Intracranial Pathologies and Endocrine Results: Single Pediatric Endocrinology Center Experience

Year 2022, Volume: 32 Issue: 6, 714 - 718, 31.12.2022

Ülkü Gül Şiraz

https://doi.org/10.54005/geneltip.1200537

Abstract

ABSTRACT
Intracranial pathologies can affect pituitary hormone levels whether they are primarily related to the pituitary gland or not. In pituitary hormone deficiencies, the size and location of the pituitary gland may be normal, as well as one or more hormone effects may be observed after hypoplasia, partial empty sella, ectopic neurohypophysis, Rathke's cleft cyst, adenomas and other pituitary masses or surgeries. In early puberty, the pituitary dimensions are usually increased, rarely hypoplasia and rathke cleft cyst are seen as MRI findings. Non-pituitary pathologies cause especially early puberty, single or multiple pituitary hormone deficiency.
In this study, we aimed to categorize the patients with pituitary/cranial lesions and hormonal pathology and to determine their frequency and distribution in the single pediatric endocrinology clinic for ten years.
The data of 485 patients, 186 (38.3%) male, were retrospectively analyzed. Their mean age was 9.3 ± 3.2 years. The incidental pituitary lesion was found in 28 (5.77%) of all cases. There was no hormonal influence in 20 (71.4%) of them. In most of the 454 cases with hormonal disorders, MRI (Magnetic Resonance Imaging) findings were normal in most of the 454 cases with hormonal disorders (71.8%). The most common hormonal pathologies were precocious puberty and isolated Growth Hormone deficiency, 57.9% and 26.4% respectively. Non-pituitary lesions (n=23, 5%) were most frequently accompanied by early puberty (39.1%).
The hypothalamus-pituitary axis may be affected by primary lesions in its own region, or it may be seen as a result of other cranial pathologies. Cranial evaluation is also important in addition to pituitary imaging in pituitary hormone disorders.

Keywords

Pituitary Hormone Disorders, Central Nervous System Lesions, Precocious Puberty, Magnetic Resonance Imaging.

İNTRAKRANİYAL PATOLOJİLER VE ENDOKRİN SONUÇLARI: TEK ÇOCUK ENDOKRİNOLOJİ MERKEZİ TECRÜBESİ

Abstract

İntrakranial patolojiler hipofiz beziyle primer bağlantılı olsun veya olmasın hipofizer hormon düzeylerini etkileyebilirler. Hipofizer hormon eksikliklerinde hipofiz bezi boyutları ve yerleşimi normal olabildiği gibi hipoplazi, parsiyel empty sella, ektopik nörohipofiz, rathke kleft kisti, adenomlar ve hipofiz yerleşimli diğer kitleler veya cerrahilerinden sonra da bir veya birçok hormon etkilenmesi görülebilir. Erken pubertede hipofiz boyutları genellikle artar, nadiren hipoplazi ve rathke yarık kisti Manyetik Rezonans Görüntüleme (MRG) bulguları olarak görülür. Hipofiz dışı patolojiler özellikle erken ergenliğe, tek veya çoklu hipofiz hormon eksikliğine neden olur.
Bu çalışmada, tek pediatrik endokrinoloji kliniğinde on yıl boyunca hipofiz/kraniyal lezyonları ve hormonal patolojisi olan hastaların kategorize edilmesi, sıklık ve dağılımlarını belirlenmesi amaçlanmıştır.
186'sı (%38,3) erkek 485 hastanın verileri geriye dönük olarak incelendi. Ortalama yaşları 9.3 ± 3.2 yıldı. Tüm olguların 28'inde (%5.77) tesadüfi hipofiz lezyonu saptandı. Bunların 20'sinde (%71,4) hormonal etki yoktu. Hormonal bozukluğu olan 454 olgunun çoğunda MRG bulguları normaldi (%71.8). En sık görülen hormonal patolojiler sırasıyla %57.9 ve %26.4 ile erken ergenlik ve izole büyüme hormonu eksikliği idi. Hipofiz dışı lezyonlara (n=23, %5) en sık erken ergenlik (%39.1) eşlik ediyordu.
Hipotalamus-hipofiz ekseni kendi bölgesindeki primer lezyonlardan etkilenebileceği gibi diğer kraniyal patolojilerin sonucu olarak da görülebilir. Hipofiz hormon bozukluklarında hipofiz MRG’yle birlikte kraniyal değerlendirme de yapılmalıdır.

Keywords

Hipofizer Hormon Bozuklukları, Santral Sinir Sistemi Lezyonları, Puberte Prekoks, Manyetik Rezonans Görüntüleme

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