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Child's Nervous System
Published in: Child's Nervous System 1/2012

Open Access 01-01-2012 | Original Paper

Usefulness of magnetic resonance findings of the hypothalamic-pituitary region in the management of short children with growth hormone deficiency: evidence from a longitudinal study

Authors: Maria A. Kalina, Barbara Kalina-Faska, Katarzyna Gruszczyńska, Jan Baron, Ewa Małecka-Tendera

Published in: Child's Nervous System | Issue 1/2012

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Abstract

Purpose

The purpose of this study is to assess the relationship between magnetic resonance images (MRI) of the hypothalamic–pituitary (H-P) region and response to recombinant human growth hormone (rhGH) treatment in short children with growth hormone deficiency, basing on changes of auxologic parameters, as well as to answer the question if MRI may serve for selecting and monitoring the rhGH responders.

Patients and methods

The study group comprised 85 children treated with rhGH, aged 7.3–18.7 years, followed for the mean period of 3.2 years (range, 2.1–9.5 years). Auxologic parameters (height deficit hSDS, deviation from the mid-parental height hSDS–mpSDS, bone delay index bone age/chronological age ratio (BA/CA)) were assessed before, during and at the end of rhGH treatment; growth velocity was calculated before and during rhGH therapy. Parameters were correlated with the MRI of the H-P region.

Results

Structural anomalies of the H-P region were found in 22 (25.9%) children: empty sella syndrome (ESS) in 12 (14.1%) patients, ectopic posterior pituitary (EPP) in ten (11.8%). Patients’ height deficit and their deviation from parental height before rhGH therapy was significantly greater in the EPP group (median hSDS = −3.8; hSDS–mpSDS = −2.5), bone age delay was the greatest in the ESS group (median BA/CA = 0.69), after therapy – in the EPP group (median BA/CA = 0.82). Growth velocity improved in the first year of the rhGH therapy in all groups; however, the most significant acceleration was observed in the EPP group (median delta hSDS = 0.9), then stabilised and was comparable in all groups.

Conclusions

MRI may be helpful in predicting response to the rhGH treatment, providing midline abnormalities are taken into account.
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Metadata
Title
Usefulness of magnetic resonance findings of the hypothalamic-pituitary region in the management of short children with growth hormone deficiency: evidence from a longitudinal study
Authors
Maria A. Kalina
Barbara Kalina-Faska
Katarzyna Gruszczyńska
Jan Baron
Ewa Małecka-Tendera
Publication date
01-01-2012
Publisher
Springer-Verlag
Published in
Child's Nervous System / Issue 1/2012
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-011-1594-7

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