An Audit of Hypopituitarism in Paediatric Patients Seen at Chris Hani Baragwanath Academic Hospital from January 2011 to December 2021

Abstract

Background Congenital hypopituitarism is a rare but important condition, as normal pituitary function is crucial for neurocognitive development, growth, metabolism, homeostasis and puberty progression. Objectives To describe the demographics, anthropometry, clinical presentation, MRI findings, biochemical abnormalities, bone age and response to treatment of children with congenital hypopituitarism. Methods A retrospective, descriptive study from 1 January 2011 to 31 December 2021 of paediatric endocrine clinic patients at CHBAH (n = 46). Results Two-thirds of patients had panhypopituitarism and the remainder had hypopituitarism. The mean age at presentation was 4.7 years (SD ± 5.3). The male:female ratio was 3.6:1 and the majority were Black (97.8%). The most common presentation was short stature (70%) and pituitary stalk interruption syndrome (45.3%) on MRI. The height-for-age z-score was -4.2 (SD ± 2.1) at baseline and -1.7 (SD ± 1.9) at year 7 on treatment (p < 0.05) for those that received recombinant growth hormone. The mean delay in bone age was 2.6 years (SD ± 2.4) before growth hormone initiation. The most common complication was hypoglycemia (43.5%). Conclusion Hypopituitarism is a rare disease that requires early detection. Intervention with growth hormone replacement has shown a significant improvement in HAZ achieving a normal range for the majority of treated patients.