Evaluation of thyrotrophic and lactotrophic reserves in patients with pituitary dwarfism with and without empty sella turcica

ES is common in children with GHD but presents distinct features compared to adults. Central hypothyroidism (CeH) was observed in 45.6 % of patients with ES and 54.8 % without ES. Mild TSH elevation was frequent and rarely associated with anti-TPO antibodies, supporting the exclusion of primary hypothyroidism and suggesting underlying hypothalamic dysfunction. Subclinical hormonal abnormalities were also frequent among euthyroid patients. The TRH stimulation test proved valuable in distinguishing hypothalamic dysfunction from pituitary or primary hypothyroidism. Genetic testing for POU1F1 and PROP1 mutations may be warranted in selected cases with combined deficiencies.