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UCLA Pituitary and Skull Base Tumor Program

UCLA Pituitary and Skull Base Tumor Program
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GH Deficiency

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Synopsis

Our patient is a 19-year-old female with short stature and primary amenorrhea, found to have prolactin-secreting macroadenoma only partially responsive to D2-agonist therapy. Imaging revealed large cystic sellar mass, which upon resection, was found to be necrotic tissue. Discussion of growth hormone deficiency management.


Clinical History


Pre-Operative Imaging


Operative Findings


Surgical Pathology


Post-Operative Course


Discussion

References

Bengtsson BA, Eden S, Lonn L, Kvist H, Stokland A, Lindstedt G, Bosaeus I, Tolli J, Sjostrom L, Isaksson OG. Treatment of adults with growth hormone (GH) deficiency with recombinant human GH. J Clin Endocrinol Metab 1993;76:309-317. http://www.ncbi.nlm.nih.gov/pubmed/8432773

Beshyah SA, Henderson A, Niththyananthan R, Skinner E, Anyaoku V, Richmond W, Sharp P, Johnston DG. The effects of short and long-term growth hormone replacement therapy in hypopituitary adults on lipid metabolism and carbohydrate tolerance. J Clin Endocrinol Metab 1995;80:356-363. http://www.ncbi.nlm.nih.gov/pubmed/7852490

Capaldo B, Patti L, Oliviero U, Longobardi S, Pardo F, Vitale F, Fazio S, Di Rella F, Biondi B, Lombardi G, Sacca L. Increased arterial intima-media thickness in childhood-onset growth hormone deficiency. J Clin Endocrinol Metab 1997;82:1378-1381. http://www.ncbi.nlm.nih.gov/pubmed/9141519

de Boer H, Blok GJ, Voerman HJ, Phillips M, Schouten JA. Serum lipid levels in growth hormone- deficient men. Metabolism 1994;43:199-203. http://www.ncbi.nlm.nih.gov/pubmed/8121302

Deijen JB, Arwert LI, Witlox J, Drent ML. Differential effect sizes of growth hormone replacement on Quality of Life, well-being and health status in growth hormone deficient patients: a meta-analysis. Health Qual Life Outcomes 2005;3:63. PMCID 1277839 http://www.ncbi.nlm.nih.gov/pubmed/16236167

Gharib H, Cook DM, Saenger PH, Bengtsson BA, Feld S, Nippoldt TB, Rodbard HW, Seibel JA, Vance ML, Zimmerman D. American Association of Clinical Endocrinologists medical guidelines for clinical practice for growth hormone use in adults and children--2003 update. Endocr Pract 2003;9:64-76. http://www.ncbi.nlm.nih.gov/pubmed/12917095

High WM, Jr., Briones-Galang M, Clark JA, Gilkison C, Mossberg KA, Zgaljardic DJ, Masel BE, Urban RJ. Effect of growth hormone replacement therapy on cognition after traumatic brain injury. J Neurotrauma 2010;27:1565- 1575. PMCID 2966848 http://www.ncbi.nlm.nih.gov/pubmed/20578825

Holmes SJ, Economou G, Whitehouse RW, Adams JE, Shalet SM. Reduced bone mineral density in patients with adult onset growth hormone deficiency. J Clin Endocrinol Metab 1994;78:669-674. http://www.ncbi.nlm.nih.gov/pubmed/8126140

Jorgensen JO, Pedersen SA, Thuesen L, Jorgensen J, Moller J, Muller J, Skakkebaek NE, Christiansen JS. Long-term growth hormone treatment in growth hormone deficient adults. Acta Endocrinol (Copenh) 1991;125:449-453. http://www.ncbi.nlm.nih.gov/pubmed/1759534

Jorgensen JO, Thuesen L, Muller J, Ovesen P, Skakkebaek NE, Christiansen JS. Three years of growth hormone treatment in growth hormone-deficient adults: near normalization of body composition and physical performance. Eur J Endocrinol 1994;130:224-228. http://www.ncbi.nlm.nih.gov/pubmed/8156094

Molitch ME, Clemmons DR, Malozowski S, Merriam GR, Shalet SM, Vance ML, Stephens PA. Evaluation and treatment of adult growth hormone deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2006;91:1621-1634. http://www.ncbi.nlm.nih.gov/pubmed/16636129

Omar A, Cohen P. The Pituitary Gland and Growth Failure. In: Manual of Endocrinology and Metabolism, 4th Ed. ed, 2009: 95-105.

Rosen T, Wilhelmsen L, Landin-Wilhelmsen K, Lappas G, Bengtsson BA. Increased fracture frequency in adult patients with hypopituitarism and GH deficiency. Eur J Endocrinol 1997;137:240-245. http://www.ncbi.nlm.nih.gov/pubmed/9330587

Savage MO, Drake WM, Carroll PV, Monson JP. Transitional care of GH deficiency: when to stop GH therapy. Eur J Endocrinol 2004;151 Suppl 1:S61-65. http://www.ncbi.nlm.nih.gov/pubmed/15339246

ter Maaten JC, de Boer H, Kamp O, Stuurman L, van der Veen EA. Long-term effects of growth hormone (GH) replacement in men with childhood-onset GH deficiency. J Clin Endocrinol Metab 1999;84:2373-2380. http://www.ncbi.nlm.nih.gov/pubmed/10404806

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