An Investigation On The Clinical Features Of Combined Pituitary Hormone Deficiency Of Children Patients

Objective Collect the medical material of outpatients and inpatients,to investigate theclinical features of combined pituitary hormone deficiency of children patients,and tosummarize the experience of the diagnosis and treatment,contributing to the practice ofPediatric Endocrinology.Methods Twenty-four cases of children of combined pituitary hormone deficiencyattended from May2010to June2012were concluded in this investigation,whosemedical materials were collected and processed,to analyze the clinical features and thetreatment effects,experience of the diagnosis and treatment obtained as well.Allreceived regular growth hormone provocative test,Thyroid function tests,Adrenal cortexfunction tests,bone age determination,pituitary MRI,blood biochemistry,and so on.Partof them were involved in gonadotropin-releasing hormone analogues provocationtest.Some cases received medicine therapy who caught main attention,some receivedsurgery,few just follows up regularly.Simple mood and feeling questionnaire werefinished respectively before and one year after medicine therapy,to discover the changeof depression after intervention.Results Of twenty-four cases,all were suffering from deficiency of at least two kinds ofpituitary hormone.Growth hormone deficiency was found in all cases,thyroidstimulating hormone deficiency in thirteen cases,adrenocorticotropic hormonedeficiency in nineteen cases.Of fifteen cases who received gonadotropin-releasinghormone analogues provocation test,thirteen was found to be with gonadotropin deficiency.Growth hormone deficiency accounted for100percentage,most of whichshown complete deficiency.Gonadotropin deficiency took up great proportion.All gaveexpression of short stature.Delayed puberty,external genital hypoplasia and mentalretardation were common as well.Eight cases provided birth asphyxia history,five birthdystocia history,three both of above,one premature birth history,one expired birthhistory.Patients’ conditions improved after hormone treatment.Pituitary crisis happenedon one case.Twelve cases of simple mood and feeling questionnaire werecollected,without statistical analysis due to scarcity of sample number.Conclusion Systematic examinations of hypothalamic-pituitary-target gland axis areneeded for those children who give the expression of short stature,to establish thediagnose of combined pituitary hormone deficiency.Those with abnormal birth historyare of greater risk of combined pituitary hormone deficiency.Patients’ conditionsimproved after hormone treatment.