Korean J Pediatr Gastroenterol Nutr.  2010 Mar;13(1):51-57. 10.5223/kjpgn.2010.13.1.51.

Nonalcoholic Fatty Liver Disease in Children with Hypopituitarism

• Yoon JM
• Ko JS
• Seo JK
• Shin CH
• Yang SW
• Moon JS
• Yang HR
• Chang JY

• KMID: 1459444
• DOI: http://doi.org/10.5223/kjpgn.2010.13.1.51

Abstract

PURPOSE
It has been reported that children with hypopituitarism have features of metabolic syndrome, including obesity, impaired glucose tolerance, and dyslipidemia. The aim of this study was to investigate the clinical features and liver histology of pediatric non-alcoholic fatty liver disease (NAFLD) associated with hypopituitarism.
METHODS
We reviewed the clinical data of 11 children diagnosed with NAFLD among patients with hypopituitarism.
RESULTS
The mean age at the time of diagnosis of hypopituitarism was 10.4+/-3.2 years, and the mean age at the time of diagnosis of NAFLD was 13.1+/-2.7 years. A craniopharyngioma was the most common cause of pituitary dysfunction. At the time of diagnosis of NAFLD, 9 patients (82%) had a body mass index greater than the 85th percentile, 5 patients (45%) had elevated fasting blood glucose levels, and 9 patients (82%) had hypertriglyceridemia. The mean height SD score was significantly lower at the time of diagnosis of NAFLD than at the time of diagnosis of hypopituitarism. Of the six patients who were biopsied, one had cirrhosis, two had non-alcoholic steatohepatitis (NASH) with bridging fibrosis, two had NASH with mild portal fibrosis, and one had simple steatosis.
CONCLUSION
Children with hypopituitarism are at risk of short stature, obesity, dyslipidemia, and NAFLD. The early diagnosis of NAFLD is important in children with hypopituitarism because advanced fibrosis is common.

Keyword

Child; Fatty liver; Hypopituitarism; Obesity

MeSH Terms

Blood Glucose
Body Mass Index
Child
Craniopharyngioma
Dyslipidemias
Early Diagnosis
Fasting
Fatty Liver
Fibrosis
Glucose
Humans
Hypertriglyceridemia
Hypopituitarism
Liver
Obesity
Blood Glucose
Fatty Liver
Glucose

Figure

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  Fig. 1 Liver histologic findings show micro-nodular cirrhotic changes (A) and bridging fibrosis (B) (H&E, ×200).

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