title: Evidence of morphological and functional abnormalities in the hypothalamus of growth-hormone-deficient children: a combined magnetic resonance imaging and endocrine study.
abstract: Fifty-seven children with growth hormone deficiency and 15 healthy age-matched controls were studied by magnetic resonance imaging (MRI). Of the patients, 36 (63%) had isolated GH deficiency (IGHD) and 21 (37%) multiple pituitary hormone deficiency (MPHD). MRI studies showed a marked reduction in pituitary volume in all patients in comparison with normal controls. Moreover, a striking morphological abnormality with the apparent absence of the pituitary stalk and an ectopic posterior pituitary lobe was detected in 34 of the patients (59%). This pituitary stalk abnormality was detected in 95% of the MPHD patients and in 39% of the IGHD patients. All but one of the patients with a normal pituitary stalk had IGHD. Endocrine evaluation showed no correlation with MRI data: in particular patients with an apparent anatomical interruption of the hypothalamic-pituitary axis showed a variety of patterns of hormonal responses. In conclusion, our study shows a high frequency of hypothalamic-pituitary anomalies in patients with GH deficiency, particularly related with MPHD. However, further studies are needed to improve our understanding of the relationship between MRI and endocrine data.
authors.affiliation: Department of Pediatrics, University of Milan, Scientific Institute H San Raffaele, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Bressani
authors.forename: B
authors.initials: B
authors.lastname: di Natale
authors.forename: C
authors.initials: C
authors.lastname: Pellini
authors.forename: F
authors.initials: F
authors.lastname: Triulzi
authors.forename: G
authors.initials: G
authors.lastname: Scotti
authors.forename: G
authors.initials: G
authors.lastname: Chiumello
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D013006:Growth Hormone / Q000172:deficiency*; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007018:Hypopituitarism / Q000503:physiopathology; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D007031:Hypothalamus / Q000002:abnormalities / Q000473:pathology*; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D010907:Pituitary Hormones / Q000378:metabolism; D013963:Thyroid Hormones / Q000378:metabolism
chemical_list: D010907:Pituitary Hormones; D013963:Thyroid Hormones; D013006:Growth Hormone; D006854:Hydrocortisone