Evolving hypopituitarism following cranial irradiation.
Increasing survival after treatment for childhood cancer in recent years has left many patients with long-term sequelae. Following cranial irradiation, changes in hypothalamic-pituitary function evolve over several years and multiple hormone deficiencies are frequently found. In the present study we describe a boy whose initial presentation with a cerebral tumour included central precocious puberty. He was followed for more than 15 years and sequentially developed deficiencies of growth hormone, thyroid-stimulating hormone, gonadotrophins and adrenocorticotropic hormone after high-dose cranial irradiation. Long-term endocrine follow up of such children is essential for the early diagnosis and optimal management of hormone deficiencies.
Kanumakala
S
S
Department of Endocrinology & Diabetes, Royal Children's Hospital, Melbourne, Victoria, Australia.
Warne
G L
GL
Zacharin
M R
MR
D001254:Astrocytoma / Q000175:diagnosis / Q000532:radiotherapy*; D001932:Brain Neoplasms / Q000175:diagnosis / Q000532:radiotherapy*; D002675:Child, Preschool; D016371:Cranial Irradiation / Q000009:adverse effects* / Q000379:methods; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D007018:Hypopituitarism / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D007037:Hypothyroidism / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D011629:Puberty, Precocious / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D011879:Radiotherapy Dosage; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors