Childhood Hypopituitarism: A Three Decades of Experience from a Major Teaching Hospital in Central Region (Riyadh) Saudi Arabia
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 11, Issue 2
Abstract
Childhood hypopituitarism is a clinical syndrome of deficiency in pituitary hormone production. Presentation varies from asymptomatic to acute collapse depending on the etiology, rapidity of onset and predominant hormone involved. A retrospective hospital-based cohort study was conducted at the pediatric endocrine service, King Khalid University Hospital Riyadh, Saudi Arabia (January 1989-December 2017). All the patients (total of 202 patients) who were diagnosed to have hypopituitarism, at the pediatric endocrine service, King Khalid University Hospital Riyadh, Saudi Arabia (January 1989-December 2017). A total of 202 patients were diagnosed to have hypopituitarism. Mean age was 8-9years. Beside congenital causes, diversity of acquired causes were encountered with a non-tumor causes being the commonest. Growth Hormone Deficiency (GHD) was diagnosed in 152 (70.2%) patients. Isolated GHD in 123 patients. Multiple pituitary hormone deficiency was the diagnoses in 29 patients. Central adrenal insufficiency was present in 59(29.2%) patients. Diabetes insipidus associated with hypopituitarism in 24(11.9%) patients. Childhood hypopituitarism is not that rare. High index of suspension coupled with appropriate hormone assay, and head MRI are essential for management. The pituitary gland is a midline structure located just beneath the optic chiasm. It is composed of two main lobs, the predominant anterior lobe which is known as adenohypophysis and the posterior lobe which is known as neurohypophysis and the vestigial intermediate lobe [1]. Hypopituitarism is a clinical syndrome of deficiency in pituitary hormone production. It might be a life threating condition. It can result from disorders involving the pituitary gland, the hypothalamus or the surrounding structures, such as tumor, inflammation, infection, surgical destruction, radiation, traumatic or vascular insult. It might be associated with birth trauma and perinatal asphyxia or midline defects such as cleft lip, septo-optic hypoplasia and encephalocele. Hypopituitarism could be partial or complete insufficiency of pituitary hormone. Panhypopituitarism refer to involvement of two or more pituitary hormone. However, involvement of one hormone only refer to isolated or partial hypopituitarism. The younger the child is at the time of presentation the more likely the etiology is to be congenital. However, on occasions, congenital forms may present or get diagnosed well after birth and conversely, some children with acquired forms are discovered relatively early in life [2-8]. This article reports on the clinical experience of childhood hypopituitarism from a major teaching hospital, King Khalid University Hospital (KKUH) in the central region of Saudi Arabia over more than 25 years, January 1989 to December 2017. KKUH is affiliated to King Saud University and provides primary, secondary and tertiary health care service to the local population and receives patients’ referral from all over the country.
Authors and Affiliations
Reem AH Al Khalifah, Nasir AM Al Jurayyan, Rushaid NA Al Jurayyan, Mossa NA Al Motawa, Sharifah DA Al Issa, Hessa MN Al Otaibi
Keywords
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- EP ID EP586752
- DOI 10.26717/BJSTR.2018.11.002081
- Views 173
- Downloads 0
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