PRIMARY EMPTY SELLA - DIFFERENCES AND SIMILARITIES BETWEEN CHILDREN AND ADULTS

To identify possible differences between empty sella in children and a dults we studied 43 subjects (age 13.6 +/- 5.4 years, range 4.1-27 yea rs) with hypothalamic-pituitary disorders and empty sella at magnetic resonance imaging. Pituitary function, presence of non-endocrine sympt oms, perinatal history, sellar volume, pituitary height, midline or in trasellar anatomical abnormalities were evaluated. Twenty subjects had isolated growth hormone deficiency, 17 multiple pituitary hormone def iciency and 6 puberty disorders (3 precocious puberty, 2 idiopathic de layed puberty, 1 Kallmann syndrome). The group with multiple pituitary hormone deficiency had a higher percentage of subjects with complete empty sella, i.e pituitary height < 2mm (p = 0.016), or intrasellar an atomical abnormalities (p = 0.0002) than the other groups. The subject s with puberty disorders had a mean sellar volume higher than the othe r groups (p < 0.05). Apart from pituitary dysfunction, symptoms of the empty sella syndrome were infrequent (9.3% of cases) in our subjects. The age of our subjects, the frequent association between empty sella and pituitary dwarfism and the non-enlarged sellae suggest a a differ ent aetiology, perhaps congenital, for empty sella in our subjects. As in adults, empty sella may be associated with both pituitary hypo- an d hyperfunction.