Endocrine Abstracts

JOINT2524

Background: Anterior pituitary deficiencies can be isolated or combined, affecting single or multiple hormonal axes, often congenital. The clinical description varies based on the deficient hormones, and prevalence in Cameroon is not well-known.

Methodology: We conducted a retrospective descriptive study by examining 27 patient records followed at the Mother and Child Center of the Chantal Biya Foundation in Yaoundé, Cameroon. We analyzed the circumstances of discovery, anthropometric parameters during the first endocrinology consultation, the affected axes, and hormonal results when they were available. The data were recorded and analyzed using Microsoft Excel 2010.

Results: The median age of our participants was 16 [12.5–21] years, with a male predominance of 74%. In 59.3% of cases, children were brought to consultation by parents after an average symptom evolution duration of 3 [5–13] years. The reasons for consultation included short stature (78%), hypoglycemia (7.4%), and convulsions. The median age at diagnosis was 9 [1–4] years. Severe stunted growth was observed in 74% of cases, with a mean parental target height of 171 cm. Underweight was noted in 35% of cases, and severe malnutrition in 18.5% of cases. Hormonal assays were not always completed, with 37% of cases showing isolated GH deficiency and 63% showing multiple combined anterior pituitary deficiencies. The deficient axes included somatotropic (66.6%), corticotropic (22.2%), thyrotropic (25.9%), and gonadotropic (22.2%). No genetic diagnosis was made in any of the cases. Among the patients, only 33% had their cortisol levels measured, 40.7% had their FT4 levels measured, 37% had their IGF-1 levels measured, and 18.52% had their growth hormone levels measured. FSH/LH levels were measured at 18.5%, and bone age was assessed in 37%. The average bone age was 8.2 ± 3.19 years.

Conclusion: Anterior pituitary deficiencies are diagnosed late in our context. Parents raise the alarm when stunted growth is severe. In a context where hormonal assays are costly, emphasis should be placed on clinical surveillance and early warning. There is an interest in the genetic diagnosis of anterior pituitary deficiencies in our country.

Keywords: Hypopituitarism, growth delay, clinical diagnosis delay, Cameroon.