Pituitary imaging in 129 children with growth hormone deficiency: A spectrum of findings.

Growth Hormone (GH) deficiency is the most common pituitary hormone deficiency in children. Magnetic Resonance Imaging (MRI) of the brain detects structural pituitary anomalies associated with GH deficiency. This retrospective hospital-based study was conducted at King Khalid University hospital (KKUH), Riyadh, Saudi Arabia, during the period (January 1995-June 2016). The available radiological, clinical and laboratory records of all children with confirmed GH deficiency by dynamic testing who had MRI brain were reviewed. A total of 129 patients were diagnosed with GH deficiency and had MRI brain performed. Isolated GH deficiency (IGHD) was diagnosed in 118 (91.5%) and multiple pituitary hormone deficiency (MPHD) in 11 (8.5%) patients. Most children with IGHD had normal MRI findings (n = 86/118), while 14/118 had hypoplasia of the anterior pituitary and 11/118 had aplasia of the anterior pituitary. Most of the children with MPHD (6/11) showed anterior pituitary hypoplasia or (3/11) aplasia and only 2/11 children with MPHD had normal MRI. In conclusion, our study showed a spectrum of MRI changes in children with GH deficiency.

Short stature in children: Pattern and frequency in a pediatric clinic, Riyadh, Saudi Arabia.

Longitudinal growth assessment is essential in child care. Short stature can be promptly recognized only with accurate measurements of growth and critical analysis of growth data. The objective of this study was to determine the pattern of short stature among patients referred to an endocrine pediatric clinic, King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia and to ascertain the aetiological profile of short stature. This is a retrospective review of patients referred to a pediatric endocrine clinic with short stature during the period January 1990 and December 2009. After a proper detailed medical history, growth analysis and physical examination, followed by a radiological (bone age) and laboratory screening (complete blood count and thyroid function). Growth hormone stimulation tests were performed when indicated. Magnetic resonance imaging (MRI) of the pituitary was performed when necessary. As well, celiac screening and small bowel biopsy were performed when appropriate. During the period under review, hundred and ten patients were evaluated for short stature. Their age ranged from 2 years and six months to 4 years. The male to female ratio was 1.3:1. The commonest etiology was genetic short stature found in 57 (51.8%) patients, while in the other 53 (48.2%) patients, variable endocrine and nutritional causes were noted. Short stature was a common referral. A wide variety of etiological diagnosis was noticed with genetic short stature being the commonest. A wide variety of endocrine causes were evident, with growth hormone deficiency, as a results of different etiologies, being the commonest.