{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T01:02:19Z","timestamp":1781571739518,"version":"3.54.5"},"reference-count":78,"publisher":"Walter de Gruyter GmbH","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,7,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec id=\"j_jpem-2019-0075_s_999\">\n<jats:title id=\"d3356547e56254\">Background<\/jats:title>\n<jats:p>Persistent hypoglycemia (PH) beyond 3 days of life warrants investigation which includes a critical sample. We report our case series of five neonates who presented with PH as the first sign of congenital hypopituitarism.<\/jats:p><\/jats:sec>\n<jats:sec id=\"j_jpem-2019-0075_s_998\">\n<jats:title id=\"d3356547e56262\">Design<\/jats:title>\n<jats:p>This is a case series.<\/jats:p><\/jats:sec>\n<jats:sec id=\"j_jpem-2019-0075_s_997\">\n<jats:title id=\"d3356547e56270\">Methods\/Results<\/jats:title>\n<jats:p>This is a case series of five neonates evaluated at our academic institution in a 3-year period (2013\u20132016), who presented with persistent severe hypoglycemia and were subsequently diagnosed with congenital hypopituitarism. All neonates were full term (mean gestational age 39.8\u2009\u00b1\u20091.4 weeks) born by caesarian section with a mean weight of 3.5\u2009\u00b1\u20090.16 kg and a mean length of 51.2\u2009\u00b1\u20091.2 cm at birth. All five neonates had PH beyond 3 days with an average blood glucose (BG) &lt;35 mg\/dL at presentation, requiring a mean glucose infusion rate (GIR) of 7.22\u2009\u00b1\u20091.98 mg\/kg\/min. The average BG during the critical sample was 42\u2009\u00b1\u20090.16 mg\/dL (three patients). The mean duration of requirement of the glucose infusion was 6.2\u2009\u00b1\u20093 days during the immediate neonatal period. Diagnosis of the hypopituitarism took 2\u201352 days from the initial presentation of hypoglycemia. Besides growth hormone (GH) deficiency, cortisol deficiency was diagnosed in all the five neonates. Neuroimaging findings in all the neonates were consistent with pituitary stalk interruption syndrome (hypoplastic anterior pituitary, ectopic posterior pituitary [EPP] and interrupted pituitary stalk).<\/jats:p><\/jats:sec>\n<jats:sec id=\"j_jpem-2019-0075_s_996\">\n<jats:title id=\"d3356547e56278\">Conclusions<\/jats:title>\n<jats:p>Hypoglycemia is a common metabolic complication affecting an infant in the immediate neonatal period. Delay in the diagnosis of hypopituitarism presenting as hypoglycemia is the result of the lack of awareness among neonatologists and\/or pediatricians. We propose that providers be cognizant that PH can be the only presentation of hypopituitarism in the neonatal period. Therefore, having a high index of suspicion about this condition can avoid a delay in the evaluation, diagnosis and treatment of hypopituitarism.<\/jats:p><\/jats:sec>","DOI":"10.1515\/jpem-2019-0075","type":"journal-article","created":{"date-parts":[[2019,6,18]],"date-time":"2019-06-18T09:03:13Z","timestamp":1560848593000},"page":"767-774","source":"Crossref","is-referenced-by-count":17,"title":["Severe, persistent neonatal hypoglycemia as a presenting feature in patients with congenital hypopituitarism: a review of our case series"],"prefix":"10.1515","volume":"32","author":[{"given":"Shilpa","family":"Mehta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Preneet Cheema","family":"Brar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","reference":[{"key":"ref701","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.jpeds.2018.05.009","article-title":"Reduced hepatocellular expression of canalicular transport proteins in infants with neonatal cholestasis and congenital hypopituitarism","volume":"200","year":"2018","journal-title":"J Pediatr"},{"key":"ref291","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1056\/NEJM196801112780201","article-title":"Growth and growth hormone. II. A comparison of isolated growth-hormone deficiency and multiple pituitary-hormone deficiencies in 35 patients with idiopathic hypopituitary dwarfism","volume":"278","year":"1968","journal-title":"N Engl J Med"},{"key":"ref491","first-page":"7","article-title":"[Clinical and genetic aspects of combined pituitary hormone deficiencies]","volume":"69","year":"2008","journal-title":"Ann Endocrinol"},{"key":"ref371","first-page":"2333794x14563385","article-title":"Repeating ACTH stimulation test is necessary to diagnose ACTH deficiency in neonatal hypopituitarism with initial false negative result","volume":"1","year":"2014","journal-title":"Glob Pediatr Health"},{"key":"ref611","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1111\/j.1365-2265.2005.02215.x","article-title":"An update on the biochemical diagnosis of congenital ACTH insufficiency","volume":"62","year":"2005","journal-title":"Clin Endocrinol"},{"key":"ref431","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1016\/j.jpeds.2009.06.044","article-title":"Knowledge gaps and research needs for understanding and treating neonatal hypoglycemia: workshop report from Eunice Kennedy Shriver National Institute of Child Health and Human Development","volume":"155","year":"2009","journal-title":"J Pediatr"},{"key":"ref451","doi-asserted-by":"crossref","first-page":"1520","DOI":"10.1016\/j.jpeds.2015.02.045","article-title":"Re-evaluating \u201ctransitional neonatal hypoglycemia\u201d: mechanism and implications for management","volume":"166","year":"2015","journal-title":"J Pediatr"},{"key":"ref731","first-page":"695","article-title":"The course of neonatal cholestasis in congenital combined pituitary hormone deficiency","volume":"20","year":"2007","journal-title":"J Pediatr Endocrinol Metab"},{"key":"ref661","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1016\/S0022-3476(63)80229-2","article-title":"Hypoglycemia, growth retardation, and probable isolated growth hormone deficiency in a 1-year-old child","volume":"63","year":"1963","journal-title":"J Pediatr"},{"key":"ref111","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1016\/j.earlhumdev.2009.08.057","article-title":"Genetic forms of hypopituitarism and their manifestation in the neonatal period","volume":"85","year":"2009","journal-title":"Early Hum Dev"},{"key":"ref201","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.clp.2017.10.007","article-title":"Hyperinsulinism in the neonate","volume":"45","year":"2018","journal-title":"Clin Perinatol"},{"key":"ref601","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.clp.2017.10.007","article-title":"Hyperinsulinism in the neonate","volume":"45","year":"2018","journal-title":"Clin Perinatol"},{"key":"ref631","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1097\/MED.0000000000000027","article-title":"Update on neonatal hypoglycemia","volume":"21","year":"2014","journal-title":"Curr Opin Endocrinol Diab Obes"},{"key":"ref741","first-page":"921","article-title":"Congenital hypopituitarism: clinico-radiological correlation","volume":"22","year":"2009","journal-title":"J Pediatr Endocrinol Metab"},{"key":"ref81","first-page":"325","article-title":"Congenital absence of hypoplasia of the endocrine glands","volume":"17","year":"1969","journal-title":"J Genet Hum"},{"key":"ref621","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1210\/jc.2015-1710","article-title":"Diagnosis and treatment of primary adrenal insufficiency: an endocrine society clinical practice guideline","volume":"101","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"ref761","first-page":"313","article-title":"Whole arm deletions of 18p: medical and developmental effects","volume":"167a","year":"2015","journal-title":"Am J Med Genet A"},{"key":"ref51","doi-asserted-by":"crossref","first-page":"1520","DOI":"10.1016\/j.jpeds.2015.02.045","article-title":"Re-evaluating \u201ctransitional neonatal hypoglycemia\u201d: mechanism and implications for management","volume":"166","year":"2015","journal-title":"J Pediatr"},{"key":"ref361","first-page":"313","article-title":"Whole arm deletions of 18p: medical and developmental effects","volume":"167a","year":"2015","journal-title":"Am J Med Genet A"},{"key":"ref651","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1038\/jp.2015.125","article-title":"Neonatal hypoglycemia: is 60 the new 40? The questions remain the same","volume":"36","year":"2016","journal-title":"J Perinatol"},{"key":"ref571","first-page":"918","article-title":"Hypoglycemia in hypopituitary children","volume":"129","year":"1975","journal-title":"Am J Dis Child (1960)"},{"key":"ref311","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1016\/0002-9343(65)90127-0","article-title":"An evaluation of seventy-five patients with hypopituitarism beginning in childhood","volume":"38","year":"1965","journal-title":"Am J Med"},{"key":"ref321","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1016\/S0022-3476(86)80276-1","article-title":"Detection of congenital hypopituitary hypothyroidism: ten-year experience in the Northwest Regional Screening Program","volume":"109","year":"1986","journal-title":"J Pediatr"},{"key":"ref71","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1007\/s40618-014-0139-9","article-title":"Diagnostic pitfalls in the assessment of congenital hypopituitarism","volume":"37","year":"2014","journal-title":"J Endocrinol Invest"},{"key":"ref131","doi-asserted-by":"crossref","first-page":"e20","DOI":"10.4081\/pr.2011.e20","article-title":"Three Japanese patients with congenital pituitary hormone deficiency and ophthalmological anomalies","volume":"3","year":"2011","journal-title":"Pediatr Rep"},{"key":"ref561","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1542\/peds.2010-3851","article-title":"Postnatal glucose homeostasis in late-preterm and term infants","volume":"127","year":"2011","journal-title":"Pediatrics"},{"key":"ref251","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1038\/jp.2015.125","article-title":"Neonatal hypoglycemia: is 60 the new 40? The questions remain the same","volume":"36","year":"2016","journal-title":"J Perinatol"},{"key":"ref21","volume-title":"Merenstein & Gardner\u2019s Handbook of Neonatal Intensive Care","year":"2002"},{"key":"ref551","doi-asserted-by":"crossref","first-page":"3715","DOI":"10.1210\/jc.2003-030137","article-title":"Spontaneous hypoglycemia in childhood is accompanied by paradoxically low serum growth hormone and appropriate cortisol counter regulatory hormonal responses","volume":"88","year":"2003","journal-title":"J Clin Endocrinol Metab"},{"key":"ref181","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/S0022-3476(73)80006-X","article-title":"Islet cell function and glucose homeostasis in hypopituitary dwarfism: synergism between growth hormone and cortisone","volume":"82","year":"1973","journal-title":"J Pediatr"},{"key":"ref541","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1126\/science.140.3570.987","article-title":"Hypoglycemia: a potent stimulus to secretion of growth hormone","volume":"140","year":"1963","journal-title":"Science (New York, NY)"},{"key":"ref211","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1111\/j.1365-2265.2005.02215.x","article-title":"An update on the biochemical diagnosis of congenital ACTH insufficiency","volume":"62","year":"2005","journal-title":"Clin Endocrinol"},{"key":"ref261","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1016\/S0022-3476(63)80229-2","article-title":"Hypoglycemia, growth retardation, and probable isolated growth hormone deficiency in a 1-year-old child","volume":"63","year":"1963","journal-title":"J Pediatr"},{"key":"ref581","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/S0022-3476(73)80006-X","article-title":"Islet cell function and glucose homeostasis in hypopituitary dwarfism: synergism between growth hormone and cortisone","volume":"82","year":"1973","journal-title":"J Pediatr"},{"key":"ref711","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1016\/0002-9343(65)90127-0","article-title":"An evaluation of seventy-five patients with hypopituitarism beginning in childhood","volume":"38","year":"1965","journal-title":"Am J Med"},{"key":"ref191","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1210\/jcem-42-5-846","article-title":"The role of growth hormone and cortisone on glucose and gluconeogenic substrate regulation in fasted hypopituitary children","volume":"42","year":"1976","journal-title":"J Clin Endocrinol Metab"},{"key":"ref271","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.1016\/j.jpeds.2013.04.048","article-title":"50 Years ago in The Journal of Pediatrics: hypoglycemia, growth retardation, and probable isolated growth hormone deficiency in a 1-year-old child","volume":"163","year":"2013","journal-title":"J Pediatr"},{"key":"ref01","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1542\/peds.105.5.1141","article-title":"Controversies regarding definition of neonatal hypoglycemia: suggested operational thresholds","volume":"105","year":"2000","journal-title":"Pediatrics"},{"key":"ref61","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/j.jpeds.2015.03.057","article-title":"Recommendations from the Pediatric Endocrine Society for Evaluation and Management of Persistent Hypoglycemia in Neonates, Infants, and Children","volume":"167","year":"2015","journal-title":"J Pediatr"},{"key":"ref471","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1007\/s40618-014-0139-9","article-title":"Diagnostic pitfalls in the assessment of congenital hypopituitarism","volume":"37","year":"2014","journal-title":"J Endocrinol Invest"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1016\/j.jpeds.2012.05.022","article-title":"Incidence of neonatal hypoglycemia in babies identified as at risk","volume":"161","year":"2012","journal-title":"J Pediatr"},{"key":"ref671","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.1016\/j.jpeds.2013.04.048","article-title":"50 Years ago in The Journal of Pediatrics: hypoglycemia, growth retardation, and probable isolated growth hormone deficiency in a 1-year-old child","volume":"163","year":"2013","journal-title":"J Pediatr"},{"key":"ref151","doi-asserted-by":"crossref","first-page":"3715","DOI":"10.1210\/jc.2003-030137","article-title":"Spontaneous hypoglycemia in childhood is accompanied by paradoxically low serum growth hormone and appropriate cortisol counter regulatory hormonal responses","volume":"88","year":"2003","journal-title":"J Clin Endocrinol Metab"},{"key":"ref421","volume-title":"Merenstein & Gardner\u2019s Handbook of Neonatal Intensive Care","year":"2002"},{"key":"ref641","first-page":"S7","article-title":"Neonatal hypoglycemia 30 years later: does it injure the brain? Historical summary and present challenges","volume":"39","year":"1997","journal-title":"Acta Paediatr Japon: Overseas Ed"},{"key":"ref231","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1097\/MED.0000000000000027","article-title":"Update on neonatal hypoglycemia","volume":"21","year":"2014","journal-title":"Curr Opin Endocrinol Diab Obes"},{"key":"ref771","first-page":"2333794x14563385","article-title":"Repeating ACTH stimulation test is necessary to diagnose ACTH deficiency in neonatal hypopituitarism with initial false negative result","volume":"1","year":"2014","journal-title":"Glob Pediatr Health"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1016\/j.jpeds.2009.06.044","article-title":"Knowledge gaps and research needs for understanding and treating neonatal hypoglycemia: workshop report from Eunice Kennedy Shriver National Institute of Child Health and Human Development","volume":"155","year":"2009","journal-title":"J Pediatr"},{"key":"ref241","first-page":"S7","article-title":"Neonatal hypoglycemia 30 years later: does it injure the brain? Historical summary and present challenges","volume":"39","year":"1997","journal-title":"Acta Paediatr Japon: Overseas Ed"},{"key":"ref121","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1007\/BF03345541","article-title":"Congenital adenohypophysis aplasia: clinical features and analysis of the transcriptional factors for embryonic pituitary development","volume":"29","year":"2006","journal-title":"J Endocrinol Invest"},{"key":"ref331","first-page":"695","article-title":"The course of neonatal cholestasis in congenital combined pituitary hormone deficiency","volume":"20","year":"2007","journal-title":"J Pediatr Endocrinol Metab"},{"key":"ref461","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/j.jpeds.2015.03.057","article-title":"Recommendations from the Pediatric Endocrine Society for Evaluation and Management of Persistent Hypoglycemia in Neonates, Infants, and Children","volume":"167","year":"2015","journal-title":"J Pediatr"},{"key":"ref161","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1542\/peds.2010-3851","article-title":"Postnatal glucose homeostasis in late-preterm and term infants","volume":"127","year":"2011","journal-title":"Pediatrics"},{"key":"ref441","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1016\/j.jpeds.2012.05.022","article-title":"Incidence of neonatal hypoglycemia in babies identified as at risk","volume":"161","year":"2012","journal-title":"J Pediatr"},{"key":"ref781","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1530\/eje.1.01911","article-title":"Evaluation of adrenal function in patients with growth hormone deficiency and hypothalamic-pituitary disorders: comparison between insulin-induced hypoglycemia, low-dose ACTH, standard ACTH and CRH stimulation tests","volume":"152","year":"2005","journal-title":"Eur J Endocrinol"},{"key":"ref281","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.clp.2017.11.001","article-title":"Congenital hypopituitarism","volume":"45","year":"2018","journal-title":"Clin Perinatol"},{"key":"ref221","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1210\/jc.2015-1710","article-title":"Diagnosis and treatment of primary adrenal insufficiency: an endocrine society clinical practice guideline","volume":"101","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"ref381","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1530\/eje.1.01911","article-title":"Evaluation of adrenal function in patients with growth hormone deficiency and hypothalamic-pituitary disorders: comparison between insulin-induced hypoglycemia, low-dose ACTH, standard ACTH and CRH stimulation tests","volume":"152","year":"2005","journal-title":"Eur J Endocrinol"},{"key":"ref301","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.jpeds.2018.05.009","article-title":"Reduced hepatocellular expression of canalicular transport proteins in infants with neonatal cholestasis and congenital hypopituitarism","volume":"200","year":"2018","journal-title":"J Pediatr"},{"key":"ref481","first-page":"325","article-title":"Congenital absence of hypoplasia of the endocrine glands","volume":"17","year":"1969","journal-title":"J Genet Hum"},{"key":"ref591","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1210\/jcem-42-5-846","article-title":"The role of growth hormone and cortisone on glucose and gluconeogenic substrate regulation in fasted hypopituitary children","volume":"42","year":"1976","journal-title":"J Clin Endocrinol Metab"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/j.pedneo.2016.12.002","article-title":"Retrospective evaluation of a national guideline to prevent neonatal hypoglycemia","volume":"58","year":"2017","journal-title":"Pediat Neonatol"},{"key":"ref751","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1007\/s00247-012-2349-7","article-title":"A retrospective review of pituitary MRI findings in children on growth hormone therapy","volume":"42","year":"2012","journal-title":"Pediatr Radiol"},{"key":"ref391","first-page":"138","article-title":"Hypopituitarism oddities: congenital causes","volume":"68","year":"2007","journal-title":"Horm Res"},{"key":"ref401","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1542\/peds.105.5.1141","article-title":"Controversies regarding definition of neonatal hypoglycemia: suggested operational thresholds","volume":"105","year":"2000","journal-title":"Pediatrics"},{"key":"ref521","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1007\/BF03345541","article-title":"Congenital adenohypophysis aplasia: clinical features and analysis of the transcriptional factors for embryonic pituitary development","volume":"29","year":"2006","journal-title":"J Endocrinol Invest"},{"key":"ref141","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1126\/science.140.3570.987","article-title":"Hypoglycemia: a potent stimulus to secretion of growth hormone","volume":"140","year":"1963","journal-title":"Science (New York, NY)"},{"key":"ref681","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.clp.2017.11.001","article-title":"Congenital hypopituitarism","volume":"45","year":"2018","journal-title":"Clin Perinatol"},{"key":"ref791","first-page":"138","article-title":"Hypopituitarism oddities: congenital causes","volume":"68","year":"2007","journal-title":"Horm Res"},{"key":"ref351","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1007\/s00247-012-2349-7","article-title":"A retrospective review of pituitary MRI findings in children on growth hormone therapy","volume":"42","year":"2012","journal-title":"Pediatr Radiol"},{"key":"ref721","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1016\/S0022-3476(86)80276-1","article-title":"Detection of congenital hypopituitary hypothyroidism: ten-year experience in the Northwest Regional Screening Program","volume":"109","year":"1986","journal-title":"J Pediatr"},{"key":"ref691","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1056\/NEJM196801112780201","article-title":"Growth and growth hormone. II. A comparison of isolated growth-hormone deficiency and multiple pituitary-hormone deficiencies in 35 patients with idiopathic hypopituitary dwarfism","volume":"278","year":"1968","journal-title":"N Engl J Med"},{"key":"ref91","first-page":"7","article-title":"[Clinical and genetic aspects of combined pituitary hormone deficiencies]","volume":"69","year":"2008","journal-title":"Ann Endocrinol"},{"key":"ref171","first-page":"918","article-title":"Hypoglycemia in hypopituitary children","volume":"129","year":"1975","journal-title":"Am J Dis Child (1960)"},{"key":"ref341","first-page":"921","article-title":"Congenital hypopituitarism: clinico-radiological correlation","volume":"22","year":"2009","journal-title":"J Pediatr Endocrinol Metab"},{"key":"ref411","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/j.pedneo.2016.12.002","article-title":"Retrospective evaluation of a national guideline to prevent neonatal hypoglycemia","volume":"58","year":"2017","journal-title":"Pediat Neonatol"},{"key":"ref531","doi-asserted-by":"crossref","first-page":"e20","DOI":"10.4081\/pr.2011.e20","article-title":"Three Japanese patients with congenital pituitary hormone deficiency and ophthalmological anomalies","volume":"3","year":"2011","journal-title":"Pediatr Rep"},{"key":"ref511","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1016\/j.earlhumdev.2009.08.057","article-title":"Genetic forms of hypopituitarism and their manifestation in the neonatal period","volume":"85","year":"2009","journal-title":"Early Hum Dev"}],"container-title":["Journal of Pediatric Endocrinology and Metabolism"],"original-title":[],"link":[{"URL":"http:\/\/www.degruyter.com\/view\/j\/jpem.2019.32.issue-7\/jpem-2019-0075\/jpem-2019-0075.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2019-0075\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,22]],"date-time":"2021-04-22T01:45:40Z","timestamp":1619055940000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2019-0075\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7,26]]},"references-count":78,"journal-issue":{"issue":"7"},"URL":"https:\/\/doi.org\/10.1515\/jpem-2019-0075","relation":{},"ISSN":["2191-0251","0334-018X"],"issn-type":[{"value":"2191-0251","type":"electronic"},{"value":"0334-018X","type":"print"}],"subject":[],"published":{"date-parts":[[2019,7,26]]}}}