Liver Involvement in Congenital Hypopituitarism

Indian J Pediatr. 2019 May;86(5):412-416. doi: 10.1007/s12098-018-2833-7. Epub 2019 Jan 21.

Abstract

Objective: Cholestatic jaundice in early infancy is a complex diagnostic challenge. Cholestasis caused by endocrine disease is rare and poorly recognized. The aim of this paper is to report patients with liver dysfunctions resulting from hypopituitarism.

Methods: Six patients with liver dysfunction diagnosed as hypopituitarism were studied and followed up at Uludag University Faculty of Medicine.

Results: The median age of the patients at first presentation was 2.5 mo. Three patients were diagnosed with congenital hypopituitarism at the first visit, and the other three were diagnosed during follow-up. Serum aminotransferase levels were very high in two patients and only moderately elevated in the others. Combined adrenal, thyroid, and growth hormone deficiencies were diagnosed in two patients, while remaining 4 patients had various combinations of adrenal, thyroid, and growth hormone deficiencies. Liver function abnormalities resolved between 10 d and 2 mo follow-up after hormone replacement therapy.

Conclusions: Abnormal liver biochemical test results due to hormonal deficiencies in infants should be considered in the differential diagnosis by pediatricians. Hormone replacement therapy is the basis of treatment.

Keywords: Cholestasis; Hyperbilirubinemia; Hypopituitarism.

Publication types

  • Case Reports

MeSH terms

  • Diagnosis, Differential
  • Female
  • Hormone Replacement Therapy
  • Humans
  • Hypopituitarism / complications*
  • Hypopituitarism / congenital*
  • Hypopituitarism / diagnosis
  • Hypopituitarism / physiopathology
  • Infant
  • Liver / abnormalities
  • Liver Diseases / diagnosis
  • Liver Diseases / etiology*
  • Liver Diseases / physiopathology
  • Male
  • Transaminases / blood
  • Turkey

Substances

  • Transaminases