ESPE Abstracts

Growth Hormone (GH) deficiency is the most common pituitary hormone deficiency in children. Magnetic Resonance Imaging (MRI) of the brain detects structural pituitary anomalies associated with GH deficiency. The prevalence of MRI abnormalities in patients with GHD, ranging from 25.9–100.0%. The Growth Hormone Research Society currently recommends that an MRI of the brain, with particular attention to the hypothalamic–pituitary region, should be carried out in any child diagnosed with GHD. The aim of this study was to ascertain the abnormality that is the best predictor of severity and type of GHD amongst the different MRI findings. This is a retrospective study of 52 patients followed in our center: The available radiological, clinical and laboratory records of these children with confirmed GH deficiency by dynamic testing who had malformative anomaly in MRI brain were reviewed. Of the 52 patients in this study, there were 34 boys 65 % and 18 girls 35 % with a sex ratio of 1.88. Isolated GH deficiency (IGHD) was diagnosed in 30 (57.7%) and multiple pituitary hormone deficiency (MPHD) in 22 (42.3%) patients. For all patients, Regular follow-up of growth might have allowed earlier diagnosis in the children with growth hormonal and radiological characteristics. The anomalies found were pituitary hypoplasia in 32 cases, aplasia of the anterior pituitary in 3 cases; patients with pituitary stalk interruption syndrome (PSIS) in 17 cases. All children with aplasia of the anterior pituitary had MPHD (100%), while 21 % had hypoplasia of the anterior pituitary and 70% had pituitary stalk interruption syndrome (PSIS). The average age at diagnosis of pituitary hypoplasia is 9 years with extremes ranging from 2 years to 17 years .The growth under GH treatment was similar in the patient groups and did not vary according to the pituitary MRI findings. The annual growth was evaluated as well as the chronology of the appearance of the associated pituitary deficits. The types and incidence of MRI abnormalities of the sellar region differ significantly between the IGHD and MPHD groups. The progressive worsening of endocrine impairment throughout childhood justifies periodic follow-up to check for additional hormonal deficiencies.