Prognosis

Prolonged untreated hypopituitarism results in a considerable deficit in final height. Untreated children achieve final height standard deviation scores of -4 to -6.[22][23]

The long-term effects of GHD on cardiovascular morbidity and mortality are unclear. However, adults with GHD have an increased fat mass and decreased lean body and bone mass, are often overweight, and have elevated lipids. They are often low in mood with an impaired quality of life. GH treatment can reverse and reduce many of these abnormalities.[80][81] Adult bone mineral density is improved with continuous as opposed to discontinuous treatment. Therefore, in the future, treatment may be routinely recommended for adults with severe GHD.

The finding of an undescended posterior pituitary in patients with "idiopathic" isolated GHD has also been shown to be a specific marker of permanent GHD (although other studies have shown that this is not always so), and is associated with a 2-fold risk of developing combined pituitary hormone deficiencies (CPHD) as compared with isolated GHD.[82][83][84][85][86] Additionally, the absence of the pituitary stalk has been associated with CPHD as opposed to isolated GHD.[2][85] These data imply that magnetic resonance imaging may be of prognostic use in patients with isolated GHD. Patients who have GHD in association with CPHD (especially if there are ≥3 other hormone deficits) are likely to be GH deficient as adults.

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