| Effective use of magnetic resonance imaging in the assessment of children with possible growth hormone deficiency. | |
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MedLine Citation:
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PMID: 15251557 Owner: NLM Status: PubMed-not-MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To present our experience with diagnosis of growth hormone (GH) deficiency in children and to determine which patients are most likely to benefit from magnetic resonance imaging (MRI). METHODS: We retrospectively reviewed medical records of pediatric patients who underwent assessment for possible GH deficiency during a 6-year period and correlated clinical variables, stimulated GH responses, and MRI findings. RESULTS: Of 100 children who failed outpatient GH screening tests, 14 were classified as at risk for hypothalamic pituitary defects, and 86 were considered not at risk, having short stature only. Patients were further stratified by age, sex, growth variables, maximal GH response to provocative testing, and MRI findings. A significant relationship existed between the presence of risk factors, maximal GH of <5 mg/L, and sellar defects. With no risk factors, MRI scans showed normal findings in 15 of 17 patients with maximal GH of <5 mg/L, in 33 of 34 patients with GH between 5 and 10 mg/L, and in all 35 patients with GH of >10 mg/L. Abnormal MRI findings included posterior pituitary ectopy, decreased pituitary size, absent midline central nervous system structures, enlarged infundibulum, and hamartoma. In one child with a 4-year history of growth failure and a maximal GH of 3.5 mg/L, craniopharyngioma was diagnosed. CONCLUSION: MRI scans should be obtained in any child with multiple pituitary hormone deficiencies, hypoglycemia, ophthalmologic anomalies, low-stimulated GH, or acquired growth failure. Otherwise asymptomatic children with growth delay and maximal GH of >10 mg/L do not need routine MRI screening. Such a strategy could result in substantial cost savings. |
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Authors:
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J P Frindik; S F Kemp; C Pihoker |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists Volume: 2 ISSN: 1530-891X ISO Abbreviation: Endocr Pract Publication Date: 1996 Jan-Feb |
Date Detail:
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Created Date: 2004-07-14 Completed Date: 2005-02-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9607439 Medline TA: Endocr Pract Country: United States |
Other Details:
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Languages: eng Pagination: 8-12 Citation Subset: - |
Affiliation:
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Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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