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Endocrine Function and Growth in Children with Craniopharyngioma

Journal of the Korean Pediatric Society 2003;46(3):277-283.
Published online March 15, 2003.
Endocrine Function and Growth in Children with Craniopharyngioma
Yoo Mi Chung, Choong Ho Shin, Sei Won Yang
Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
소아 두개인두종 환자에서 치료 전후의 뇌하수체 기능과 성장 및 체중 변화
정유미, 신충호, 양세원
서울대학교 의과대학 소아과학교실
Correspondence: 
Sei Won Yang, Email: growth@plaza.snu.ac.kr
Abstract
Purpose
: Craniopharyngiomas are often accompanied by severe endocrine disorders. Although there is universal growth hormone deficiency(GHD), the resulting growth pattern is very heterogeneous. We report the growth and endocrine outcome of 44 children with craniopharyngioma, with emphasis on initial symptoms, growth before and during growth hormone(GH) treatment and spontaneous growth in spite of GHD.
Methods
: We performed a retrospective study of 44 children treated at our centre between 1984 and 2002.
Results
: About 30% of patients had symptoms suggesting endocrine disorder at diagnosis. After surgery, multiple endocrinopathies were almost universal. Before GH therapy, height velocity was 8.00?.71 cm/yr in the normal growth group(n=11) and 1.79?.10 cm/yr in the subnormal growth group(n=7) during the first year and during the second year, 6.76?.49 cm/yr and 2.29?.33 cm/yr, respectively. There was no difference of body mass index(BMI) change between before and after surgery in the two groups. Height standard deviation score(SDS) was -1.46?.74 in the normal growth group and -0.43?.97 in the subnormal growth group. Before GH treatment height SDS was -1.31?.25 and BMI was 20.46?.60. During GH treatment, height SDS increased to -0.60?.37 in the first, and to -0.41?.54 in the second year(P<0.05), but BMI did not change significantly.
Conclusion
: The endocrine morbidity could develop in most children with craniopharyngioma before and after the operation and should be managed properly. Although all treated patients benefit from GH therapy, further studies are necessary to find out the possible mechanism of growth regulation in normally growing children, despite GH deficient.
Key Words: Craniopharyngioma, Endocrinopathy, Growth hormone deficiency


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