Introduction: Growth hormone deficiency (GHD) is a non-exceptional cause of short stature. Hormonal evaluation and hypothalamic-pituitary MRI are essential to establish the etiological diagnosis. The objective of our study is to assess the different pituitary lesions found in imaging in a group of children with GHD.
Patients and Methods: This is a retrospective longitudinal study of 23 cases of GHD who underwent pituitary MRI examination collected in the Endocrinology-Diabetology Department of Mohammed VI University Hospital.
Results: The mean age at diagnosis was 10,9 years with a sex ratio (M/F) of 2.14. Mean height Z-score at time of diagnosis was -4,46 SD. The mean bone age (BA) at the time of diagnosis was 6,23 years. The delay of BA over the chronological age was of 5,37 years on average. The diagnosis of total GHD was found in 77,3% of patients and partial GHD in 22,7% of patients. The isolated deficiency was noted in 31,8% of cases and multiple deficiencies in 68,2 % of cases. Magnetic resonance imaging of the hypothalamic-pituitary region was normal in 27,3% of cases. Pituitary stalk interruption was observed in 56,5 % of patients, pituitary hypoplasia was observed in 17,3 % of patients, an empty sella was observed in 12 % of patients, and agenesis of anterior pituitary in 12% of patients.
Most of the children with MPHD showed pituitary stalk interruption in 43.75% of children and anterior pituitary aplasia/hypoplasia in 25% of children, while only (18.75%) children with MPHD had normal MRI.
Conclusion: The multiplanar capability of MR imaging plays an important role in the assessment of the hypothalamic-pituitary area and in determining the underlying cause of various pituitary disorders in GHD. And it has been shown that the prevalence of pituitary abnormalities is in most cases greater in patients with combined GH deficiency than those with an isolated GH deficiency.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology