title: Predictor Variables of Developing Anterior Pituitary Deficiencies in a Group of Paediatric Patients with Central Diabetes Insipidus and Langerhans Cell Histiocytosis.
abstract: BACKGROUND
  Langerhans cell histiocytosis (LCH) is a rare histiocytic disorder of unknown etiopathogenesis. Central diabetes insipidus (CDI) is the most frequent endocrine manifestation and is a known risk factor for the development of further anterior pituitary hormone deficiencies (APD). However, not all CDI patients develop APD, as observed during prolonged periods of follow-up.
  
  
  OBJECTIVE
  To find predictors of developing APD in LCH children with CDI followed in our institution.
  
  
  METHODS
  We retrospectively analysed 44 patients over a median period (quartiles) of 12.3 years (8.79-14.24). Patients were subdivided into group 1 and group 2, according to absence or presence of APD, respectively. The main variables studied were: (1) chronological age (CA) at LCH diagnosis, (2) the primary site of LCH at diagnosis: low risk (LR) and multisystemic risk organs, and (3) the presence of reactivation.
  
  
  RESULTS
  Multivariate Cox regression analysis showed that APD was positively associated with CA at LCH diagnosis [relative risk (RR) 1.14, p < 0.01], the LR clinical form (RR 8.6, p < 0.03), and negatively associated with the presence of reactivations (RR 0.3, p < 0.01).
  
  
  CONCLUSIONS
  Patients with older CA at LCH diagnosis, LR clinical forms, and fewer reactivation episodes might represent a subgroup of paediatric LCH CDI patients with a higher risk of developing APD.
authors.affiliation: Endocrine Service, Hospital de Pediatria Garrahan, Buenos Aires, Argentina.
authors.forename: Elisa
authors.initials: E
authors.lastname: Vaiani
authors.forename: Carmen
authors.initials: C
authors.lastname: Malossetti
authors.forename: Lina Margarita
authors.initials: LM
authors.lastname: Vega
authors.forename: Pedro
authors.initials: P
authors.lastname: Zubizarreta
authors.forename: Jorge
authors.initials: J
authors.lastname: Braier
authors.forename: Alicia
authors.initials: A
authors.lastname: Belgorosky
mesh_terms: D000293:Adolescent; D002648:Child; D003919:Diabetes Insipidus / Q000097:blood / Q000150:complications / Q000175:diagnosis; D005260:Female; D006646:Histiocytosis, Langerhans-Cell / Q000097:blood / Q000150:complications / Q000175:diagnosis; D006801:Humans; D008297:Male; D010908:Pituitary Hormones, Anterior / Q000172:deficiency*; D012307:Risk Factors
chemical_list: D010908:Pituitary Hormones, Anterior