Prevalence and Characterization of Brain and Pituitary Abnormalities in Children with Pituitary Dysfunction

Abstract

Introduction: Imaging studies help identify structural abnormalities associated with pituitary dysfunction, such as Ectopic Posterior Pituitary (EPP). Aim: To detect the prevalence of IGHD or CPHD in children with EPP, the association between the location of EPP and pituitary dysfunction; and, to determine the prevalence of brain and pituitary abnormalities detected by MRI. Methods: A retrospective chart review of MRI reports at St. Christopher’s Hospital for Children (SCHC) from 2006-2018 that were found to have EPP. Pituitary hormone function was evaluated in the majority. Results: 66 patients, age of (8.31±6.26) included. Of those, 26 patients had EPP. The prevalence rate of documented pituitary dysfunction was higher in patients with EPP (95%). Of the 26 patients with EPP, age (5.98±5.18 yrs) 20 patients had an endocrine evaluation. Of the 20 children, 14 had CPHD and 4 had IGHD. Patients with EPP were classified into 3 groups (upper, middle & lower). Of the 21 patients with upper EPP, 17 (100%) were found to have pituitary dysfunction (14 with CPHD, 3 with IGHD). Of the 4 children with middle EPP, 1 had pituitary dysfunction which was IGHD. Diabetes insipidus was not identified in any of the children. Patients with CPHD had higher prevalence of EPP (73.7%) as compared to those with IGHD (21.1%). Conclusion: Our study supports previous reports that CPHD and IGHD are frequent in patients with EPP. No cases of DI have been reported in children with EPP. No CPHD was reported in middle/lower but IGHD was found in the middle EPP group.