Pituitary abnormalities in patients with pediatric growth hormone deficiency in a single tertiary center
Purpose There is controversy as to whether brain magnetic resonance imaging (MRI) should be performed on all children with growth hormone deficiency (GHD) including those judged to have mild GHD. This study was aimed to determine the frequency of pituitary or intracranial abnormalities in pediatric...
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Korean Society of Pediatric Endocrinology
2024-12-01
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| Series: | Annals of Pediatric Endocrinology & Metabolism |
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| Online Access: | http://e-apem.org/upload/pdf/apem-2448070-035.pdf |
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| author | Hyeon Jun Jung Jeong Rye Kim Jeesuk Yu |
| author_facet | Hyeon Jun Jung Jeong Rye Kim Jeesuk Yu |
| author_sort | Hyeon Jun Jung |
| collection | DOAJ |
| description | Purpose There is controversy as to whether brain magnetic resonance imaging (MRI) should be performed on all children with growth hormone deficiency (GHD) including those judged to have mild GHD. This study was aimed to determine the frequency of pituitary or intracranial abnormalities in pediatric GHD and to identify risk factors that may predict pituitary or intracranial abnormalities. Methods A total of 95 pediatric GHD patients were included. Their medical records and brain magnetic resonance (MR) images were reviewed retrospectively. Results Abnormal pathogenic MR images were found in 14 patients (14.7%), including 10 (10.5%) with pituitary hypoplasia and 4 (4.2%) with pituitary stalk interruption syndrome. Serum levels of insulin-like growth factor-I (IGF-I), IGF-I standard deviation score (SDS), insulin-like growth factor binding protein 3 (IGFBP3), and growth hormone (GH) peak level of GH stimulation test were statistically significantly lower in the group with abnormal brain MRI. The frequency of abnormal MRI was statistically significantly higher in the complete GHD group. IGF-1 SDS showed the highest area under the curve which can predict the presence of brain abnormality with a sensitivity of 85% and a specificity of 71.4%, if IGF-1 SDS was less than -1.365. IGF-1, IGFBP3, and GH peak levels also showed good sensitivity of over 80% for predicting brain abnormalities with cutoff values of 70.285 ng/mL, 1,604 ng/mL, and 4.205 ng/mL, respectively. Conclusions The sensitivity and specificity of each cutoff value of IGF-1, IGF-1 SDS, IGFBP3, and GH peak levels were good and statistically significant in predicting brain MRI abnormalities. However, it was insufficient to predict all brain abnormalities with these variables. Therefore, we would like to recommend performing a brain MRI if a child is diagnosed with GHD. |
| format | Article |
| id | doaj-art-e2fa70eec53647c68c6d28248acf135f |
| institution | OA Journals |
| issn | 2287-1012 2287-1292 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Korean Society of Pediatric Endocrinology |
| record_format | Article |
| series | Annals of Pediatric Endocrinology & Metabolism |
| spelling | doaj-art-e2fa70eec53647c68c6d28248acf135f2025-08-20T02:19:19ZengKorean Society of Pediatric EndocrinologyAnnals of Pediatric Endocrinology & Metabolism2287-10122287-12922024-12-0129636537010.6065/apem.2448070.0351065Pituitary abnormalities in patients with pediatric growth hormone deficiency in a single tertiary centerHyeon Jun Jung0Jeong Rye Kim1Jeesuk Yu2 Department of Pediatrics, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea Department of Radiology, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea Department of Pediatrics, Dankook University Hospital, Dankook University College of Medicine, Cheonan, KoreaPurpose There is controversy as to whether brain magnetic resonance imaging (MRI) should be performed on all children with growth hormone deficiency (GHD) including those judged to have mild GHD. This study was aimed to determine the frequency of pituitary or intracranial abnormalities in pediatric GHD and to identify risk factors that may predict pituitary or intracranial abnormalities. Methods A total of 95 pediatric GHD patients were included. Their medical records and brain magnetic resonance (MR) images were reviewed retrospectively. Results Abnormal pathogenic MR images were found in 14 patients (14.7%), including 10 (10.5%) with pituitary hypoplasia and 4 (4.2%) with pituitary stalk interruption syndrome. Serum levels of insulin-like growth factor-I (IGF-I), IGF-I standard deviation score (SDS), insulin-like growth factor binding protein 3 (IGFBP3), and growth hormone (GH) peak level of GH stimulation test were statistically significantly lower in the group with abnormal brain MRI. The frequency of abnormal MRI was statistically significantly higher in the complete GHD group. IGF-1 SDS showed the highest area under the curve which can predict the presence of brain abnormality with a sensitivity of 85% and a specificity of 71.4%, if IGF-1 SDS was less than -1.365. IGF-1, IGFBP3, and GH peak levels also showed good sensitivity of over 80% for predicting brain abnormalities with cutoff values of 70.285 ng/mL, 1,604 ng/mL, and 4.205 ng/mL, respectively. Conclusions The sensitivity and specificity of each cutoff value of IGF-1, IGF-1 SDS, IGFBP3, and GH peak levels were good and statistically significant in predicting brain MRI abnormalities. However, it was insufficient to predict all brain abnormalities with these variables. Therefore, we would like to recommend performing a brain MRI if a child is diagnosed with GHD.http://e-apem.org/upload/pdf/apem-2448070-035.pdfgrowth hormone deficiencymagnetic resonance imaginginsulin-like growth factor-istandard deviation score |
| spellingShingle | Hyeon Jun Jung Jeong Rye Kim Jeesuk Yu Pituitary abnormalities in patients with pediatric growth hormone deficiency in a single tertiary center Annals of Pediatric Endocrinology & Metabolism growth hormone deficiency magnetic resonance imaging insulin-like growth factor-i standard deviation score |
| title | Pituitary abnormalities in patients with pediatric growth hormone deficiency in a single tertiary center |
| title_full | Pituitary abnormalities in patients with pediatric growth hormone deficiency in a single tertiary center |
| title_fullStr | Pituitary abnormalities in patients with pediatric growth hormone deficiency in a single tertiary center |
| title_full_unstemmed | Pituitary abnormalities in patients with pediatric growth hormone deficiency in a single tertiary center |
| title_short | Pituitary abnormalities in patients with pediatric growth hormone deficiency in a single tertiary center |
| title_sort | pituitary abnormalities in patients with pediatric growth hormone deficiency in a single tertiary center |
| topic | growth hormone deficiency magnetic resonance imaging insulin-like growth factor-i standard deviation score |
| url | http://e-apem.org/upload/pdf/apem-2448070-035.pdf |
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