1. Predictor Variables of Developing Anterior Pituitary Deficiencies in a Group of Paediatric Patients with Central Diabetes Insipidus and Langerhans Cell Histiocytosis
- Author
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Jorge Braier, Pedro Zubizarreta, Alicia Belgorosky, Lina Margarita Vega, Carmen Malossetti, and Elisa Vaiani
- Subjects
Male ,medicine.medical_specialty ,CIENCIAS MÉDICAS Y DE LA SALUD ,Adolescent ,Endocrinology, Diabetes and Metabolism ,Medicina Clínica ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Langerhans cell histiocytosis ,Pituitary Hormones, Anterior ,Risk Factors ,PITUITARY ,030225 pediatrics ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,DIABETES ,Risk factor ,Child ,HISTIOCYTOSIS ,Histiocyte ,Proportional hazards model ,business.industry ,medicine.disease ,Histiocytosis, Langerhans-Cell ,Histiocytosis ,030220 oncology & carcinogenesis ,Relative risk ,CELLS ,Pediatrics, Perinatology and Child Health ,Diabetes insipidus ,Immunology ,Female ,Medicina Critica y de Emergencia ,business ,Diabetes Insipidus - Abstract
Background: Langerhans cell histiocytosis (LCH) is a rare histiocytic disorder of unknown etiopathogenesis. Central diabetes insipidus (CDI) is the most frequent endocrine manifestation and is a known risk factor for the development of further anterior pituitary hormone deficiencies (APD). However, not all CDI patients develop APD, as observed during prolonged periods of follow-up. Aim: To find predictors of developing APD in LCH children with CDI followed in our institution. Methods: We retrospectively analysed 44 patients over a median period (quartiles) of 12.3 years (8.79-14.24). Patients were subdivided into group 1 and group 2, according to absence or presence of APD, respectively. The main variables studied were: (1) chronological age (CA) at LCH diagnosis, (2) the primary site of LCH at diagnosis: low risk (LR) and multisystemic risk organs, and (3) the presence of reactivation. Results: Multivariate Cox regression analysis showed that APD was positively associated with CA at LCH diagnosis [relative risk (RR) 1.14, p < 0.01], the LR clinical form (RR 8.6, p < 0.03), and negatively associated with the presence of reactivations (RR 0.3, p < 0.01). Conclusions: Patients with older CA at LCH diagnosis, LR clinical forms, and fewer reactivation episodes might represent a subgroup of paediatric LCH CDI patients with a higher risk of developing APD. Fil: Vaiani, Elisa. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina Fil: Malossetti, Carmen. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina Fil: Vega, Lina Margarita. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina Fil: Zubizarreta, Pedro. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina Fil: Braier, Jorge. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina Fil: Belgorosky, Alicia. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
- Published
- 2016
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