ISSN: 1308-5727 | E-ISSN: 1308-5735
Volume: 16 Issue: 4 Year: 2024
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Abstracting & Indexing
Turkish Society for Pediatric Endocrinology and Diabetes
Growth Hormone Treatment and Papilledema: A Prospective Pilot Study [J Clin Res Pediatr Endocrinol]
J Clin Res Pediatr Endocrinol. 2021; 13(2): 146-151 | DOI: 10.4274/jcrpe.galenos.2020.2020.0007

Growth Hormone Treatment and Papilledema: A Prospective Pilot Study

Nieves Martín-Begué1, Eduard Mogas2, Charlotte Wolley Dod1, Silvia Alarcón1, María Clemente3, Ana Fábregas2, Diego Yeste3
1Hospital Universitari Vall d’Hebron, Department of Paediatric Ophthalmology, Barcelona, Spain
2Hospital Universitari Vall d’Hebron, Department of Paediatric Endocrinology, Barcelona, Spain
3Hospital Universitari Vall d’Hebron, Department of Paediatric Endocrinology, Barcelona, Spain & Universitat Autònoma de Barcelona (UAB), Barcelona, Spain & Centro de Investigación Biomédica en Red: Enfermedades Raras (CIBERER), Madrid, Spain

Objective: To investigate the incidence of pseudotumor cerebri syndrome (PTCS) in children treated with growth hormone (GH) in a paediatric hospital and to identify risk factors for this complication.
Methods: Prospective pilot study of paediatric patients treated with recombinant human GH, prescribed by the Paediatric Endocrinology Department, between February 2013 and September 2017. In all these patients, a fundus examination was performed before starting treatment and 3-4 months later.
Results: Two hundred and eighty-nine patients were included, of whom 244 (84.4%) had GH deficiency, 36 (12.5%) had short stature associated with small for gestational age, six (2.1%) had a mutation in the SHOX gene and three (1.0%) had Prader-Willi syndrome. Five (1.7%) developed papilledema, all were asymptomatic and had GH deficiency due to craniopharyngioma (n=1), polymalformative syndrome associated with hypothalamic-pituitary axis anomalies (n=2), a non-specified genetic disease with hippocampal inversion (n=1) and one with normal magnetic resonance imaging who had developed a primary PTCS years before.
Conclusion: GH treatment is a cause of PTCS. In our series, at risk patients had GH deficiency and hypothalamic-pituitary anatomic anomalies or genetic or chromosomal diseases. Fundus examination should be systematically screened in all patients in this at-risk group, irrespective of the presence or not of symptoms.

Keywords: Growth hormone treatment, pseudotumor cerebri syndrome, idiopathic intracranial hypertension, papilledema, risk factors


Manuscript Language: English
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