Empty sella in children as a key for diagnosis
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Published on: January 17, 2018
J Takanashi1, H Suzuki, K Nagasawa
1Department of Pediatrics, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, 260-8677, Chiba, Japan. jtaka@med.m.chiba-u.ac.jp
Insights
Empty sella findings on pituitary MRI in children are rare but significantly linked to idiopathic intracranial hypertension and nevoid basal cell carcinoma syndrome. This imaging can aid in diagnosing these conditions.
Area of Science:
- Pediatric Neurology
- Neuroradiology
- Endocrinology
Background:
- The empty sella is a common finding in adults, but its prevalence and significance in children are less understood.
- Idiopathic intracranial hypertension (IIH) and nevoid basal cell carcinoma syndrome (NBCCS) are rare pediatric conditions with potential neurological and endocrine manifestations.
Purpose of the Study:
- To investigate the prevalence of empty sella in a pediatric population undergoing pituitary MRI.
- To determine the association between empty sella and specific pediatric conditions, particularly IIH and NBCCS.
Main Methods:
- Retrospective analysis of 354 children who underwent pituitary MRI.
- Review of clinical data, hormonal results, and diagnoses for children with empty sella.
- Statistical analysis to assess the significance of empty sella frequency in specific conditions.
Main Results:
- An empty sella was identified in 11 out of 354 children (3.1%), all with normal hormonal profiles.
- A significantly high frequency of empty sella was observed in children with IIH (4/4) and NBCCS (3/5).
- The estimated prevalence of empty sella in children, excluding IIH and NBCCS, was 1.2%, considerably lower than in adults.
Conclusions:
- Pituitary MRI in children can reveal an empty sella, which is uncommon but warrants further investigation.
- The high association of empty sella with IIH and NBCCS suggests its utility as a potential diagnostic clue for these syndromes in pediatric patients.
- Further research is needed to elucidate the specific mechanisms linking empty sella to these pediatric conditions.
Abstract:
We performed magnetic resonance imaging of the pituitary gland in 354 children who were under the care of our pediatric neurological outpatient department. Among them, an empty sella was recognized in 11 children, who all showed normal hormonal results. The frequency of an empty sella was significantly high in idiopathic intracranial hypertension (4/4; P<0.0001) and nevoid basal cell carcinoma syndrome (3/5; P<0.0001). The ratio of an empty sella in children, excluding patients with idiopathic intracranial hypertension and nevoid basal cell carcinoma syndrome, is estimated to be 4/345 (1.2%), which is markedly lower than that in adults. Magnetic resonance imaging of the pituitary gland in children could provide important clues for the diagnosis of idiopathic intracranial hypertension or nevoid basal cell carcinoma syndrome.
