Auxologic parameters and response to 2-year therapy with recombinant human growth hormone in growth hormone deficient children with an ectopic posterior pituitary
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Structural defects of the hypothalamic-pituitary area in MRI are suggested as being a more accurate marker of growth hormone deficiency (GHD) than laboratory assays.
To compare auxological characteristics in GHD children with normal pituitary (NP) function and with ectopic posterior pituitary (EPP), prior to therapy with recombinant human growth hormone (rhGH), extending the follow-up to two years following treatment.
Eighty-six (86) GHD patients were divided into two groups depending on the pituitary MRI: the EPP (23 children, 3.2–16.8 years old) and the NP group (63 children, 3.3–14.8 years old). Height deficits in the population (hSD) and parents (hSD-mpSD) and the change of hSD and bone/chronological age ratio were assessed before and after 12 and 24 months of rhGH therapy.
Height deficits before treatment were significantly greater in EPP compared to NP [median −4.07 (−7.06, −2.75) −3.15 (−4.9, −2.35) for hSD, and −3.65 (−7.06, −1.21) vs −1.83 (−4.31, −0.28) for hSD-mpSD; p<0.05]. Bone age was significantly delayed in the EPP group [0.62 (0.27, 0.92) vs 0.75 (0.21, 0.71); p<0.05]; differences remained significant during follow-up. After 12 months of rhGH therapy, EPP showed significantly greater catch-up growth compared to NP [ΔhSD=1.2 (0.42, 2.69) vs 0.74 (0.05, 1.48); p<0.05]. In the 2nd year, height velocity slowed down and was comparable in the two groups. At the conclusion of the study, hSD was similar in both groups, but hSD-mpSD was more deviated in EPP [−1.79 (−3.71, −1.21) vs −1.1 (0.98, −0.07); p<0.05].
The study showed relevant auxologic differences between EPP and NP children, as well as beneficial effects of rhGH therapy in both groups.
Key wordsChildren Ectopic posterior pituitary Recombinant growth hormone
- 2.Growth Hormone Research Society, 2000 Consensus guidelines for the diagnosis and treatment of growth hormone (GH) deficiency in childhood and adolescence: summary statement of the GH Research Society. J Clin Endocrinol Metab 85: 3990–3993.Google Scholar
- 4.Coutant R, Rouleau S, Despert F, Magontier N, Loisel D, Limal JM, 2001 Growth and adult height in GH-treated children with nonacquired GH deficiency and idiopathic short stature: the influence of pituitary magnetic resonance imaging findings. J Clin Endocrinol Metab 10: 4649–4654.CrossRefGoogle Scholar
- 8.Palczewska J, Niedzwiecka Z, 2001 Somatic development indices in children and youth of Warsaw. Med Wieku Rozwoj 2: Suppl 1: 18–118.Google Scholar
- 9.Greulich WW, Pyle SI 1959 Radiographic atlas of skeletal development of the hand and wrist, Stanford, California: Stanford University Press.Google Scholar
- 11.Chaler EA, Ballerini G, Lazzati JM, et al, 2013 Cut-off values of serum growth hormone (GH) in pharmacological stimulation tests (PhT) evaluated in short-statured children using a chemiluminescent immunometric assay (ICMA) calibrated with the International Recombinant Human GH Standard 98/574. Clin Chem Lab Med 51: 95–97.CrossRefGoogle Scholar
- 20.Zenaty D, Garel C, Limoni C, Czernichow P, Leger J, 2003 Presence of magnetic resonance imagining abnormalities of the hypothalamic-pituitary axis is a significant determinant of the first 3 years growth response to human growth hormone treatment in prepubertal children with nonaquired growth hormone deficiency. Clin Endocrinol (Oxf) 58: 647–652.Google Scholar
- 22.Hamilton J, Blaser S, Daneman D, 1998 MR imaging in idiopathic growth hormone deficiency. Am J Neuroradiol 9: 1609–1615.Google Scholar