Growth hormone replacement therapy: is it safe to use in children with asymptomatic pituitary lesions?
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Breanna L. Sheldon
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Michael W. O’Brien
Abstract
Objectives
Small pituitary cysts are commonly discovered on pediatric brain magnetic resonance imagings (MRIs), particularly in patients with growth hormone deficiency (GHD). We examined the need for operative management in children with these masses as well as the effect of growth hormone replacement (GHR) on these lesions.
Methods
This was a retrospective review of pituitary protocol MRIs conducted in children 0–19 at a single center between April 2010–November 2020. Sex, indication for initial MRI, volume, and whether surgery was performed was determined. Records were reviewed to determine whether GHD was present and treatment with GHR documented. For patients with subsequent MRIs, volume on most recent scan was calculated.
Results
Of the 101 children with cysts, 25 had laboratory-confirmed GHD and 76 did not. GHD patients had a higher mean age compared to no growth hormone deficiency (NGHD) cohort (11.2 and 8.4 years, respectively; p=0.02) and a larger proportion of males (p<0.001). The mean cyst volume on initial MRI was not significantly smaller in patients with GHD (0.063 ± 0.012 cm3) vs. those without GHD (0.171 ± 0.039 cm3, p=0.11). Of the 21 GHD patients who received GHR and had follow-up MRIs, 10 had no change in pituitary cyst size, two had cysts that shrank, and seven disappeared. The remaining two cysts enlarged an average of 0.061 ± 0.033 cm3. Zero GHR recipients required surgical intervention.
Conclusions
Small sellar cysts discovered incidentally on imaging in children are unlikely to require surgical intervention. GHR does not appear to significantly enlarge these pediatric pituitary lesions and is safe for use.
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Research funding: None declared.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Not applicable.
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Ethical approval: The local Institutional Review Board deemed the study exempt from review.
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Disclosures: None of the authors have any disclosures.
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© 2021 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
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- Genotype and phenotypic spectrum of vitamin D dependent rickets type 1A: our experience and systematic review
- Questioning the adequacy of standardized vitamin D supplementation protocol in very low birth weight infants: a prospective cohort study
- Growth hormone replacement therapy: is it safe to use in children with asymptomatic pituitary lesions?
- Comparing adolescent self staging of pubertal development with hormone biomarkers
- Reverse circadian glucocorticoid treatment in prepubertal children with congenital adrenal hyperplasia
- The concordance between ultrasonographic stage of breast and Tanner stage of breast for overweight and obese girls: a school population-based study
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- Case Reports
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Artikel in diesem Heft
- Frontmatter
- Review Article
- Calcitonin and complementary biomarkers in the diagnosis of hereditary medullary thyroid carcinoma in children and adolescents
- Original Articles
- Genotype and phenotypic spectrum of vitamin D dependent rickets type 1A: our experience and systematic review
- Questioning the adequacy of standardized vitamin D supplementation protocol in very low birth weight infants: a prospective cohort study
- Growth hormone replacement therapy: is it safe to use in children with asymptomatic pituitary lesions?
- Comparing adolescent self staging of pubertal development with hormone biomarkers
- Reverse circadian glucocorticoid treatment in prepubertal children with congenital adrenal hyperplasia
- The concordance between ultrasonographic stage of breast and Tanner stage of breast for overweight and obese girls: a school population-based study
- Cross-sectional analysis: clinical presentation of children with persistently low ALP levels
- The utility of continuous glucose monitoring systems in the management of children with persistent hypoglycaemia
- Long-term effect of conventional phosphate and calcitriol treatment on metabolic recovery and catch-up growth in children with PHEX mutation
- Role of magnetic resonance diffusion weighted imaging in diagnosis of diabetic nephropathy in children living with type 1 diabetes mellitus
- Investigation of quality of life in obese adolescents: the effect of psychiatric symptoms of obese adolescent and/or mother on quality of life
- Predictive value of WHO vs. IAP BMI charts for identification of metabolic risk in Indian children and adolescents
- Case Reports
- COVID-19 triggered encephalopathic crisis in a patient with glutaric aciduria type 1
- Aromatase deficiency in an Ontario Old Order Mennonite family
- A case of monogenic diabetes mellitus caused by a novel heterozygous RFX6 nonsense mutation in a 14-year-old girl
