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Korean J Pediatr 2010 July;53(7) :759-765.
Risk factor for pituitary dysfunction in children and adolescents with Rathkes cleft cysts
Han Hyuk Lim (Lim HH)1, Sei Won Yang (Yang SW)2
1Department of Pediatrics1, School of Medicine, Chungnam National University, Daejeon, Korea
2Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
Corresponding Author: Sei Won Yang ,Email:
Copyright © 2010 by The Korean Pediatric Society
Purpose : This study evaluated the clinical manifestations of and risk factors for pituitary insufficiency in children and adolescents with Rathkes cleft cysts. Methods : Forty-four patients with Rathkes cleft cysts younger than 19 years who visited Seoul National University Childrens Hospital between January 1995 and September 2009 were enrolled. Rathkes cleft cysts were confirmed histologically through an operation in 15 patients and by brain magnetic resonance imaging (MRI) in 29 patients. The clinical, hormonal, and imaging features were reviewed retrospectively. Results : The clinical presentation of symptomatic patients was as follows: headache (65%), endocrinopathy (61%), and visual disturbance (19%). Endocrinopathy included central precocious puberty (18%), diabetes insipidus (14%), general weakness (11%), and decreased growth velocity (7%). After surgery, hyperprolactinemia resolved in all patients, but growth hormone insufficiency, hypothyroidism, and diabetes insipidus did not improve. Pituitary insufficiency except gonadotropin abnormality correlated significantly with severe headache, visual disturbance, general weakness, and cystic size. Suprasellar extension of cysts and high signals in the T2-weighted image on brain MRI were related to hypothyroidism, hypocortisolism, and diabetes insipidus. Multivariable linear regression analysis showed that only general weakness was a risk factor for pituitary insufficiency (R2=0.549). Conclusion : General weakness is a risk factor for pituitary insufficiency in patients with Rathkes cleft cysts. When a patient with a Rathkes cleft cyst complains of general weakness, the clinician should evaluate pituitary function and consider surgical treatment.
Keywords: Rathkes cleft cysts | Pituitary insufficiency
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