JCRPE (Jun 2021)

Growth Hormone Treatment and Papilledema: A Prospective Pilot Study

  • Nieves Martín-Begué,
  • Eduard Mogas,
  • Charlotte Wolley Dod,
  • Silvia Alarcón,
  • María Clemente,
  • Ariadna Campos-Martorell,
  • Ana Fábregas,
  • Diego Yeste

DOI
https://doi.org/10.4274/jcrpe.galenos.2020.2020.0007
Journal volume & issue
Vol. 13, no. 2
pp. 146 – 151

Abstract

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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.

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