Clinico-radiological correlation of pituitary stalk interruption syndrome in children with growth hormone deficiency
Authors' conclusion
Male gender, breech presentation, external congenital anomalies like cryptorchidism, midline defects and nystagmus were more common in children with PSIS. MPHD were more frequently seen in PSIS whereas IGHD in non-PSIS cohort. AVP deficiency is very rare in PSIS despite of absent or ectopic posterior pituitary in MRI. High index of clinical suspicion in all severe short stature may lead to early diagnosis and prompt initiation of growth hormone treatment for better outcome.
Study context
- Population
- Children with severe short stature and proven growth hormone deficiency (GHD), short stature clinic of a tertiary care referral hospital, over 3 years
- Participants
- 57 children
- Exposure
- Pituitary stalk interruption syndrome (PSIS) vs non-PSIS in children with GHD
- PSISn = 14
- Outcome
- Prevalence of PSIS among children with GHD
Methodological detailsprospective, single-centre, tertiary care referral hospital
- Prospective
- Single-centre
- Tertiary care referral hospital
Main finding
As reported in the abstract
PSIS
24%
14
Observational data: associations, not effects.
Further findings
- Age at diagnosis (PSIS)
- 11.8 · mean · ± 2.6 · years
- Age at diagnosis (PSIS) — Male to female ratio
- 2.5:1
Hormone deficiency pattern in PSIS
- Multiple pituitary hormone deficiency (MPHD)
- 9 (64%)
- Isolated growth hormone deficiency (IGHD)
- 5 (36%)
- Arginine vasopressin (AVP) deficiency despite absent or ectopic posterior pituitary on Magnetic Resonance Imaging (MRI)
- 1
Posterior pituitary position on MRI in PSIS
- Ectopic posterior pituitary (EPP) near median eminence
- 6 (44%)
- EPP elsewhere
- 4 (28%)
- Absent posterior pituitary
- 4 (28%)
Height gain following GH therapy
- Height gain following GH therapy better in PSIS vs non-PSIS
Original publication
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