A retrospective review of pituitary MRI findings in children on growth hormone therapy
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Patients with congenital hypopituitarism might have the classic triad of pituitary stalk interruption syndrome, which consists of: (1) an interrupted or thin pituitary stalk, (2) an absent or ectopic posterior pituitary (EPP), and (3) anterior pituitary hypoplasia or aplasia.
To examine the relationship between pituitary anatomy and the degree of hormonal dysfunction.
Materials and methods
This study involved a retrospective review of MRI findings in all children diagnosed with congenital growth hormone deficiency from 1988 to 2010 at a tertiary-level pediatric hospital.
Of the 52 MRIs reviewed in 52 children, 26 children had normal pituitary anatomy and 26 had one or more elements of the classic triad. Fourteen of fifteen children with multiple pituitary hormone deficiencies had structural anomalies on MRI. Twelve of 37 children with isolated growth hormone deficiency had an abnormal MRI.
Children with multiple pituitary hormone deficiencies were more likely to have the classic triad than children with isolated growth hormone deficiency. A normal MRI was the most common finding in children with isolated growth hormone deficiency.
KeywordsPituitary MRI Hypopituitarism Congenital growth hormone deficiency Classic triad
This work was presented at the following meetings: the Endocrine Society Meeting, June 2010, San Diego, CA, USA (poster); the Canadian Pediatric Endocrine Group Meeting, February 2011, Toronto, Canada (oral presentation); and the European Society of Pediatric Radiology Meeting, June 2010, Bordeaux, France (oral presentation).
We would like to thank Dr. Margaret Lawson for assisting with generation of research questions, Ms. Brenda Fraser, RN, for assistance with the patient database, and Dr. Jeffrey Tsai for review of manuscript.
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