ESPE2023 Poster Category 2 Pituitary, Neuroendocrinology and Puberty (28 abstracts)
Diagnostic and predictive value of brain magnetic resonance imaging in Algerian children with growth hormone deficiency
Sakina Kherra 1 , Noureddine Boutaghane 2 , Sihem Bellouti 2 , Latifa Sifour 3 , Hassiba Sahli 1 , Adel Djermane 4 , Ouarezki Yasmine 4 , Asmahane Ladjouze 5 , Fatiha Talbi 1 , Imane Bendakir 1 & Amina Chikh 1
1CHU Nafissa Hamoud, Ex Parnet, Pediatric unit, Algiers, Algeria. 2CHU Nafissa Hamoud, Ex Parnet Neonatology Unit, Algiers, Algeria. 3CHU Lamine Debaghine, Bab El oud, Neonatology Unit, Algiers, Algeria. 4Hassan Bey Hospital, Ex Belfort, Pediatric Unit, Algiers, Algeria. 5CHU Lamine Debaghine, Bab El Oued, Pediatric Unit, Algiers, Algeria
Background: Growth hormone deficiency (GHD) in children is a rare condition. It may be idiopathic or may develop as a consequence of congenital or acquired organic pathology of the hypothalamic-pituitary axis. GHD can be partial or part of a combined pituitary deficiency. Brain magnetic resonance imaging (MRI) is very useful in establishing the etiology of GHD and predicting its severity.
Study aims: To investigate the relationship between the detection of organic pathologies with MRI of the pituitary gland and the clinical and laboratory findings in a group of patients followed for GHD.
Materials and Methods: The study included a total of 131 Algerian children with confirmed GHD, who have been followed up in the pediatric departement of CHU Nafissa Hamoud, Pediatrics « A » in Algiers over a period of five years from (2017 - 2022) and whose pituitary MRI images were available. The patients were divided into tow groups: those with and without pathology demenstrabale on brain MRI. Clinical and laboratory features were compared between these tow groups.
Results: Mean (range) age at diagnosis was 08,4 (0,8 - 16,8) years, sex ratio: 2,3:1 (94M – 41F). Mean (range) height standard deviation score (SDS) was 2.6 (- 4,66 DS - 0,47) with severe short stature (- 4 DS) noted in 2,7 % of patients. GH deficiency was total (< 3,5 ng/ml) in 45,6 % of cases and partial (3,5 – 7 ng/ml) in 45,40 % of cases. Abnormal MRI was found in 47 (38 %) children, with pituitary hypoplasia (n= 22: 16,7 %) and empty sella (n= 12; 9,2 %) being the most frequent findings, MRI was normal in 84 (64 %) of cases. Patients with anatomical abnormalities had more severe characteristics of GHD (p < 0,05) and MRI abnormalities were more frequent in multiple GH deficiency than in the isolated forme (P= 0,05).
Discussion: The use of brain MRI remains a significant contribution to the assessment of pituitary pathology in children. It is the investigation of choice in the exploration of this region and especially in the context of GH deficiency. GHD is associated with a wide variety of neuroanatomical abnormalities which can be identified by MRI, which should be carried out according to a structural algorithm. Our study shows a clear association between anatomical and functional abnormalities of the pituitary.
Conclusion: Brain magnetic resonance imaging is a useful tool in assessing GH deficiency pathogenesis and in predicting its evolution.
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