Koizumi Mikiko, Ida Shinobu, Shoji Yasuko, Etani Yuri, Hatsukawa Yoshikazu, Okamoto Nobuhiko
Department of Gastroenterology and Endocrinology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan.
Department of Ophthalmology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan.
Clin Pediatr Endocrinol. 2017;26(2):89-98. doi: 10.1297/cpe.26.89. Epub 2017 Apr 22.
A clinical diagnosis of septo-optic dysplasia (SOD) is made when two or more of the classical triad of optic nerve hypoplasia, pituitary hormone abnormalities or midline brain defects. To date, a clinical study of SOD, regarding its endocrinological features in particular, has not been undertaken in Japan. We retrospectively evaluated 14 SOD patients at our institution. Hormonal dysfunction was present in 78% of cases: ten cases presented combined hypopituitarism and one case presented precocious puberty. GHD and hypothyroidism were the most common endocrinopathies. A thin pituitary stalk and a gradual decrease in hormone secretion were the main characteristics. SOD patients usually visited ophthalmologists during early infancy because of eye problems; however, the medical examination did not always lead to endocrine assessments being made. Consequently, children who have eye problems with optic nerve hypoplasia should undergo head MRI imaging. If diagnosed with SOD, it is very important to evaluate pituitary functions. Their endocrinological status should be followed for a long time, even if they do not exhibit any endocrinological problems at evaluation.
当出现视神经发育不全、垂体激素异常或中线脑缺陷这一经典三联征中的两项或更多项时,即可做出视隔发育不良(SOD)的临床诊断。迄今为止,日本尚未开展关于SOD的临床研究,尤其是其内分泌特征方面的研究。我们对本机构的14例SOD患者进行了回顾性评估。78%的病例存在激素功能障碍:10例表现为垂体功能减退合并症,1例表现为性早熟。生长激素缺乏症(GHD)和甲状腺功能减退是最常见的内分泌疾病。垂体柄纤细和激素分泌逐渐减少是主要特征。SOD患者通常在婴儿早期因眼部问题就诊于眼科医生;然而,医学检查并不总是能促使进行内分泌评估。因此,患有视神经发育不全且有眼部问题的儿童应接受头部磁共振成像(MRI)检查。如果诊断为SOD,评估垂体功能非常重要。即使在评估时未表现出任何内分泌问题,也应长期跟踪他们的内分泌状况。