Supplementary Material for: Incidence and Outcomes of Pituitary Microadenomas in Children with Short Stature/Growth Hormone Deficiency

<b><i>Background/Aims:</i></b> Patients with short stature (SS)/growth hormone deficiency (GHD) and precocious puberty (PP) undergo brain MRI to evaluate for structural brain abnormalities or pituitary lesions, and pituitary microadenomas are a common finding. Theoretically, a mass effect from these lesions could cause GHD and growth hormone treatment could cause them to enlarge, but they should not cause PP, at least in females. <b><i>Methods:</i></b> We investigated if pituitary microadenomas cause GHD by comparing their incidence in patients with SS/GHD to that in females with PP. We performed a retrospective chart review of patients with these disorders who had a brain MRI between 2000 and 2013. <b><i>Results:</i></b> The incidence of microadenoma was high in both groups, 18.5% for SS (<i>n</i> = 346) and 21.1% for PP females (<i>n</i> = 194), but did not differ between groups (<i>p</i> = 0.46). In patients with microadenomas, repeat imaging showed resolution in 58% (SS, <i>n</i> = 33) and 67% (PP females, <i>n</i> = 21). Importantly, none of the lesions grew, even in patients treated with growth hormone. <b><i>Conclusions:</i></b> Pituitary microadenomas are common in children with GHD/SS and PP, but it does not appear that they are a cause of GHD. They appear to be of limited clinical significance and should not be considered a contraindication to growth hormone therapy.