Pituitary Hypoplasia Is the Best MRI Predictor of the Severity and Type of Growth Hormone Deficiency in Children With Congenital Growth Hormone Deficiency

Abstract Background and Objectives: Congenital idiopathic growth hormone deficiency(GHD) is associated with various MRI abnormalities, including both sellar anomalies such as pituitary hypoplasia, ectopic pituitary, empty sella abnormalities of the stalk extrasellar Arnold Chiari malformation, corpus callosum agenesis, arachnoid cyst, septum pellucidum enlarged ventricles, vermis dysplasia, sphenoid cyst. However, it remains contentious whether brain findings could provide an additional avenue for precisely predicting differentiation GHD based on severity(severe or partial) type(isolated multiple deficiency MPHD). This study aimed to ascertain abnormality that best predictor severe type amongst different findings. Methods: was analytical cross-sectional conducted from 2018-2020. During period, we included a total 100 subjects diagnosed have after exclusion syndromic causes, system illness, presence mass, those h/o cranial irradiation. Patients were divided into partial peak stimulated GH <5 ng/dl ≥ 5 respectively groups isolated MPHD. further hypoplasia,extrasellar (EBA), posterior and/or abnormalities(EPP/PSA), respectively. Analyses performed using SPSS version 24.0 software. Results: Amongst congenital GHD, 66 (66%) had Isolated while remaining 34 (34%) 71 29 GHD. findings, hypoplasia most common finding observed in 53% patients, 23(23%) EBA, 25(25%) EPP/PSA. Pituitary be severity odds ratio(OR) 10.8 (95% CI 3.38-29.6) followed by /pituitary (OR =2.8, 95% 1.5-9.5) weakest =1.8, 1.05-3.2). only significantly predict MPHD (OR=9.2). On ROC analysis, height SDS -2.03 73.2 % sensitivity specificity 79.3%(AUC =0.787,95% 0.7-0.873) 88.2 66.7% (AUC =0.745, 0.68-0.877) Conclusion: We not frequent but also abnormalities.