Hypopituitarism induced by traumatic brain injury in the transition phase.
Traumatic brain injury (TBI) has been associated with hypopituitarism in general and GH deficiency (GHD) in particular; the consequences of this on growth and development are likely to be critical in children and adolescents in the so-called "transition phase". In order to verify the consequences of TBI on pituitary function in the transition phase, we studied a population of adolescents and young adults 3 and 12 months after brain injury [no. = 23, 9 females, 14 males; age: 16-25 yr; body mass index (BMI): 21.9 +/- 0.6 kg/m2]. At 3 months, hypopituitarism was present in 34.6%. Total, multiple and isolated deficits were present in 8.6, 4.3 and 21.7%, respectively. Diabetes insipidus (DI) was present in 8.6% patients and mild hyperprolactinemia in 4.3%. At 12 months, hypopituitarism was present in 30.3%. Total, multiple and isolated deficits were present in 8.6, 4.3 and 17.4%, respectively. DI was present in 4.3% of patients and mild hyperprolactinemia in 4.3%. Total hypopituitarism was always confirmed at retesting. Multiple and isolated hypopituitarism were confirmed in 0/1 and 2/5, respectively. Two/23 patients showed isolated hypopituitarism at 12 months only; 1 patient with isolated at 3 months showed multiple hypopituitarism at retesting. GHD and secondary hypogonadism were the most common acquired pituitary deficits. These results show the high risk of TBI-induced hypopituitarism also in the transition age. Thus it is recommended that pediatric endocrinologists follow-up pituitary function of children and adolescents after brain injuries.
Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Turin, Turin, Italy. gianluca.aimaretti@unito.it
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G
Aimaretti
M R
MR
Ambrosio
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Di Somma
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M
Gasperi
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S
Cannavò
C
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Scaroni
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L
De Marinis
R
R
Baldelli
G
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Bona
G
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Giordano
E
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Ghigo
D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000097:blood / Q000150:complications*; D003919:Diabetes Insipidus / Q000209:etiology; D005260:Female; D019382:Human Growth Hormone / Q000097:blood / Q000172:deficiency; D006801:Humans; D006966:Hyperprolactinemia / Q000209:etiology; D007018:Hypopituitarism / Q000175:diagnosis / Q000209:etiology*; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D010902:Pituitary Gland / Q000503:physiopathology*; D013997:Time Factors
D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I