Pitfalls of diagnosing pituitary hypoplasia in the patients with short stature
Purpose Height age (HA) and bone age (BA) delay is well known in the patients with short stature. Therefore assessing pituitary hypoplasia based on chronological age (CA) might cause overdiagnosis of pituitary hypoplasia. We aimed to investigate the diagnostic and prognostic value of the PH and PV b...
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| Veröffentlicht in: | Endocrine 2024-10, Vol.86 (1), p.349-357 |
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| creator | Kiremitci Yilmaz, Seniha Yilmaz Ovali, Gülgün Ozalp Kizilay, Deniz Tarhan, Serdar Ersoy, Betul |
| description | Purpose
Height age (HA) and bone age (BA) delay is well known in the patients with short stature. Therefore assessing pituitary hypoplasia based on chronological age (CA) might cause overdiagnosis of pituitary hypoplasia. We aimed to investigate the diagnostic and prognostic value of the PH and PV based on CA, HA, or BA in the patients with GHD.
Methods
Fifty-seven patients with severe and 40 patients with partial GHD and 39 patients with ISS assigned to the study. For defining the most accurate diagnosis of pituitary hypoplasia, PH and PV were evaluated based on CA, BA and HA. The relationship of each method with clinical features was examined.
Results
The mean PV was significantly larger in patients with ISS compared to the GH-deficient patients. PV was more correlated with clinical features including height SDS, stimulated GH concentration, IGF-1 and IGFBP-3 SDS, height velocity before and after rGH therapy. We found BA-based PV could discriminate GHD from ISS (Sensitivity: 17%, specificity: 98%, positive predictive value: 94%, negative predictive value: 39%), compared to the other methods based on PH or PV respect to CA and HA. 3% of patients with ISS, 17% of patients with GHD had pituitary hypoplasia based on PV-BA.
Conclusion
PV based on BA, has the most accurate diagnostic value for defining pituitary hypoplasia. But it should be kept in mind that there might be still misdiagnosed patients by this method. PV is also a significant predictor for the rGH response. |
| doi_str_mv | 10.1007/s12020-024-03951-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11445333</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3112100018</sourcerecordid><originalsourceid>FETCH-LOGICAL-c356t-8c139265671b4fb51df6114591db791390a35b2e6721cbd8a20fdb4c05023e883</originalsourceid><addsrcrecordid>eNp9UcFO3DAQtSpQF7b9gR6QJS5cUsZ27MSnCq0KVELAoT1bTuJsjLJxsB0q_r6GbLdbDszFI703b974IfSFwFcCUJwHQoFCBjTPgElOMvkBHRHOZQYJP9jrF-g4hAcASqkoPqIFK6WQEuQRur23sdV9H7BrcWP1enDBDms82jjZqP0z7p5HN_Y6WI3tgGNn8KijNUMM-LeNHQ6d8xGHqOPkzSd0mNSC-bx9l-jX5fefq-vs5u7qx-riJqsZFzEra8IkFVwUpMrbipOmFYTkXJKmKmTCQDNeUSMKSuqqKTWFtqnyGjhQZsqSLdG3WXecqo1p6mTH616N3m6SZ-W0Vf8jg-3U2j2ptCXnLNUSnW0VvHucTIhqY0Nt-l4Pxk1BMSgELbkUIlFP31Af3OSHdJ9ihND0v0BeLNGZVXsXgjftzg0B9ZKXmvNSKS_1mpeSaehk_47dyN-AEoHNhJCgYW38v93vyP4BjTeg2A</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3112100018</pqid></control><display><type>article</type><title>Pitfalls of diagnosing pituitary hypoplasia in the patients with short stature</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Kiremitci Yilmaz, Seniha ; Yilmaz Ovali, Gülgün ; Ozalp Kizilay, Deniz ; Tarhan, Serdar ; Ersoy, Betul</creator><creatorcontrib>Kiremitci Yilmaz, Seniha ; Yilmaz Ovali, Gülgün ; Ozalp Kizilay, Deniz ; Tarhan, Serdar ; Ersoy, Betul</creatorcontrib><description>Purpose
Height age (HA) and bone age (BA) delay is well known in the patients with short stature. Therefore assessing pituitary hypoplasia based on chronological age (CA) might cause overdiagnosis of pituitary hypoplasia. We aimed to investigate the diagnostic and prognostic value of the PH and PV based on CA, HA, or BA in the patients with GHD.
Methods
Fifty-seven patients with severe and 40 patients with partial GHD and 39 patients with ISS assigned to the study. For defining the most accurate diagnosis of pituitary hypoplasia, PH and PV were evaluated based on CA, BA and HA. The relationship of each method with clinical features was examined.
Results
The mean PV was significantly larger in patients with ISS compared to the GH-deficient patients. PV was more correlated with clinical features including height SDS, stimulated GH concentration, IGF-1 and IGFBP-3 SDS, height velocity before and after rGH therapy. We found BA-based PV could discriminate GHD from ISS (Sensitivity: 17%, specificity: 98%, positive predictive value: 94%, negative predictive value: 39%), compared to the other methods based on PH or PV respect to CA and HA. 3% of patients with ISS, 17% of patients with GHD had pituitary hypoplasia based on PV-BA.
Conclusion
PV based on BA, has the most accurate diagnostic value for defining pituitary hypoplasia. But it should be kept in mind that there might be still misdiagnosed patients by this method. PV is also a significant predictor for the rGH response.</description><identifier>ISSN: 1559-0100</identifier><identifier>ISSN: 1355-008X</identifier><identifier>EISSN: 1559-0100</identifier><identifier>DOI: 10.1007/s12020-024-03951-9</identifier><identifier>PMID: 38969909</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adolescent ; Adult ; Age ; Age Determination by Skeleton ; Body Height ; Child ; Diabetes ; Dwarfism, Pituitary - diagnosis ; Endocrinology ; Female ; Growth hormones ; Human Growth Hormone - blood ; Human Growth Hormone - deficiency ; Humanities and Social Sciences ; Humans ; Hypopituitarism - diagnosis ; Hypoplasia ; Insulin-like growth factor I ; Insulin-Like Growth Factor I - analysis ; Insulin-Like Growth Factor I - metabolism ; Insulin-like growth factor-binding protein 3 ; Insulin-like growth factors ; Internal Medicine ; Male ; Medicine ; Medicine & Public Health ; multidisciplinary ; Original ; Original Article ; Pituitary ; Pituitary Gland - abnormalities ; Pituitary Gland - diagnostic imaging ; Prognosis ; Science ; Young Adult</subject><ispartof>Endocrine, 2024-10, Vol.86 (1), p.349-357</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2024 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c356t-8c139265671b4fb51df6114591db791390a35b2e6721cbd8a20fdb4c05023e883</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12020-024-03951-9$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12020-024-03951-9$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38969909$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kiremitci Yilmaz, Seniha</creatorcontrib><creatorcontrib>Yilmaz Ovali, Gülgün</creatorcontrib><creatorcontrib>Ozalp Kizilay, Deniz</creatorcontrib><creatorcontrib>Tarhan, Serdar</creatorcontrib><creatorcontrib>Ersoy, Betul</creatorcontrib><title>Pitfalls of diagnosing pituitary hypoplasia in the patients with short stature</title><title>Endocrine</title><addtitle>Endocrine</addtitle><addtitle>Endocrine</addtitle><description>Purpose
Height age (HA) and bone age (BA) delay is well known in the patients with short stature. Therefore assessing pituitary hypoplasia based on chronological age (CA) might cause overdiagnosis of pituitary hypoplasia. We aimed to investigate the diagnostic and prognostic value of the PH and PV based on CA, HA, or BA in the patients with GHD.
Methods
Fifty-seven patients with severe and 40 patients with partial GHD and 39 patients with ISS assigned to the study. For defining the most accurate diagnosis of pituitary hypoplasia, PH and PV were evaluated based on CA, BA and HA. The relationship of each method with clinical features was examined.
Results
The mean PV was significantly larger in patients with ISS compared to the GH-deficient patients. PV was more correlated with clinical features including height SDS, stimulated GH concentration, IGF-1 and IGFBP-3 SDS, height velocity before and after rGH therapy. We found BA-based PV could discriminate GHD from ISS (Sensitivity: 17%, specificity: 98%, positive predictive value: 94%, negative predictive value: 39%), compared to the other methods based on PH or PV respect to CA and HA. 3% of patients with ISS, 17% of patients with GHD had pituitary hypoplasia based on PV-BA.
Conclusion
PV based on BA, has the most accurate diagnostic value for defining pituitary hypoplasia. But it should be kept in mind that there might be still misdiagnosed patients by this method. PV is also a significant predictor for the rGH response.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age</subject><subject>Age Determination by Skeleton</subject><subject>Body Height</subject><subject>Child</subject><subject>Diabetes</subject><subject>Dwarfism, Pituitary - diagnosis</subject><subject>Endocrinology</subject><subject>Female</subject><subject>Growth hormones</subject><subject>Human Growth Hormone - blood</subject><subject>Human Growth Hormone - deficiency</subject><subject>Humanities and Social Sciences</subject><subject>Humans</subject><subject>Hypopituitarism - diagnosis</subject><subject>Hypoplasia</subject><subject>Insulin-like growth factor I</subject><subject>Insulin-Like Growth Factor I - analysis</subject><subject>Insulin-Like Growth Factor I - metabolism</subject><subject>Insulin-like growth factor-binding protein 3</subject><subject>Insulin-like growth factors</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>multidisciplinary</subject><subject>Original</subject><subject>Original Article</subject><subject>Pituitary</subject><subject>Pituitary Gland - abnormalities</subject><subject>Pituitary Gland - diagnostic imaging</subject><subject>Prognosis</subject><subject>Science</subject><subject>Young Adult</subject><issn>1559-0100</issn><issn>1355-008X</issn><issn>1559-0100</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9UcFO3DAQtSpQF7b9gR6QJS5cUsZ27MSnCq0KVELAoT1bTuJsjLJxsB0q_r6GbLdbDszFI703b974IfSFwFcCUJwHQoFCBjTPgElOMvkBHRHOZQYJP9jrF-g4hAcASqkoPqIFK6WQEuQRur23sdV9H7BrcWP1enDBDms82jjZqP0z7p5HN_Y6WI3tgGNn8KijNUMM-LeNHQ6d8xGHqOPkzSd0mNSC-bx9l-jX5fefq-vs5u7qx-riJqsZFzEra8IkFVwUpMrbipOmFYTkXJKmKmTCQDNeUSMKSuqqKTWFtqnyGjhQZsqSLdG3WXecqo1p6mTH616N3m6SZ-W0Vf8jg-3U2j2ptCXnLNUSnW0VvHucTIhqY0Nt-l4Pxk1BMSgELbkUIlFP31Af3OSHdJ9ihND0v0BeLNGZVXsXgjftzg0B9ZKXmvNSKS_1mpeSaehk_47dyN-AEoHNhJCgYW38v93vyP4BjTeg2A</recordid><startdate>20241001</startdate><enddate>20241001</enddate><creator>Kiremitci Yilmaz, Seniha</creator><creator>Yilmaz Ovali, Gülgün</creator><creator>Ozalp Kizilay, Deniz</creator><creator>Tarhan, Serdar</creator><creator>Ersoy, Betul</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20241001</creationdate><title>Pitfalls of diagnosing pituitary hypoplasia in the patients with short stature</title><author>Kiremitci Yilmaz, Seniha ; Yilmaz Ovali, Gülgün ; Ozalp Kizilay, Deniz ; Tarhan, Serdar ; Ersoy, Betul</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-8c139265671b4fb51df6114591db791390a35b2e6721cbd8a20fdb4c05023e883</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age</topic><topic>Age Determination by Skeleton</topic><topic>Body Height</topic><topic>Child</topic><topic>Diabetes</topic><topic>Dwarfism, Pituitary - diagnosis</topic><topic>Endocrinology</topic><topic>Female</topic><topic>Growth hormones</topic><topic>Human Growth Hormone - blood</topic><topic>Human Growth Hormone - deficiency</topic><topic>Humanities and Social Sciences</topic><topic>Humans</topic><topic>Hypopituitarism - diagnosis</topic><topic>Hypoplasia</topic><topic>Insulin-like growth factor I</topic><topic>Insulin-Like Growth Factor I - analysis</topic><topic>Insulin-Like Growth Factor I - metabolism</topic><topic>Insulin-like growth factor-binding protein 3</topic><topic>Insulin-like growth factors</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>multidisciplinary</topic><topic>Original</topic><topic>Original Article</topic><topic>Pituitary</topic><topic>Pituitary Gland - abnormalities</topic><topic>Pituitary Gland - diagnostic imaging</topic><topic>Prognosis</topic><topic>Science</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kiremitci Yilmaz, Seniha</creatorcontrib><creatorcontrib>Yilmaz Ovali, Gülgün</creatorcontrib><creatorcontrib>Ozalp Kizilay, Deniz</creatorcontrib><creatorcontrib>Tarhan, Serdar</creatorcontrib><creatorcontrib>Ersoy, Betul</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Endocrine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kiremitci Yilmaz, Seniha</au><au>Yilmaz Ovali, Gülgün</au><au>Ozalp Kizilay, Deniz</au><au>Tarhan, Serdar</au><au>Ersoy, Betul</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pitfalls of diagnosing pituitary hypoplasia in the patients with short stature</atitle><jtitle>Endocrine</jtitle><stitle>Endocrine</stitle><addtitle>Endocrine</addtitle><date>2024-10-01</date><risdate>2024</risdate><volume>86</volume><issue>1</issue><spage>349</spage><epage>357</epage><pages>349-357</pages><issn>1559-0100</issn><issn>1355-008X</issn><eissn>1559-0100</eissn><abstract>Purpose
Height age (HA) and bone age (BA) delay is well known in the patients with short stature. Therefore assessing pituitary hypoplasia based on chronological age (CA) might cause overdiagnosis of pituitary hypoplasia. We aimed to investigate the diagnostic and prognostic value of the PH and PV based on CA, HA, or BA in the patients with GHD.
Methods
Fifty-seven patients with severe and 40 patients with partial GHD and 39 patients with ISS assigned to the study. For defining the most accurate diagnosis of pituitary hypoplasia, PH and PV were evaluated based on CA, BA and HA. The relationship of each method with clinical features was examined.
Results
The mean PV was significantly larger in patients with ISS compared to the GH-deficient patients. PV was more correlated with clinical features including height SDS, stimulated GH concentration, IGF-1 and IGFBP-3 SDS, height velocity before and after rGH therapy. We found BA-based PV could discriminate GHD from ISS (Sensitivity: 17%, specificity: 98%, positive predictive value: 94%, negative predictive value: 39%), compared to the other methods based on PH or PV respect to CA and HA. 3% of patients with ISS, 17% of patients with GHD had pituitary hypoplasia based on PV-BA.
Conclusion
PV based on BA, has the most accurate diagnostic value for defining pituitary hypoplasia. But it should be kept in mind that there might be still misdiagnosed patients by this method. PV is also a significant predictor for the rGH response.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>38969909</pmid><doi>10.1007/s12020-024-03951-9</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Age Age Determination by Skeleton Body Height Child Diabetes Dwarfism, Pituitary - diagnosis Endocrinology Female Growth hormones Human Growth Hormone - blood Human Growth Hormone - deficiency Humanities and Social Sciences Humans Hypopituitarism - diagnosis Hypoplasia Insulin-like growth factor I Insulin-Like Growth Factor I - analysis Insulin-Like Growth Factor I - metabolism Insulin-like growth factor-binding protein 3 Insulin-like growth factors Internal Medicine Male Medicine Medicine & Public Health multidisciplinary Original Original Article Pituitary Pituitary Gland - abnormalities Pituitary Gland - diagnostic imaging Prognosis Science Young Adult |
| title | Pitfalls of diagnosing pituitary hypoplasia in the patients with short stature |
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