Endocrine Function and Growth in Children with Craniopharyngioma

ABSTRACT

PURPOSE: Craniopharyngiomas are often accompanied by severe endocrine disorders. Although there is universal growth hormone deficiency(GHD), the resulting growth pattern is very heterogeneous. We report the growth and endocrine outcome of 44 children with craniopharyngioma, with emphasis on initial symptoms, growth before and during growth hormone(GH) treatment and spontaneous growth in spite of GHD. METHODS: We performed a retrospective study of 44 children treated at our centre between 1984 and 2002. RESULTS: About 30% of patients had symptoms suggesting endocrine disorder at diagnosis. After surgery, multiple endocrinopathies were almost universal. Before GH therapy, height velocity was 8.00+/-2.71 cm/yr in the normal growth group(n=11) and 1.79+/-1.10 cm/yr in the subnormal growth group(n=7) during the first year and during the second year, 6.76+/-2.49 cm/yr and 2.29+/-1.33 cm/yr, respectively. There was no difference of body mass index(BMI) change between before and after surgery in the two groups. Height standard deviation score(SDS) was -1.46+/-0.74 in the normal growth group and -0.43+/-0.97 in the subnormal growth group. Before GH treatment height SDS was -1.31+/-1.25 and BMI was 20.46 & gt; or =3.60. During GH treatment, height SDS increased to -0.60+/-1.37 in the first, and to -0.41+/-1.54 in the second year(P & lt;0.05), but BMI did not change significantly. CONCLUSION: The endocrine morbidity could develop in most children with craniopharyngioma before and after the operation and should be managed properly. Although all treated patients benefit from GH therapy, further studies are necessary to find out the possible mechanism of growth regulation in normally growing children, despite GH deficient.