Three years prospective investigation of anterior pituitary function after traumatic brain injury: a pilot study.
OBJECTIVE
It has been recently demonstrated that traumatic brain injury (TBI)-mediated hypopituitarism could be more frequent than previously known. However, most of the previous data were obtained from retrospective studies, and the natural history of the hypopituitarism due to TBI is still unclear. So far no study has been reported in which the pituitary function of the same patients has been investigated more than 1 year after TBI. Therefore, we report the results of 3 years prospective follow-up of anterior pituitary function in patients with mild, moderate and severe TBI.


METHODS
Thirty patients (25 males, 5 females; age 37.2 +/- 2.4 years) with TBI were included in the study. Pituitary function was evaluated at 1 and 3 years after TBI.


RESULTS
After individual evaluation of GH deficiency from 1 year to 3 years after TBI, 7 of 13 (53.8%) GH-deficient patients at 1st year recovered after 3 years of TBI, and GH deficiency detected at 3 years in one patient was new onset. Additionally, five of six (83.3%) ACTH-deficient patients at 1st year recovered after 3 years of TBI, and ACTH deficiency detected at 3 years in one patient was new onset.


CONCLUSIONS
GH deficiency is the most common pituitary deficit 1 and 3 years after TBI. In patients with mild and moderate TBI, pituitary function improves over time in a considerable number of patients, but it may also worsen rarely over the 3-year period. In patients with severe TBI, ACTH and GH deficiencies at 1st year evaluation persist at 3rd year.
Tanriverdi
Fatih
F
Department of Endocrinology, Erciyes University Medical School, Kayseri, Turkey.
Ulutabanca
Halil
H
Unluhizarci
Kursad
K
Selcuklu
Ahmet
A
Casanueva
Felipe F
FF
Kelestimur
Fahrettin
F
D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D001930:Brain Injuries / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D007018:Hypopituitarism / Q000097:blood / Q000209:etiology*; D008297:Male; D010865:Pilot Projects; D010903:Pituitary Gland, Anterior / Q000293:injuries* / Q000503:physiopathology*; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors
D019382:Human Growth Hormone; D000324:Adrenocorticotropic Hormone