BACKGROUND: The diagnosis of congenital hypopituitarism is difficult and often delayed because its symptoms are nonspecific. AIM: To describe the different clinical presentations of children with congenital hypopituitarism to reduce the time for diagnosis and to begin a precocious and appropriate treatment. STUDY DESIGN: We analyzed a cohort of five children with congenital hypopituitarism, describing their clinical, biochemical and radiological characteristics from the birth to diagnosis. RESULTS: As first sign of the disease, all of five patients presented a neonatal hypoglycemia, associated in four cases with jaundice. In all these four cases, the clinicians hypothesized a metabolic disease delaying the diagnosis, which was performed in only two cases within the neonatal period. In the other three cases, the diagnosis was formulated at 2, 5 and 8 years of life because there was severe and precocious growth impairment. CONCLUSIONS: It is important to suspect congenital hypopituitarism in the presence of persistent neonatal hypoglycemia associated with jaundice and of a precocious and severe reduction of the growth velocity in childhood. In all these cases, it is necessary to undertake a hypothalamic-pituitary magnetic resonance imaging scan as soon as possible, and to start appropriate treatment.
BACKGROUND: The diagnosis of congenital hypopituitarism is difficult and often delayed because its symptoms are nonspecific. AIM: To describe the different clinical presentations of children with congenital hypopituitarism to reduce the time for diagnosis and to begin a precocious and appropriate treatment. STUDY DESIGN: We analyzed a cohort of five children with congenital hypopituitarism, describing their clinical, biochemical and radiological characteristics from the birth to diagnosis. RESULTS: As first sign of the disease, all of five patients presented a neonatal hypoglycemia, associated in four cases with jaundice. In all these four cases, the clinicians hypothesized a metabolic disease delaying the diagnosis, which was performed in only two cases within the neonatal period. In the other three cases, the diagnosis was formulated at 2, 5 and 8 years of life because there was severe and precocious growth impairment. CONCLUSIONS: It is important to suspect congenital hypopituitarism in the presence of persistent neonatal hypoglycemia associated with jaundice and of a precocious and severe reduction of the growth velocity in childhood. In all these cases, it is necessary to undertake a hypothalamic-pituitary magnetic resonance imaging scan as soon as possible, and to start appropriate treatment.
Authors: Kyriaki S Alatzoglou; James P Turton; Daniel Kelberman; Peter E Clayton; Ameeta Mehta; Charles Buchanan; Simon Aylwin; Elisabeth C Crowne; Henrik T Christesen; Niels T Hertel; Peter J Trainer; Martin O Savage; Jamal Raza; Kausik Banerjee; Sunil K Sinha; Svetlana Ten; Talat Mushtaq; Raja Brauner; Timothy D Cheetham; Peter C Hindmarsh; Primus E Mullis; Mehul T Dattani Journal: J Clin Endocrinol Metab Date: 2009-06-30 Impact factor: 5.958
Authors: Jolanda C Naafs; Jan Pieter Marchal; Eric Fliers; Paul H Verkerk; Michiel A J Luijten; Anita Boelen; A S Paul van Trotsenburg; Nitash Zwaveling-Soonawala Journal: J Clin Endocrinol Metab Date: 2021-03-08 Impact factor: 5.958