Pituitary function in paediatric survivors of severe traumatic brain injury.
BACKGROUND
Traumatic brain injury (TBI)-mediated hypopituitarism is an increasingly recognised problem. Paediatric survivors of TBI may be vulnerable to the possible effects of pituitary deficits as pituitary hormones control normal growth and development. Research concerning pituitary dysfunction following childhood TBI is limited.


OBJECTIVE
To identify pituitary dysfunction in paediatric survivors of severe TBI.


METHODS
Of 1020 children who sustained a TBI and were admitted to the Royal Children's Hospital, Melbourne, Australia over 10 years, 117 were identified as survivors of severe TBI. 54 patients (31 males) were enrolled and administered questionnaires regarding quality of life and possible endocrine dysfunction. Where indicated, hormone testing was performed.


RESULTS
29 of the 54 patients underwent hormonal investigations, while 21 who had satisfactory questionnaires did not (four patients had already been diagnosed with pituitary deficiencies). In those 29 patients, TBI occurred at ages ranging from 0.25 to 16.80 years (median 9.7 years). Time from TBI to study ranged from 0.9 to 8.5 years (median 4.5 years). Of the 54 patients, nine had pituitary dysfunction, of whom four had multiple pituitary hormone deficiencies.


CONCLUSIONS
Our study that confirms that paediatric survivors of severe TBI may develop pituitary dysfunction. Pituitary function should therefore be determined in these patients.
Poomthavorn
P
P
Department of Endocrinology and Diabetes, The Royal Children's Hospital, Melbourne, Australia.
Maixner
W
W
Zacharin
M
M
D000293:Adolescent; D000328:Adult; D001827:Body Height; D001835:Body Weight; D001930:Brain Injuries / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006130:Growth Disorders / Q000209:etiology; D006728:Hormones / Q000097:blood; D006801:Humans; D007018:Hypopituitarism / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D018579:Patient Selection; D010902:Pituitary Gland / Q000503:physiopathology; D010907:Pituitary Hormones / Q000172:deficiency
D006728:Hormones; D010907:Pituitary Hormones