Anterior pituitary hormone effects on hepatic functions in infants with congenital hypopituitarism

Wikrom W Karnsakul, Pairunyar Sawathiparnich, Saroj Nimkarn, Supawadee Likitmaskul, Jeerunda Santiprabhob, Prapun Aanpreung

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Background: Congenital hypopituitarism is an uncommon cause of neonatal cholestasis. Little is known about the effect of anterior pituitary hormone on hepatic functions. Methods: A retrospective review of the medical charts of eight infants with congenital hypopituitarism and neonatal cholestasis was performed. The results of endocrinological investigations, eye examinations, and magnetic resonance imaging were used to classify these infants. Results: Eight infants (4 male and 4 female; mean age, 1.7 weeks) who presented with cholestatic jaundice subsequently (mean age, 7.6 weeks) developed isolated or multiple anterior pituitary hormone deficiencies. Persistent hypoglycemia, ocular abnormalities, and microphallus were often clinical signs prompting further endocrinological and radiological investigations. Septo-optic dysplasia was prevalent, occurring in five cases. Cholestasis and hepatosplenomegaly resolved within a mean of 9.7 and 10 weeks, respectively, in the majority of cases after replacement of glucocorticoid and thyroid hormones. However, transaminase levels remained high after hormone replacement. Cortisol deficiency and hypoglycemia were noted in all cases, often following stress. Hyperlipidemia persisted in one case after the resolution of cholestasis and after corticosteroid and thyroid hormone replacement therapy. Growth hormone deficiency was not corrected due to the absence of hypoglycemia after corticosteroid hormone, an infant's age, and/or a lack of financial resources. Conclusions: In our series, it appears that glucocorticoid and thyroid hormones play a significant role in the resolution of cholestasis and hepatosplenomegaly. A persistently elevated transaminase level and hyperlipidemia after corticosteroid and thyroid hormone replacement may indicate the need for long-term follow-up and/or growth hormone therapy.

Original languageEnglish (US)
Title of host publicationAnnals of Hepatology
Pages97-103
Number of pages7
Volume6
Edition2
StatePublished - Apr 2007
Externally publishedYes

Fingerprint

Anterior Pituitary Hormones
Hypopituitarism
Cholestasis
Thyroid Hormones
Hypoglycemia
Liver
Adrenal Cortex Hormones
Transaminases
Hyperlipidemias
Glucocorticoids
Growth Hormone
Septo-Optic Dysplasia
Eye Abnormalities
Hormones
Obstructive Jaundice
Hormone Replacement Therapy
Hydrocortisone
Magnetic Resonance Imaging

Keywords

  • Cholestasis
  • Elevated transaminase levels
  • Pituitary hormone deficiency
  • Septo-optic dysplasia

ASJC Scopus subject areas

  • Hepatology

Cite this

Karnsakul, W. W., Sawathiparnich, P., Nimkarn, S., Likitmaskul, S., Santiprabhob, J., & Aanpreung, P. (2007). Anterior pituitary hormone effects on hepatic functions in infants with congenital hypopituitarism. In Annals of Hepatology (2 ed., Vol. 6, pp. 97-103)

Anterior pituitary hormone effects on hepatic functions in infants with congenital hypopituitarism. / Karnsakul, Wikrom W; Sawathiparnich, Pairunyar; Nimkarn, Saroj; Likitmaskul, Supawadee; Santiprabhob, Jeerunda; Aanpreung, Prapun.

Annals of Hepatology. Vol. 6 2. ed. 2007. p. 97-103.

Research output: Chapter in Book/Report/Conference proceedingChapter

Karnsakul, WW, Sawathiparnich, P, Nimkarn, S, Likitmaskul, S, Santiprabhob, J & Aanpreung, P 2007, Anterior pituitary hormone effects on hepatic functions in infants with congenital hypopituitarism. in Annals of Hepatology. 2 edn, vol. 6, pp. 97-103.
Karnsakul WW, Sawathiparnich P, Nimkarn S, Likitmaskul S, Santiprabhob J, Aanpreung P. Anterior pituitary hormone effects on hepatic functions in infants with congenital hypopituitarism. In Annals of Hepatology. 2 ed. Vol. 6. 2007. p. 97-103
Karnsakul, Wikrom W ; Sawathiparnich, Pairunyar ; Nimkarn, Saroj ; Likitmaskul, Supawadee ; Santiprabhob, Jeerunda ; Aanpreung, Prapun. / Anterior pituitary hormone effects on hepatic functions in infants with congenital hypopituitarism. Annals of Hepatology. Vol. 6 2. ed. 2007. pp. 97-103
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