Prevalence of Hypothalamic-Pituitary Abnormalities in Pediatric Patients with Growth Hormone Deficiency

Growth hormone deficiency (GHD) is a key differential diagnosis in children with proportionate short stature. While brain magnetic resonance imaging (MRI) is recommended for all confirmed GHD cases to rule out hypothalamic-pituitary anomalies, its universal application remains debated We conducted a retrospective, single-center study including 84 pediatric patients diagnosed with isolated GHD Brain MRI revealed hypothalamic-pituitary abnormalities in 27.4%. Compared to those with normal MRIs, patients with abnormalities were younger (6.78 ± 2.72 vs 8.34 ± 3.38 years, P = .038), shorter (height SDS -2.83 ± 0.58 vs -2.56 ± .64, P = .032), and had lower IGF-1 SDS (-1.07 ± .66 vs -.78 ± .70, P = .041). Multivariate logistic regression confirmed age, height SDS, and IGF-1 SDS as independent predictors of MRI anomalies. ROC analysis identified cutoff values with moderate predictive accuracy: age <7.1 years, height SDS <-2.7, and IGF-1 SDS <-.9.