scholarly journals The prevalence and volumetry of pituitary cysts in children with growth hormone deficiency and idiopathic short stature

2018 ◽  
Vol 0 (0) ◽  
Author(s):  
Nicholas Krasnow ◽  
Bradley Pogostin ◽  
James Haigney ◽  
Brittany Groh ◽  
Winston Weiler ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Short Stature ◽  
Growth Failure ◽  
Brain Magnetic Resonance Imaging ◽  
Idiopathic Short Stature ◽  
Hormone Deficiency ◽  
Gh Treatment ◽  
Cyst Volume ◽  
Pituitary Cysts

AbstractBackgroundPituitary cysts have been speculated to cause endocrinopathies. We sought to describe the prevalence and volumetry of pituitary cysts in patients with growth hormone deficiency (GHD) and idiopathic short stature (ISS).MethodsSix hundred and eighteen children evaluated for growth failure at the Division of Pediatric Endocrinology at New York Medical College between the years 2002 and 2012, who underwent GH stimulation testing and had a brain magnetic resonance imaging (MRI) prior to initiating GH treatment were randomly selected to be a part of this study. High resolution MRI was used to evaluate the pituitary gland for size and the presence of a cyst. Cyst prevalence, cyst volume and percentage of the gland occupied by the cyst (POGO) were documented.ResultsFifty-six patients had a cyst, giving an overall prevalence of 9.1%. The prevalence of cysts in GHD patients compared to ISS patients was not significant (13.5% vs. 5.7%, p=0.46). Mean cyst volume was greater in GHD patients than ISS patients (62.0 mm3vs. 29.4 mm3, p=0.01). POGO for GHD patients was significantly greater (p=0.003) than for ISS patients (15.3%±12.8 vs. 7.1%±8.0). Observers were blinded to patient groups.ConclusionsGHD patients had a significantly greater volume and POGO compared to ISS patients. This raises the question of whether cysts are implicated in the pathology of growth failure.

Pituitary volume in children with growth hormone deficiency, idiopathic short stature and controls

2016 ◽  
Vol 29 (10) ◽  
Author(s):  
Marion Kessler ◽  
Michael Tenner ◽  
Michael Frey ◽  
Richard Noto
Keyword(s):  
Growth Hormone ◽  
Magnetic Resonance ◽  
Growth Hormone Deficiency ◽  
Short Stature ◽  
Hormone Secretion ◽  
Growth Hormone Secretion ◽  
Magnetic Resonance Images ◽  
Idiopathic Short Stature ◽  
Hormone Deficiency ◽  
Significant Difference

AbstractBackground:The objective of the study was to describe the pituitary volume (PV) in pediatric patients with isolated growth hormone deficiency (IGHD), idiopathic short stature (ISS) and normal controls.Methods:Sixty-nine patients (57 male, 12 female), with a mean age of 11.9 (±2.0), were determined to have IGHD. ISS was identified in 29 patients (20 male, 9 female), with a mean age of 12.7 (±3.7). Sixty-six controls (28 female, 38 male), mean age 9.8 (±4.7) were also included. Three-dimensional (3D) magnetic resonance images with contrast were obtained to accurately measure PV.Results:There was a significant difference in the mean PV among the three groups. The IGHD patients had a mean PV 230.8 (±89.6), for ISS patients it was 286.8 (±108.2) and for controls it was 343.7 (±145.9) (p<0.001). There was a normal increase in PV with age in the ISS patients and controls, but a minimal increase in the IGHD patients.Conclusions:Those patients with isolated GHD have the greatest reduction in PV compared to controls and the patients with ISS fall in between. We speculate that a possible cause for the slowed growth in some ISS patients might be related to diminished chronic secretion of growth hormone over time, albeit having adequate pituitary reserves to respond acutely to GH stimulation. Thus, what was called neurosecretory GHD in the past, might, in some patients, be relative pituitary hypoplasia and resultant diminished growth hormone secretion. Thus, PV determinations by magnetic resonance imaging (MRI) could assist in the diagnostic evaluation of the slowly growing child.

Comparison of nocturnal and morning ghrelin concentration in children with growth hormone deficiency and with idiopathic short stature

2020 ◽  
Vol 37 (11) ◽  
pp. 1629-1635
Author(s):  
Renata Stawerska ◽  
Marzena Kolasa-Kicińska ◽  
Anna Łupińska ◽  
Maciej Hilczer ◽  
Andrzej Lewiński
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Short Stature ◽  
Idiopathic Short Stature ◽  
Hormone Deficiency ◽  
Ghrelin Concentration

scholarly journals SAT-105 The Natural History of Pituitary Cysts in Patients with Growth Hormone Deficiency and Idiopathic Short Stature

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Zeyad El-Naghy ◽  
Nicholas Andrew Krasnow ◽  
James Haigney ◽  
Tara Patale ◽  
Liam McGuirk ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Short Stature ◽  
Idiopathic Short Stature ◽  
Hormone Deficiency ◽  
Pediatric Endocrinology ◽  
Post Contrast ◽  
Pituitary Cyst ◽  
Pituitary Cysts ◽  
Over Time

Abstract Background: The sequential follow-up of simple fluid-filled pituitary cysts (PC) has not been fully elucidated. In this study, we further report our follow up of PCs in a cohort of pediatric patients (PTs). Objective: To further analyze the sequential cyst volume (CV) change in short children. Patients and Methods: A pediatric endocrinology and neuroradiology center was queried for the presence of PCs. PTs who underwent multiple high resolution post-contrast MRIs (1mm slices) were subjects of this study. PTs with additional MRI abnormalities were excluded. Pituitary volumes (PV) and CVs were measured using the ellipsoid formula (LxWxH/2). The percentage of the gland occupied by the cyst (POGO) was measured and calculated. A cyst with a POGO ≤15% was defined as a small pituitary cyst (SPC), and a POGO &gt;15% was defined as a large pituitary cyst (LPC). 34 PTs met inclusion criteria, all of whom were diagnosed with short stature (23 growth hormone deficient (GHD) PTs and 11 idiopathic short stature (ISS) PTs). All PTs were receiving GH during data collection. Results: The mean (MN) and median (MD) ages for these subjects were 10.7 yrs ±3.5 and 11.1 yrs, respectively (RSP). Of the 34 PTs, 24 PTs’ (71%) initial MRI demonstrated a SPC and 10 PTs’ (29%) initial MRI demonstrated a LPC. The MN and MD times between first and second MRIs were 1.23 yrs and 0.83 yrs RSP, with a range (RG) of 0.14 to 4.08 yrs. The MN and MD ΔCV for all PTs was 23.33% ±179.17% and -25.94% RSP, with a RG of -100.00% to 763.94%. The MN and MD ΔPOGO by the cyst for all PTs was 48.59% ±313.26% and -36.84% RSP, with a RG of -100.00% to 1734.79%. The MN and MD ΔCV for PTs with a SPC was 10.68% ±2.65% and 11.09% RSP, with a RG of -100.00% to 763.94%. The MN and MD ΔPOGO by the cyst for PTs with a SPC was 78.33% ±369.96% and -31.34% RSP, with a RG of -100.00% to 1734.79%. The MN and MD ΔCV for PTs with a LPC was -24.60% ±51.89% and -26.57% RSP, with a RG of -88.57% to 91.38%. The MN and MD ΔPOGO by the cyst for PTs with a LPC was -22.79% ±44.90% and -40.46% RSP, with a RG of -80.95% to 47.11%. Statistical analysis showed no significant %ΔCV or %ΔPOGO when comparing male vs. female, SPC vs. LPC, GHD vs. ISS, or pre-pubertal vs. pubertal PTs. Analysis of ΔPOGO of the 24 SPC PTs demonstrated that 4 (17%) of them developed into LPCs. Analysis of the 10 LPC PTs showed that 6 (60%) of them shrunk into SPCs, one of which re-enlarged into a LPC, and another of which fluctuated between LPC and SPC over a period of 7.34 yrs and 9 sequential MRIs. None of the PTs experienced significant sequelae related to their PCs. Conclusion: CV can change greatly over time, however few sequelae should be expected. LPCs tend to demonstrate major changes in size and should be tracked for CV change. A minority of SPCs will develop into LPCs. Prediction of change in CV over time requires more sequential data. Change in CV did not appear to be influenced by GH therapy.

scholarly journals Should Skeletal Maturation Be Manipulated for Extra Height Gain?

2021 ◽  
Vol 12 ◽  
Author(s):  
Jan M. Wit
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Short Stature ◽  
Precocious Puberty ◽  
Adult Height ◽  
Central Precocious Puberty ◽  
Idiopathic Short Stature ◽  
Hormone Deficiency ◽  
Skeletal Maturation ◽  
Gnrh Analogue

Skeletal maturation can be delayed by reducing the exposure to estrogens, either by halting pubertal development through administering a GnRH analogue (GnRHa), or by blocking the conversion of androgens to estrogens through an aromatase inhibitor (AI). These agents have been investigated in children with growth disorders (off-label), either alone or in combination with recombinant human growth hormone (rhGH). GnRHa is effective in attaining a normal adult height (AH) in the treatment of children with central precocious puberty, but its effect in short children with normal timing of puberty is equivocal. If rhGH-treated children with growth hormone deficiency or those who were born small-for-gestational age are still short at pubertal onset, co-treatment with a GnRHa for 2-3 years increases AH. A similar effect was seen by adding rhGH to GnRHa treatment of children with central precocious puberty with a poor AH prediction and by adding rhGH plus GnRHa to children with congenital adrenal hyperplasia with a poor predicted adult height on conventional treatment with gluco- and mineralocorticoids. In girls with idiopathic short stature and relatively early puberty, rhGH plus GnRHa increases AH. Administration of letrozole to boys with constitutional delay of growth puberty may increase AH, and rhGH plus anastrozole may increase AH in boys with growth hormone deficiency or idiopathic short stature, but the lack of data on attained AH and potential selective loss-of-follow-up in several studies precludes firm conclusions. GnRHas appear to have a good overall safety profile, while for aromatase inhibitors conflicting data have been reported.

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