Hypopituitarism in children
The pituitary gland is a small gland located at the base of the brain, approximately in the space between the eyes. The main function of this structure is the regulation and secretion of several different hormones in adults and children.
Hypopituitarism is a condition in which the pituitary gland does not secrete enough of one or more of these hormones.
This condition can develop due to disease in the pituitary gland or hypothalamus /the part of the brain that controls the pituitary gland/. The disorder in the secretion of pituitary hormones can appear at any age.
What are the symptoms?
Symptoms vary depending on the age of the child, the underlying cause, and which hormones are not being secreted enough. Signs and symptoms may develop gradually and may be non-specific.
The signs and symptoms that can appear in newborns are:
• Small genitals;
• Jaundice – a condition characterized by yellowing of the skin ;
• Apparent hypoglycemia – low levels of glucose concentration in the blood, with the following symptoms observed – slowness, nervousness and seizures;
• Irritability in diabetes insipidus – a condition in which excessive amounts of urine are excreted from the body;
In older infants and children, the following signs and symptoms may be observed:
• Short stature and slow growth, slow tooth development and late or slow teething. In addition to a delay in height growth, delayed weight gain is also observed.
• Delayed mental development;
• Increased thirst and frequent urination;
• Fatigue;
• Absence or delayed puberty;
• Weight gain is disproportionate to growth;
• Nervous system and vision problems for example reduced visual acuity, peripheral vision disorder or headache. p>
What are the causes?
The condition can be congenital and caused by:
• Birth trauma;
• Genetic /hereditary/ disorders;
• Abnormalities of the central nervous system;
• Abnormal, underdeveloped or absent pituitary gland;
The disease can be acquired and be due to:
• Radiation to the head;
• Tumors in the brain;
• Other diseases such as tuberculosis or sarcoidosis infiltrating the gland which may result to the reduction of its function.
Treatment of hypopituitarism in children
Treatment mainly consists of hormone replacement therapy. Medicines replace the deficient hormone.
• Somatotropin /recombinant human hormone/ is used to treat the deficient hormone. This therapy is used to prevent growth retardation and metabolic disorders associated with growth hormone deficiency.
The effect of treatment in infants and children with severe growth hormone deficiency is truly remarkable, as after starting therapy they rapidly begin to gain weight and grow in height.
• Levothyroxine – used to treat low thyroid hormone levels. Thyroid hormones are necessary for normal growth, metabolism and development of the nervous system.
• Hydrocortisone and fludrocortisone are used to treat adrenal insufficiency due to adrenocorticotropic hormone deficiency or other diseases of the adrenal glands.
• Vasopressin or desmopressin > can be used to treat diabetes mellitus.
Surgical intervention can be performed if a tumor is present and if it is located in or near the pituitary gland, taking into account its type, its exact location and whether it causes any symptoms.
The doctor will recommend that you schedule routine checkups every 3 months to monitor the child’s growth and development. Frequent examinations will make it possible to determine in time whether the prescribed therapy is working and whether the drugs have caused side effects.
