Differences between patients with isolated GH deficiency based on findings in brain magnetic resonance imaging

• Published in: Endocrinologia, diabetes y nutricion Vol. 67; no. 2; pp. 78 - 88
• Main Authors: Ariza Jiménez, Ana Belen, Martínez Aedo Ollero, Maria Jose, López Siguero, Juan Pedro
• Format: Journal Article
• Language: English
• Published: Spain 01-02-2020
• Subjects: Adolescent; Brain - diagnostic imaging; Child; Child, Preschool; Dwarfism, Pituitary - diagnostic imaging; Dwarfism, Pituitary - drug therapy; Female; Hormone Replacement Therapy; Human Growth Hormone - therapeutic use; Humans; Infant; Magnetic Resonance Imaging; Male; Pituitary Gland - diagnostic imaging; Retrospective Studies; Isolated GH deficiency; Resonancia magnética; Findings; Hallazgos; Magnetic resonance imaging; Severity; Gravedad; Déficit de GH aislado
• ISSN: 2530-0172; 2530-0180
• DOI: 10.1016/j.endinu.2019.09.001

Protocol for prescribing hormone replacement therapy in isolated growth hormone (GH) deficiency includes magnetic resonance imaging of the brain. There is controversy on the frequency of structural pituitary abnormalities and on the importance of abnormal MRI findings on prognosis and response to GH replacement.
A descriptive, retrospective study of children of both sexes aged 0-14 years, who had undergone brain MRI, diagnosed with isolated GH deficiency at a tertiary hospital in the past 14 years, aimed at reporting the frequency of abnormal MRI findings in isolated GH deficiency, and to establish whether differences exist in height diagnosis and evolution according to MRI findings. MRI findings were also compared with the findings reported in healthy children in order to establish incidence.
96 patients were studied, of whom 74/96 (77%) reached adult age. Abnormal MRI findings were seen in 11.5% of them (8/11 of pituitary origin). No brain or pituitary tumor was seen in any case. Patients with abnormal images had a mean age at treatment start of 8 years, a target height of -0.8SD, and a final height of 1.04SD, while patients with normal MRI findings had an age at treatment start of 10 years old, a target height of -1.44SD, and a final height of -1.75SD, with statistically significant differences.
Patients with abnormal MRI findings show a more favorable response to GH replacement therapy.