IMPE Abstracts

Introduction: Pediatric growth hormone deficiency (GHD) is characterized by short stature due to inadequate secretion of growth hormone (GH). Growth hormone stimulation test (GHST) can be used in diagnosing GHD. It is important to evaluate intracranial abnormality even though the incidence is not high. The study was aimed to find the incidence and predicting factors of pituitary abnormality in pediatric GHD in a single tertiary center.

Methods: Pediatric patients who were confirmed to have GHD and could be evaluated with MR imaging were included in the study. Retrospective review was performed about clinical, laboratory, and imaging results based on medical records. Statistical analysis was done using SPSS Statistics 28 and R 4.2.

Results: A total of 95 GHD children were included in the study. The mean age at the GHST was 7.92 (SD 3.24) years and follow up duration since GHST was 3.98 (SD 2.62) years. Pituitary abnormalities such as pituitary hypoplasia (n=10) or ectopic posterior pituitary with pituitary interruption syndrome (n=4) were found in 14 patients (14.7%). Rathke cleft cyst, arachnoid cyst, choroid fissure cyst, hippocampal sulcus remnant cyst, and pineal gland cyst were considered as incidental findings. IGF1, IGF1-SDS, IGFBP3, IGFBP3-SDS, and GH peak level during GHST were significantly lower in the patients with pituitary abnormalities (P<0.001, <0.001, <0.05, <0.05, and <0.01, respectively). -1.365 IGF1-SDS (sensitivity 85%, specificity 71.4%), 70.3 ng/mL of IGF1 level (sensitivity 89%, specificity 64%), and 4.2 ng/mL of peak GH level during GHST can be considered as the predicting values for the presence of pituitary abnormalities in the pediatric GHD.

Conclusion: Pituitary abnormality in pediatric GHD was present in 14.7%. Patients with pituitary abnormalities showed significantly lower IGF1, IGF1-SDS, IGFBP3, IGFBP3-SDS, and GH peak level during GHST.