Brain Magnetic Resonance Imaging as First-Line Investigation for Growth Hormone Deficiency Diagnosis in Early Childhood

Valentina Pampanini, Stefania Pedicelli, Jessica Gubinelli, Giuseppe Scirè, Marco Cappa, Brunetto Boscherini, Stefano Cianfarani

Research output: Contribution to journalArticle

Abstract

The diagnosis of growth hormone (GH) deficiency (GHD) in infancy and early childhood is not straightforward. GH stimulation tests are unsafe and unreliable in infants, and normative data are lacking. This study aims to investigate whether brain magnetic resonance imaging (MRI) may replace GH stimulation tests in the diagnosis of GHD in children younger than 4 years. Methods: We examined a retrospective cohort, with longitudinal followup, of 68 children consecutively diagnosed with GHD before the age of 4 years. The prevalence of hypothalamic-pituitary (HP) alterations at MRI and the associations with age and either isolated GHD (IGHD) or multiple pituitary hormone deficiency (MPHD) were assessed. Results: The prevalences of IGHD and MPHD were 54.4 and 45.6%, respectively. In the first group, brain MRI showed abnormalities in 83.8%: isolated pituitary hypoplasia in 48.7% and complex defects in 35.1%. In patients with MPHD, MRI showed complex alterations in 100%. All children younger than 24 months showed HP MRI abnormalities, regardless of the diagnosis. Complex defects were found in 94% of patients younger than 12 months and in 75% of patients between 13 and 24 months. Conclusion: Our data suggest that brain MRI may represent the first-line investigation for diagnosing GHD in infancy and early childhood.

Original languageEnglish
Pages (from-to)323-330
Number of pages8
JournalHormone Research in Paediatrics
Volume84
Issue number5
DOIs
Publication statusPublished - Nov 1 2015

Keywords

  • Childhood
  • Growth hormone deficiency diagnosis
  • Infancy
  • Magnetic resonance imaging
  • Pituitary

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

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