ESPE Abstracts

Introduction: Childhood hypophysitis (CH) is an extremely rare entity that has difficulties in definition and displays a wide variety of symptomatology. The volume and shape of pituitary gland may increase in physiological periods such as puberty and pregnancy, it may also change in various neuroendocrine and psychiatric diseases. It is important to distinguish physiological changes observed in the pituitary, especially in puberty, from hypophysitis.For this purpose in this study four adolescent cases presented

Case 1: A 13-year old girl has applied to our clinic with the complaint of fatigue. Her puberty was at Tanner stage 5. Serum ACTH, TSH and cortisol levels were found to be low. The pituitary gland height was found 7mm (above +2 SD) at the infundibulum level. Pituitary Stalk/Basilary Artery ratio (PS/BA) was measured as 0.5mm in sagittal section, being within normal limits.

Case 2: A 14-year-olds girl has applied to our hospital with an adenoma in the pituitary, which has been detected on the MRI taken due to high prolactin levels in blood tests performed at an external center she applied due to overweight. Serum LH and estradiol values were observed to be high. PS/BA ratio was measured as 0.77mm in sagittal section (0.54-0.74) regarding the patient’s pituitary MRI. The pituitary gland height was measured as 8.5 mm, it was above +2 SD according to age

Case 3: An 12-year-olds boy was admitted to our clinic with a complaint of overweight.She was morbidly obese and his puberty was at Tanner stage 5. A pituitary MRI was performed when high ACTH, TSH and Prolactin levels were detected. The pituitary gland height was found to be approximately 9 mm (above +2 SD) at the infindibulum level. PS/BA ratio was measured with 0.58 mm (0.48-0.72) within normal limits and was interpreted as pubertal pituitary enlargement.

Case 4: A 17-year-olds girl was admitted significant weight loss and anorexia nervosa. Her puberty was at Tanner stage 5. In the pituitary MRI the height of the pituitary gland was measured as 8mm, and its size was above +2 SD for age. PS/BA ratio was measured with 0.68mm within normal limits and was interpreted as pubertal enlargement.

Discussion: These data are valuable in terms of suggesting that the PS/BA ratio in non-contrast MRI is useful in physiological and pathological distinction of pituitary disorders, as well as in determining the diagnosis, monitoring and treatment decision.