Neurology Medical News about childhood craniopharygioma;endocrinologist;pediatrician

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Practical approach to childhood craniopharyngioma: A role of an endocrinologist and a general paediatrician
Child's Nervous System, 06/23/09

Kalina MA et al. – Management of craniopharyngioma in a single-institution study included repeat hormonal and metabolic assays in chosen time intervals, with an interdisciplinary team for early detection and management of co-morbidities.

Methods

Study of co-morbidities in pts with craniopharyngioma
Elaboration of an interdisciplinary follow-up protocol
Subjects: 15 children; median age at diagnosis, 10.1 yrs; mean follow-up period, 4 yrs
Surgical tumor resection: gross total in 7, subtotal or partial removal in 8 cases
Post-surgical radiotherapy in 10 cases for tumor residue or progression
Evaluation of sexual development and auxology at diagnosis and during follow-up
Determination of hormones by chemiluminescent immunometric assays
Diagnosis of antidiuretic hormone dysfunction by clinical symptoms, water-electrolyte balance, urine specific gravity, and serum osmolality
Assessment of metabolic control by levels of glucose, insulin, lipids, and transaminases
Homeostatic model assessment (HOMA) index for insulin resistance

Results

At diagnosis, median height standard deviation score (hSDS): -1.6 (5 children being short)
Median change hSDS for whole follow-up: 1.2 (4 children decelerating growth)
Diabetes insipidus diagnosed in 8 (within 0–1.8 yrs of follow-up), hypocorticolism in 8, and hypothyroidism in 12 subjects (within 0–3.75 yrs for both endocrinopathies)
Sex hormone replacement therapy required by 4 pts
At diagnosis, 5 overweight children
During follow-up, only 4 children sustained normal body mass index
Hypertransaminasaemia in 3, dyslipidaemia in 11, and hyperinsulinaemia in 7 pts (with elevated HOMA in 4 cases)

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