Abstract
Structural abnormalities of the HPA have been detected by MRI in GH deficient patients. We studied 29 children(18 boys and 11 girls) between 5-21 yr of age with GH deficiency: isolated(IGHD) or associated with multiple pituitary deficiencies (MPD). 10 cases refered abnormal deliveries. All children had GH peak levels less than 4.5ng/ml during clonidine and insulin tests, and submitted to combined TRH 200ug, GnRH 100ug and insulin 0.1 U/kg tests. Absence of TSH and PRL increment after test defined the GH deficiency as pituitary, and elevated basal TSH levels and/or high peak TSH and prolonged response defined GH deficiency as hypothalamic. MRI was performed using a 1.5 Tesla (Sigma GE) system, using spin echo sequences. The anomalies observed were:total transection of the stalk (TTS), thin stalk (TS), reduced pituitary parenchyma (RPP) and ectopic neurohypophysis (ENH).
Reduced pituitary parenchyma was seen in 82.7%, ectopic neurohypophysis and total transection of the stalk in all cases of MPD and in 53% of idiopathic IGHD. The findings suggest that IGHD and MPD were related to transection or compression of the stalk.
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Segura, T., Mendonca, B., Osorio, M. et al. 33 HIPOTHALAHO-PITUITARY AXIS (HPA) BY MAGNETIC RESONANCE IMAGING (RI) IN GROWTH HORMONE DEFICIENCY. Pediatr Res 36, 677 (1994). https://doi.org/10.1203/00006450-199411000-00057
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DOI: https://doi.org/10.1203/00006450-199411000-00057