THE ENDOCRINE EVALUATION OF THREE CHILDREN WITH VASOMOTOR FLUSHES FOLLOWING

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Abstract
Although vasomotor instability or hot flushes are a well-known occurrence in women with natural or artificially-induced menopause, they have not previously been described in children. Three children in different stages of puberty who developed vasomotor instability following surgery involving the hypothalamic-pituitary region are reprted. One, a 16 7/12 yr old female with Tanner III breast development, had low estradiol levels both pre- and post-operatively, but developed vasomotor symptoms only in the post-operative period. The 2nd, a 12 4/12 yr old boy, was sexually mature and had normal male levels of testosterone and total estrogen when he developed hot flushes post-operatively. The 3rd case, a boy, was prepubertal at the time of craniopharyngioma resection. The conclusion that neither estrogen deficiency nor gonadotropin excess are absolute requirements for the development of hot flushes was supported. It is possible that either pressure-related factors or actual manipulation of the hypothalamic-pituitary region result in biochemical changes which result in the development of post-operative vasomotor instability in these children.