Growth Hormone Treatment and Papilledema: A Prospective Pilot Study

Özet

Objective: To investigate the incidence of pseudotumor cerebri syndrome (PTCS) in children treated with growth hormone (GH) in apaediatric 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 EndocrinologyDepartment, between February 2013 and September 2017. In all these patients, a fundus examination was performed before startingtreatment 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 statureassociated 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), polymalformativesyndrome 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 anatomicanomalies or genetic or chromosomal diseases. Fundus examination should be systematically screened in all patients in this at-riskgroup, irrespective of the presence or not of symptoms.