evaluation of 80 cases of growth retardation evaluated at the Hôpital Sainte-Justine of Montreal has revealed that 20 of them (25 %; 15 boys and 5 girls) had a reduction of pituitary volume as revealed by high-resolution CT scanning of the pituitary gland. Of these patients, 8 had complete growth hormone (GH) deficiency, as evaluated by arginine infusion and L-Dopa-propranolol testing and nocturnal blood sampling, and 3 had GH neurosecretory dysfunction. Five patients had combined or multiple hormonal deficiencies. A statistically significant correlation was found between nocturnal plasma GH values and pituitary volumes. From this study it can be concluded that reduced pituitary volume is a frequent finding in growth-retarded children with hypopituitarism.

Hypothalamic-Pituitary Dysfunction in Growth Hormone-Deficient Patients with Pituitary Abnormalities*

“…(J Clin Endocrinol Metab 73: [79][80][81][82][83]1991) I DIOPATHIC hypopituitarism is a heterogeneous group of disorders of unknown etiology (1). Perinatal and postnatal complications are reported to be responsible for reduced sellar and pituitary volumes by computed tomography scan in large numbers of hypopituitaric patients (2)(3)(4)(5). Magnetic resonance (MR) imaging offers the advantage of revealing hypothalamic-pituitary abnormalities, such as pituitary hypoplasia, absence of the stalk and posterior lobe ectopia in many GH-deficient (GHD) patients (6)(7)(8)(9)(10)(11)(12); the underlying cause of these anatomic defects could be developmental in origin, dating from early intrauterine life (13)(14)(15)(16)(17).…”

“…Whereas relationship of hypopituitarism to reduced sellar and pituitary size shown by computed tomography has already been documented (2)(3)(4)(5), little is known about endocrinological findings in GHD patients investigated by MR imaging. Kikuchi et al (7) have suggested that the magnitude of hormone responses to stimuli in GHD children with hypothalamic-pituitary abnormalities evidenced by MR imaging is unrelated to pituitary gland height (7).…”