Atrium Health Navicent Children's Care Pediatric Endocrinology

Pituitary Gland Disorders

Pituitary gland disorders include conditions such as acromegaly, Cushing's syndrome, underactive thyroid or hypothyroidism and hypogonadism. While these conditions may tie back to other glands, the pituitary, as the "master gland" can affect the entire endocrine system.

Acromegaly

In children, acromegaly or overproduction of growth hormone manifests as gigantism. Without treatment, the condition results in rapid bone growth and a very tall child. Future health conditions associated with acromegaly in children can result in life-threatening and life-altering conditions, including an increased risk of heart disease, high blood pressure, diabetes, and colon polyps.

Acromegaly manifests in multiple ways other than extremely long bones. These symptoms include prominent facial bones and coarse facial features. Other symptoms include puberty delay, weakness, and deafness.

If the pituitary gland malfunction is related to a tumor, traditional surgery may correct the condition. Medication to lower growth hormone levels may be another option. These drugs work to block the level of growth hormone in the child's body. In extreme cases of surgical risk, gamma knife treatment has been effective on pituitary tumors. However, this radiation treatment has been linked to learning and emotional challenges for children following a treatment, and should only be considered as a last resort.

Cushing's Syndrome

Cushing's Syndrome is the result of an overproduction of cortisol, and can be caused by a tumor on the pituitary or adrenal gland(s). Children with Cushing's often experience growth retardation and weight gain. High blood pressure is also a concern. Over time, the syndrome can also manifest symptoms including upper body obesity, thin skin, bone and muscle weakness, and high blood sugar.

Testing will be needed to determine if the condition is related to a pituitary or an adrenal tumor. Gland removal may be an option, or medication to block the action of the hormone may suffice.

Hypothyroidism

In children, an underactive thyroid influences bone growth, mental development, and the central nervous system. If detected and treated during childhood or adolescence, hypothyroidism is quite manageable. Symptoms include cold intolerance, slow growth, and delayed tooth development. Thyroid hormone replacement can be administered orally and will need to be monitored via blood tests.

Infants with hypothyroidism are at greater risk for long-term damage if the condition is not detected and treated. A damaged or poorly formed pituitary gland can affect the functionality of the thyroid gland.

Each state has a blood test requirement for thyroid function. This test is done via heel-prick and is generally done within five days of birth. It is critical that this screening via blood is done, regardless of whether or not the child shows any physical symptoms. Brain damage can occur before other symptoms manifest, and this damage is irreversible. Thyroid hormone replacement can be administered orally to overcome the lack of hormones in the blood.

Hypogonadism

The pituitary gland is involved in the condition known as secondary hypogonadism. Primary hypogonadism relates to glandular deficiencies within the gonads themselves, including undescended testes in boys or severe infections in either sex.

Because pituitary hypogonadism can be caused by long-term use of steroids, obesity or rapid weight loss, a careful review of the child's lab work and medical history to determine hormone levels at the normal time of puberty is critical. While pubescent growth patterns can occur within a wide span of years, depending on the child, any child with a medical history of pituitary tumors, for example, may be at risk of hypogonadism. Hormone replacement therapy is critical to help the child maintain normal growth patterns.

As the "master gland," the pituitary gland can heavily impact the child's well-being from birth. Any family history of pituitary gland disorders should be discussed with your OB/GYN and intended pediatrician to confirm that all monitoring of pituitary function is undertaken as soon as safely possible for your newborn.