The prevalence and volumetry of pituitary cysts in children with growth hormone deficiency and idiopathic short stature
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Nicholas Krasnow
Abstract
Background
Pituitary cysts have been speculated to cause endocrinopathies. We sought to describe the prevalence and volumetry of pituitary cysts in patients with growth hormone deficiency (GHD) and idiopathic short stature (ISS).
Methods
Six hundred and eighteen children evaluated for growth failure at the Division of Pediatric Endocrinology at New York Medical College between the years 2002 and 2012, who underwent GH stimulation testing and had a brain magnetic resonance imaging (MRI) prior to initiating GH treatment were randomly selected to be a part of this study. High resolution MRI was used to evaluate the pituitary gland for size and the presence of a cyst. Cyst prevalence, cyst volume and percentage of the gland occupied by the cyst (POGO) were documented.
Results
Fifty-six patients had a cyst, giving an overall prevalence of 9.1%. The prevalence of cysts in GHD patients compared to ISS patients was not significant (13.5% vs. 5.7%, p=0.46). Mean cyst volume was greater in GHD patients than ISS patients (62.0 mm3 vs. 29.4 mm3, p=0.01). POGO for GHD patients was significantly greater (p=0.003) than for ISS patients (15.3%±12.8 vs. 7.1%±8.0). Observers were blinded to patient groups.
Conclusions
GHD patients had a significantly greater volume and POGO compared to ISS patients. This raises the question of whether cysts are implicated in the pathology of growth failure.
Acknowledgments
We thank all the summer research students who assisted in retrieving and analyzing patient data. We also thank our research coordinator Jane Torres for her invaluable help and assistance.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission. Nicholas Krasnow analyzed and collated the data and drafted the initial manuscript. Bradley Pogostin, James Haigney, Brittany Groh and Winston Weiler analyzed and collated the data. Michael Tenner helped conceptualize and design the study, interpreted each MRI, and measured pituitary and cyst volumes. Marion Kessler analyzed and collated the data and revised the manuscript for final submission. Michael Frey ran the assays for the growth hormone levels. Richard Noto conceptualized and designed the study, analyzed and collated data, and revised the manuscript for final submission. The authors would like to thank the late Dr. Marion Kessler for her extensive work on the production of this investigation. Dr. Kessler was critical in the conception, design, and execution of this study, as well as in drafting the manuscript. She tragically passed away just before acceptance of this paper. She will be greatly missed.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: None declared.
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Articles in the same Issue
- Frontmatter
- Original Articles
- Carotid intima media thickness and associations with serum osteoprotegerin and s-RANKL in children and adolescents with type 1 diabetes mellitus with increased risk for endothelial dysfunction
- Cardiometabolic risk factors in preschool children with abdominal obesity from Medellín, Colombia
- Long-term follow-up of gonadal dysfunction in morbidly obese adolescent boys after bariatric surgery
- Prevalence of overweight and obesity and anthropometric reference centiles for Albanian children and adolescents living in four Balkan nation-states
- High urate concentration is associated with elevated blood pressure in schoolchildren
- The association of hs-CRP and fibrinogen with anthropometric and lipid parameters in non-obese adolescent girls with polycystic ovary syndrome
- Leptin and adiposity as mediators on the association between early puberty and several biomarkers in European adolescents: the HELENA Study
- Adolescents with premenstrual syndrome: not only what you eat but also how you eat matters!
- Thyroid dysfunction in children with leukemia over the first year after hematopoietic stem cell transplantation
- Morning vs. bedtime levothyroxine administration: what is the ideal choice for children?
- Basal characteristics and first year responses to human growth hormone (GH) vary according to diagnostic criteria in children with non-acquired GH deficiency (naGHD): observations from a single center over a period of five decades
- The prevalence and volumetry of pituitary cysts in children with growth hormone deficiency and idiopathic short stature
- SHOX gene deletion screening by FISH in children with short stature and Madelung deformity and their characteristics
- FGFR3-related hypochondroplasia: longitudinal growth in 57 children with the p.Asn540Lys mutation
- Case Reports
- A variable course of Cushing’s disease in a 7 year old: diagnostic dilemma
- Severe hyperchylomicronemia in two infants with novel APOC2 gene mutation
