Association of Adverse Perinatal Events with an Empty Sella turcica in Children with Growth Hormone Deficiency

Abstract

High-resolution computed tomography (HR-CT) of the hypothalamo-pituitary region was performed in 26 consecutive children presenting with growth hormone deficiency (GHD) at one clinic. 58% had an empty sella turcica (ES) and 42% a full sella turcica (FS). There was no difference between the ES and FS groups for mean ( ± 95% confidence limits) presentation age (ES 6.7 ( ± 1.8) years, FS 5.6 ( ± 2.2) years), height standard deviation score (SDS) (ES -3.9 ( ± 0.8), FS -3.3 ( ± 0.5)) nor head circumference SDS (ES -1.9 ( ± 1.1), FS -0.7 ( ± 1.1)). There were significant associations between the ES group and a history of adverse perinatal events (p < 0.001) and multiple pituitary deficiency (p = 0.014). Growth hormone response to an acute growth hormone releasing factor test showed no association with HR-CT diagnosis. Sella turcica volumes were calculated from the HR-CT scans. All sella volumes were small; mean SDS for height was -2.6 ( ± 0.2). There was no difference in sella volume SDS between the ES and FS groups (ES -2.9 ( ± 0.3), FS -2.5 ( ± 0.4)). Adverse perinatal events may cause an ES and GHD by compromising the blood supply to the pituitary gland or infundibulum.