ECE2024 Eposter Presentations Pituitary and Neuroendocrinology (214 abstracts)
1Hamad Medical Centre, Department of Pediatrics, DOHA, Qatar
Background: Pituitary microadenomas in pediatric populations, though infrequent, present diagnostic and therapeutic challenges.
Methods: We retrospectively reviewed six pediatric cases of pituitary microadenomas diagnosed and treated at our institution. The cases were analyzed for presenting symptoms, hormonal profiles, and treatment responses.
Results: Case 1: A 12-year-old with growth hormone deficiency showed significant height improvement with somatropin treatment, without change in microadenoma size. Case 2: Central hypothyroidism was managed with levothyroxine, resulting in the resolution of headaches and fatigue, though growth deceleration persisted. Case 3: Precocious puberty was treated with a GnRH analogue, with ongoing monitoring. Case 4: The patient awaits further evaluation for recurrent headaches and elevated IGF1. Case 5: Early puberty signs were managed with triptorelin, with ongoing monitoring for microadenoma. Case 6: Treatment for precocious puberty and GH hypersecretion involved a GnRH analogue, with abnormal growth patterns under investigation.
Case | Age at Presentation | Presenting Complaints | Main Findings | Hormonal Abnormalities | Treatment/Follow-up |
1 | 12 years | Short stature | WtSDS=-2.22, HtSDS=-2.6, GV=4 cm/year, MPHSDS=-1.28, IGF1 SDS=-1.81, GH peak 5.2 mg/l | GH deficiency | Started somatropin, no significant change in microadenoma size |
2 | 12.4 years | Headaches and fatigability | HtSDS=-0.5, MPHSDS=0, GV=2.6 cm/year, IGF1 SDS=-1.28, GH peak 6.7 mg/l, low FT4, advanced bone age | Central hypothyroidism, GH deficiency | Started on levothyroxine, slow GV, continued levothyroxine after stopping |
3 | 7 years 10 months | Premature thelarche, accelerated growth, premature pubarche | GV=12.2 cm/year, HtSDS=+1.72, MPHSDS=-0.82, advanced bone age, high basal LH and FSH | Central precocious puberty | Started on GnRH analogue, will be reevaluated |
4 | 12 years | Recurrent headaches, secondary amenorrhea | BMISDS=2.5, HtSDS=+0.8, GV=2.2 cm/year, high morning ACTH, normal cortisol, prolactin, LH and FSH | ACTH hypersecretion, central precocious puberty | Planned for GH suppression test, pelvic US, and salivary cortisol |
5 | 2.8 years | Premature thelarche, family concern about accelerated growth | HtSDS=2.4, BMISD=0.44, high basal and stimulated LH and FSH, high estradiol, IGF1SDS=+3.1 | Central precocious puberty | Started on triptorelin, will be followed for growth and MRI |
6 | 7 years 5 months | Excessive body hair, symptoms of precocious puberty | Advanced bone age, high IGF1, paradoxical increase in GH during suppression test | Central precocious puberty GH and ACTH hypersecretion | Treatment with GnRH analogue, reassessment indicated abnormal growth |
Conclusions: The six cases exhibited a spectrum of growth anomalies ranging from short stature with slow growth velocity to precocious puberty with accelerated growth. Hormonal disturbances included growth hormone deficiency, central hypothyroidism, and central precocious puberty.