Endocrine Abstracts

Introduction

Hypopituitarism is the partial or complete loss of anterior pituitary function that can result from acquired or congenital causes. Understanding its clinical aspects in children could lead to early diagnosis and therefore better outcome.

Objective

The aim of this study is to evaluate the characteristics of presentation, and etiology of Hypopituitarism in children.

Methods

This descriptive retrospective database study was conducted at the Hedi Chaker university hospital, Sfax, Tunisia after collecting medical records of patients having in common anterior hypopituitarism.

Results

We collected the data of 20 patients with an average age of 10 years (between 1 and 18 years), SR was 4. In 70% of the cases, the discovery circumstance was other physicians suspecting the disease and therefore referring the patients to us. Family history showed an autoimmune disease in 10% of the cases and only 5% had a family member with hypopituitarism. 35% of our subjects had fetal distress, 5% had neonatal hypoglycemia, 10% had micropenis and 10% had a history of head trauma. Up to 75% of the individuals of our study group had growth retardation, 25% had puberty delay and 10% presented intellectual deficiency. The mean BMI was 20 ± 3.8 kg/m² and the mean height Standard Deviation was 1.5 ± 1.6. For those with growth retardation the mean age of the growth curve abruptness was 5 ± 2 years. The physical examination revealed that 25% of the individuals had dysmorphic appearance, 15% had depigmentation. The most common deficiency found was GH deficiency (80%) as well as gonadotropic deficiency (70%) whereas corticotropic deficiency was present in only 20% of the cases and thyrotropin deficiency in 15%. PRL was low in 10% of the cases, and high in 25%. No global hypopituitarism was found in our study group however 15% had partial hypopituitarism, the rest had only one pituitary hormone deficiency. MRI was conducted in 19 patients and was abnormal in 55% of the cases showing hypoplasic pituitary (15.7%), pituitary interruption syndrome (15.7%), hyperplasic pituitary (5.2%), primary empty sella syndrome (5.2%) and hypophysitis (10.5%). The most common causes of hypopituitarism found in our database were congenital causes (66.7%) followed by hypophisitis (11.1%) and hyperplasic pituitary (5%).

Conclusion

Diagnosis of hypopituitarism is important, because unrecognized pituitary dysfunction significantly affects the physical and psychological well-being of people.