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Pituitary Stalk Interruption Syndrome: Analysis of Response to Growth Hormone Therapy
Raghuraman Ravichandran1, Uma K Saikia1, Ashok K Bhuyan1
1Department of Endocrinology, Gauhati Medical College, Guwahati, Assam, India.
Objective:
To analyse the clinical and radiological characteristics of pituitary stalk interruption syndrome (PSIS).
Methods:
A retrospective analysis of confirmed cases of PSIS was performed. The development of new pituitary hormonal deficiencies and response to recombinant human growth hormone (rhGH) therapy were assessed during follow-up.
Results:
This study included 14 children (10 boys) of PSIS with median (range) age of 12.15 years (2 months - 18 years). Short stature was the most common presentation (n = 13), and micropenis (n = 4), cleft lip (n = 1) and single central incisor (n = 1) were other midline defects. Growth hormone (GH) deficiency was present in 14 children and 7 of them also had multiple pituitary hormone deficiencies at baseline. Central hypothyroidism (n = 5), secondary adrenal deficiency (n = 4) and gonadotropin deficiencies (n = 2) were also seen. All children received rhGH. The mean height gain on follow-up was 12.78 cm in first year (n = 14), 6.5 cm in second year (n = 8) and 4.07 cm in third year (n = 7) of rhGH therapy. Four children developed additional pituitary hormone deficiency on follow-up.
Conclusion:
Short stature with isolated GH deficiency was the most common presentation of PSIS that showed good response to rhGH therapy.
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