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Endocrinologic disorders and optic pathway gliomas in children with neurofibromatosis type 1
M H Cnossen1, E N Stam, L C Cooiman
1Department of Pediatrics, University Hospital Sophia/Dijkzigt, Erasmus University, Rotterdam, The Netherlands.
Objective:
To establish the prevalence of endocrinologic disorders in children with neurofibromatosis type 1 (NF1) and the relationship between these disorders and cerebral abnormalities on magnetic resonance imaging.
Design:
A prospective follow-up study. Setting. A multidisciplinary neurofibromatosis clinic.
Patients:
A total of 122 children diagnosed with NF1 according to diagnostic criteria set by the National Institutes of Health.
Results:
Central precocious puberty (CPP) was diagnosed in 3 children and growth hormone deficiency (GHD) in 3 children. Optic pathway gliomas were observed in 15 children; in 9 of the 15 cases, the optic chiasm was involved. Of the 3 children with CPP, only 1 showed a chiasma glioma on magnetic resonance imaging. In 1 case with GHD, an optic chiasm glioma was detected on neuroimaging. Two of the 9 children with an optic chiasm glioma presented with CPP or GHD.
Conclusions:
It has been suggested that CPP in children with NF1 is found exclusively in the presence of a chiasma glioma. We conclude that chiasma glioma may not be obligatory in children with NF1 and CPP or GHD. Moreover, we report a prevalence of GHD in children with NF1 of 2.5%, which has not been established earlier.