title: [Perinatal adverse events and neuroanatomical abnormalities in patients with idiopathic hypopituitarism].
abstract: OBJECTIVE
  To analyze the possible causes of growth hormone (GH) deficiency, whether isolated (GHD) or in combination with other pituitary deficiencies classified as idiopathic.
  
  
  METHODS
  We studied patients with idiopathic GHD included in a protocol of recombinant GH treatment in adults attending the outpatient clinic of the Endocrinology and Nutrition Service of the San Cecilio University Hospital. Perinatal history, findings on magnetic resonance imaging (MRI) of the hypothalamic-pituitary axis and diagnosis of GHD and other deficiencies were retrospectively evaluated.
  
  
  RESULTS
  A total of 17 patients were included: 14 men and 3 women with a mean age at diagnosis of 8.4+/-7.3 years. Perinatal adverse events occurred in 12 patients (69.2%). MRI showed empty sella (2 patients), pituitary hypoplasia or absence of the pituitary stalk (7 patients) and pituitary hypoplasia with ectopic posterior pituitary gland (6 patients); in the remaining 2 patients these data were not available. All had an established diagnosis of GHD: 15 with (88.2%) gonadotropin deficiency, 9 (52.9%) with adrenocorticotropic hormone (ACTH) deficiency and 8 (47.1%) with thyroid-stimulating hormone (TSH) deficiency.
  
  
  CONCLUSIONS
  In our patients, adverse events during pregnancy or the perinatal period and the presence of anatomical abnormalities identified by MRI are a marker of pituitary dysfunction and may be important in the pathogenesis of this entity. The clinical spectrum of disease varies from isolated GH deficiency to multiple pituitary hormone deficiencies.
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Universitario San Cecilio, Granada, España. garciamartin_t@hotmail.com
authors.forename: Antonia
authors.initials: A
authors.lastname: García Martín
authors.forename: María
authors.initials: M
authors.lastname: Cortés Berdonces
authors.forename: Carmen
authors.initials: C
authors.lastname: Tenorio Jiménez
authors.forename: Elena
authors.initials: E
authors.lastname: Torres Vela
mesh_terms: D002648:Child; D005260:Female; D005333:Fetus; D005500:Follow-Up Studies; D019382:Human Growth Hormone / Q000172:deficiency*; D006801:Humans; D007018:Hypopituitarism / Q000150:complications*; D007031:Hypothalamus / Q000002:abnormalities*; D007231:Infant, Newborn; D008297:Male; D010902:Pituitary Gland / Q000002:abnormalities*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D019382:Human Growth Hormone