Childhood Combined Pituitary Hormone Deficiency A Five-Year Retrospective Study

To emphasize the characteristics and management of combined pituitary hormone deficiency (CPHD) in childhood. A total of 51 CPHD cases were studied. There were 45 males and 6 females with a mean age of 14.7 +/- 4.5 years. The birth history, clinical features, laboratory data, and therapy were analyzed. All 51 cases had short stature with a median height SDS (standard deviation score) of -4.72. The most common deficiency (35 cases) was gonadotropin (GN) deficiency, following by thyroid-stimulating hormone (TSH) deficiency in 31, adrenocorticotropic hormone (ACTH) deficiency in 17, and prolactin in 2. Combined growth hormone (GH) and GN deficiency was noted in 17 cases, followed by GH, ACTH, TSH, and GN deficiency in 9, a GH, TSH, and GN in 7. Thirty-seven cases were found to have GN and/or ACTH deficiency. A small pituitary was found in 16 cases (31.4%), empty sella in 4 (5.6%), pituitary stalk interruption syndrome in 1, tumors in 2, and a normal pituitary gland in 3. CPHD is a common endocrinological disease in children. In children with one pituitary hormone deficiency, others should be suggested. A genetic disorder, especially Prop1 mutation, could be the main cause of CPHD in children.