Treatment of hypopituitarism in infancy. Effect on head circumference growth.
BACKGROUND
Head circumference of children with multiple pituitary-hormone deficiency (MPHD) may be subnormal for age. Moreover it is known that linear growth in infancy is growth-hormone (GH) dependent. Therefore, aim of the study has been to compare head circumference measurements in children with hypopituitarism after L-thyroxine (L-T4) therapy alone, before therapy with GH, and after GH was added to the therapy.


METHODS
Five infants (2 girls, 3 boys) with MPHD, diagnosed and treated before the age of 2 years and whose auxological parameters records during L-T4 therapy alone were available, were retrospectively studied. Head circumference and length measurements were expressed as standard deviation score (SDS). Weight measurements were expressed as weight for length ratio percentage.


RESULTS
Initially treated with L-T4 alone for a mean period of 4, 5 months, there were neither positive effects on head circumference nor on linear growth. A significant catch-up growth was observed only employing GH therapy in addition to L-T4: mean head circumference SDS and length SDS increased respectively from -2.20 to -0.89 SDS and from -4.16 to -0.87 SDS after a mean period of 18 months of combined GH and L-T4 therapy.


CONCLUSIONS
Therefore, head circumference growth, in infancy, is growth hormone dependent as well as linear growth, and during GH treatment, monitoring head circumference growth is important as much as monitoring linear growth.
Di Maio
S
S
Department of Pediatrics, University of Naples Federico II, Italy.
Salerno
M
M
Gasparini
N
N
Fusco
T
T
Pisaturo
L
L
Valerio
G
G
D004359:Drug Therapy, Combination; D005260:Female; D006257:Head / Q000254:growth & development*; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D007018:Hypopituitarism / Q000188:drug therapy*; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013974:Thyroxine / Q000627:therapeutic use*
D019382:Human Growth Hormone; D013974:Thyroxine