Poor growth or delayed puberty in children with cerebral palsy can be symptoms of multiple pituitary hormone deficiency (MPHD), according to a recent report. If MPHD symptoms are recognized early, hormone therapy can help maximize the children’s growth, and also prevent potential complications and associated mortality.
The authors of the study presented four case reports of children with cerebral palsy, aged between 11 and 16 years old, who presented a similar clinical history.
They were all born prematurely, with only 24 to 29 weeks gestation, and were referred to the endocrinology service due to short stature in one case and delayed puberty in the other three cases.
Because the clinicians suspected a hormonal imbalance, they performed a detailed analysis of the children by either magnetic resonance imaging (MRI) of their heads to uncover any possible structural alteration that could explain the symptoms, or hormone levels quantification.
The results of this evaluation demonstrated that all four children had reduced function of their pituitary gland, also known as hypopituitarism.
The pituitary gland, also called the master gland, is responsible for the production of many important hormones. One of them is the growth hormone, which regulates growth, metabolism and body composition. Other hormones regulate major features of our bodies, such as the gonadotrophins, which are the hormones that allow the maturation of the ovaries and testes, and normal development of eggs and sperm.
For the four patients reported in the study, an early medical intervention with oral hormone therapy was enough to partially overcome the effects of hypopituitarism, allowing the children to continue growing and slowly progress through puberty.
“Our case series highlight the importance of close monitoring of growth and development in children with [cerebral palsy],” the authors wrote.
“Although, the percentage of children with [cerebral palsy] with MPHD may be small, red flags such as a height below −2 SDS (standard deviation score) [2nd centile], poor growth and an abnormal pituitary gland on MRI should prompt close monitoring for pituitary hormone deficiencies and early endocrine referral,” they concluded.