Page 195 - Abstract Book KONIKA 18

Endocrinology

P-ENDO-037
Delayed Puberty in A Girl as A Rare Sign of Craniopharyngioma

Andina Nirmala Pahalawati, Ismi Citra Ismail, Frida Soesanti
Department of Child Health, Faculty of Medicine, Universitas Indonesia /Dr. Cipto Mangunkusumo General Hospital,
Jakarta, Indonesia
Abstract
Background Craniopharyngiomas are the most frequently encountered suprasellar tumours in children.
To date, hypopituitarism leading to a delayed puberty is a rare presentation of craniopharyngioma.
Objective To present a case of a 17-year-old girl with short stature and delayed puberty as a rare presentation
of craniopharyngioma. Case A 17 year-old-girl was referred from district hospital due to short stature and
delayed puberty. The genitalia were feminine having no ambiguity. She was a bright girl without mental
retardation. The patient was 135 cm in height and weight 24 kg. The parents was concern about her height
since she was 12 years old because she was the shortest in class. Local pediatrician referred her to nearest
obstetrician and gynecologist that stated it was normal since she had uterus from USG examination. At the
age of 16 years old, the menses have not been occured nor the sign of secondary sexual characteristics.
Another obstetrician and gynecologyst done another USG examination and said she has a small uterus and
refer her to endocrinologist as she saw her short stature. She felt severe headache, blurry vision, and repeated
vomiting for the last month. She came at our emergency unit with dehydration due to profuse vomiting. The
funduscopy examination showed no optic disk edema. The laboratory findings showed hypogonadotropic
hypogonadism, hypotirodism, and hypoprolactin (panhypopituitarism) leading to suspicion of brain tumor.
The patient had an MRI of the brain confirming definitive diagnosis of Craniopharyngioma and preoperative
planning. Brain tumor removal was done sucessfully without any sequele. The patient is in good condition,
undergo radiotherapy session for the remaining tumor. Conclusions Craniopharyngioma should be considered
in diagnosing patients with signs of hypopituitarism including delayed puberty and short stature.
Keywords: delayed puberty; craniopharyngioma; short stature; hypopituitarism

P-ENDO-038
Effect of Thiamazole on Body Weight Changes
in Children with Grave’s Disease at H. Adam Malik General Hospital Medan
Zakirin, Karina Sugih Arto, Tina Christina Lumban Tobing, Melda Deliana, Siska Mayasari Lubis
Department of Child Health, Faculty of Medicine Universitas Sumatera Utara/Haji Adam Malik General Hospital
Medan, North Sumatera, Indonesia
Abstract
Background Grave’s disease is the most common cause of hyperthyroidism in children and adolescents.
Thyroid hormones are involved in metabolic regulation and influenced nutritional status. Many studies found
the increment of body weight after Thiamazole treatment. Objective To evaluate change in body weight,
nutritional status, and thyroid profile after treatment of Thiamazole. Methods A cohort retrospective study
was performed from January 2018 until December 2020. Subject was patients with Grave’s Disease. Weight,
nutritional status and thyroid profile on 3 months after treatment and 6 months after treatment was recorded
on medical record. Patient with incomplete data was excluded.Results There were 32 patients. Majority of
subjects was girl (n=30, 93.8%) aged 6.6–17.4 years old. Patients presented in normal weight (n=11), obesity
(n=8), moderate malnutrition (n=7), overweight (n=5) and severe malnutrition (n=1). The increase of body
weight (3.7; 95%CI 3 to 4.4 kg), height (0.5; 95%CI 0.2 to 0.8 cm), body mass index (1.6; 95%CI 1. to 2
kg/m ) after 6 months treatment (P<0.01). There was a statistical significance of nutritional status improvement
2
after 6 months (P<0.01). Increment of body weight was significance based on nutritional status (P<0.05).
Changes of FT4 level was also significant (1.6; 95%CI 1.1 to 2.1 µg/dL; P<0.01) and TSH level was not
significant (P=0.075) Conclusion Treatment of Thiamazole increased body weight and nutritional status in
patients. Therefore, educational nutrition and long-term follow up should be performed.
Keywords: pediatric; Grave’s disease; thiamazole; body weight

KONIKA XVIII Abstract Book 147