RELATIONSHIPS BETWEEN NEURORADIOLOGICAL AND CLINICAL-FEATURES IN APPARENTLY IDIOPATHIC HYPOPITUITARISM

In this study, perinatal history, postnatal auxological and clinical e volution and endocrine features were retrospectively evaluated in 49 c hildren, adolescents and young adults with apparently idiopathic hypop ituitarism. They were divided into two groups according to magnetic re sonance images: 32 patients with isolated pituitary hypoplasia (group A) and 17 with pituitary stalk interruption syndrome (group B). The ai m of the study was to assess whether these neuroradiological pictures are associated with specific endocrine and clinical patterns. No signi ficant difference in terms of gestational age, intrauterine growth and rates of adverse perinatal events was found between the two groups. C linical signs documenting the existence of pituitary dysfunction in ut ero or shortly after birth were either slightly (micropenis, cryptorch idism, cholestatic jaundice) or significantly (hypoglycemia) more freq uent in patients in group B. Although diagnosis of hypopituitarism was made significantly earlier in patients in group B, height deficiency at diagnosis was similar in both groups. Endocrine investigations reve aled a more severe and widespread impairment of pituitary function amo ng those in group B. The main conclusion is that the postnatal clinica l course is more severe when growth hormone deficiency is associated w ith pituitary stalk interruption syndrome than when the pituitary is o nly reduced in height, probably because of the more severe and widespr ead impairment of pituitary function in the former cases.