Primary empty sella: differences and similarities between children and adults.
To identify possible differences between empty sella in children and adults we studied 43 subjects (age 13.6 +/- 5.4 years, range 4.1-27 years) with hypothalamic-pituitary disorders and empty sella at magnetic resonance imaging. Pituitary function, presence of non-endocrine symptoms, perinatal history, sellar volume, pituitary height, midline or intrasellar anatomical abnormalities were evaluated. Twenty subjects had isolated growth hormone deficiency, 17 multiple pituitary hormone deficiency and 6 puberty disorders (3 precocious puberty, 2 idiopathic delayed puberty, 1 Kallmann syndrome). The group with multiple pituitary hormone deficiency had a higher percentage of subjects with complete empty sella, i.e. pituitary height < 2 mm (p = 0.016), or intrasellar anatomical abnormalities (p = 0.0002) than the other groups. The subjects with puberty disorders had a mean sellar volume higher than the other groups (p < 0.05). Apart from pituitary dysfunction, symptoms of the empty sella syndrome were infrequent (9.3% of cases) in our subjects. The age of our subjects, the frequent association between empty sella and pituitary dwarfism and the non-enlarged sellae suggest a different aetiology, perhaps congenital, for empty sella in our subjects. As in adults, empty sella may be associated with both pituitary hypo- and hyperfunction.
Zucchini
S
S
Department of Paediatrics, University of Bologna, Italy.
Ambrosetto
P
P
Carlà
G
G
Tani
G
G
Franzoni
E
E
Cacciari
E
E
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004652:Empty Sella Syndrome / Q000209:etiology*; D005260:Female; D006801:Humans; D006964:Hyperpituitarism / Q000150:complications / Q000175:diagnosis; D007018:Hypopituitarism / Q000150:complications / Q000175:diagnosis; D007027:Hypothalamic Diseases / Q000150:complications / Q000175:diagnosis*; D008297:Male; D010900:Pituitary Diseases / Q000150:complications / Q000175:diagnosis*; D010901:Pituitary Function Tests; D011628:Puberty, Delayed / Q000175:diagnosis / Q000209:etiology; D011629:Puberty, Precocious / Q000175:diagnosis / Q000209:etiology; D013577:Syndrome