Pituitary insufficiency after infectious meningitis: a prospective study.
BACKGROUND
Data from previous retrospective studies and case reports have suggested that infectious diseases of the central nervous system could cause pituitary deficiency.


OBJECTIVE
The aim of this prospective study was to investigate pituitary function in patients admitted with infectious meningitis during the acute phase and after 12 months.


METHODS
Sixteen patients were studied. Basal pituitary function was assessed within 24 h of admission. Twelve of these patients underwent both basal and stimulated (insulin tolerance test) pituitary testing after 12 months.


RESULTS
During the acute phase, five patients (31.25%) showed apparent pituitary hormone deficiencies: two patients with gonadotropic and three patients with somatotropic deficiency. The exact status of corticosteroid sufficiency could not be defined in four patients, because no dynamic test was performed in the acute phase. In addition, seven patients (44%) had probable low T(3) syndrome. At 12 months, five patients (31.25%), two with viral and three with bacterial meningitis, had at least one anterior pituitary hormone deficiency. Two patients had isolated corticotropic and one isolated somatotropic deficiency. Combined corticotropic and somatotropic deficiencies were detected in two patients. New-onset deficiencies accounted for four of those five patients, whereas one patient demonstrated persisting somatotropic deficiency. All cases of low T(3) syndrome resolved at 12 months.


CONCLUSIONS
Isolated or combined pituitary deficiencies, which could present at the acute phase and/or occur at a later stage, can develop in a considerable proportion of patients after acute infectious meningitis.
Tsiakalos
Aristotelis
A
Pathophysiology Department, Athens University Medical School, Mikras Asias 75, 11527 Athens, Greece. atsiakalos@gmail.com
Xynos
Ioannis D
ID
Sipsas
Nikolaos V
NV
Kaltsas
Gregory
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007018:Hypopituitarism / Q000175:diagnosis* / Q000209:etiology*; D008297:Male; D016920:Meningitis, Bacterial / Q000150:complications*; D008587:Meningitis, Viral / Q000150:complications*; D008875:Middle Aged; D011446:Prospective Studies