Incidence and Outcomes of Pituitary Microadenomas in Children with Short Stature/Growth Hormone Deficiency

Derrick, Kristina M.
Gomes, William A.
Gensure, Robert C.

^aDivision of Pediatric Endocrinology, Children's Hospital at Montefiore/Albert Einstein College of Medicine, Bronx, New York, USA
^bDepartment of Radiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA

^*Kristina M. Derrick, MD, ScM, Children's Hospital at Montefiore/Albert Einstein College of Medicine, Division of Pediatric Endocrinology, 3415 Bainbridge Ave, Bronx, NY 10467 (USA), E-Mail [email protected]

Received: December 1, 2017; Accepted: April 17, 2018; Published online: September 27, 2018

Hormone Research in Paediatrics 90(3):p 151-160, November 2018. | DOI: 10.1159/000489456

Abstract

Background/Aims:

Patients with short stature (SS)/growth hormone deficiency (GHD) and precocious puberty (PP) undergo brain MRI to evaluate for structural brain abnormalities or pituitary lesions, and pituitary microadenomas are a common finding. Theoretically, a mass effect from these lesions could cause GHD and growth hormone treatment could cause them to enlarge, but they should not cause PP, at least in females.

Methods:

We investigated if pituitary microadenomas cause GHD by comparing their incidence in patients with SS/GHD to that in females with PP. We performed a retrospective chart review of patients with these disorders who had a brain MRI between 2000 and 2013.

Results:

The incidence of microadenoma was high in both groups, 18.5% for SS (n = 346) and 21.1% for PP females (n = 194), but did not differ between groups (p = 0.46). In patients with microadenomas, repeat imaging showed resolution in 58% (SS, n = 33) and 67% (PP females, n = 21). Importantly, none of the lesions grew, even in patients treated with growth hormone.

Conclusions:

Pituitary microadenomas are common in children with GHD/SS and PP, but it does not appear that they are a cause of GHD. They appear to be of limited clinical significance and should not be considered a contraindication to growth hormone therapy.