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Empty sella in short children with and without hypothalamic-pituitary abnormalities.
A T Soliman1, A Darwish, M G Asfour
1Department of Pediatrics, Royal Hospital, Muscat, Sultanate of Oman.
Indian Journal of Pediatrics
|September 1, 1995
Summary
Children with growth issues and abnormal pituitary function show a high rate of empty sella. This condition, an empty sella, is also found in 10% of short children with normal pituitary function.
Area of Science:
- Pediatric Endocrinology
- Neuroendocrinology
- Genetics
Background:
- Short stature in children can stem from various causes, including growth hormone (GH) deficiency and pituitary abnormalities.
- The presence and significance of empty sella, a condition where the pituitary gland is not fully housed within the sella turcica, require further investigation in pediatric growth disorders.
Purpose of the Study:
- To investigate the incidence of empty sella in children with growth retardation and abnormal hypothalamic-pituitary function.
- To compare the prevalence of empty sella in different groups of short children, including those with GH deficiency, sickle cell disease (SCD) with GH deficiency, and normal variant short stature (NVSS).
Main Methods:
- Assessed GH and cortisol responses to clonidine and glucagon stimulation tests.
- Measured circulating free thyroxine (FT4), thyroid stimulating hormone (TSH), insulin-like growth factor-I (IGF-I), and performed CT sellar imaging.
- Evaluated growth parameters, including height standard deviation scores (HTSDS) and annual growth velocity, in four groups of children.
Main Results:
- Empty sella was detected in 45-80% of children with GH deficiency (isolated or multiple pituitary deficiencies) and 100% of those with SCD and GH deficiency.
- Children with GH deficiency had significantly lower IGF-I concentrations compared to NVSS.
- Children with idiopathic GH deficiency and empty sella exhibited lower HTSDS and slower growth velocity than NVSS and SCD-associated empty sella groups.
Conclusions:
- Children with growth retardation and abnormal hypothalamic-pituitary function have a high incidence of empty sella.
- Empty sella is also observed in a notable proportion (10%) of short children with normal hypothalamic-pituitary function.
- The findings highlight the association between empty sella and various pediatric growth disorders, underscoring the need for comprehensive pituitary evaluation.