Traumatic brain injury in children and adolescents: surveillance for pituitary dysfunction.
BACKGROUND
Children who sustain traumatic brain injury (TBI) are at risk for developing hypopituitarism, of which growth hormone deficiency (GHD) is the most common manifestation.


OBJECTIVE
To determine the prevalence of GHD and associated features following TBI among children and adolescents.


METHODS
A total of 32 children and adolescents were recruited from a pediatric TBI clinic. Participants were diagnosed with GHD based on insufficient growth hormone release during both spontaneous overnight testing and following arginine/glucagon administration.


RESULTS
GHD was diagnosed in 5/32 participants (16%). Those with GHD exhibited more rapid weight gain following injury than those without GHD and had lower levels of free thyroxine and follicle-stimulating hormone. Males with GHD had lower testosterone levels.


CONCLUSIONS
GHD following TBI is common in children and adolescents, underscoring the importance of assessing for GHD, including evaluating height and weight velocities after TBI. Children and adolescents with GHD may further exhibit absence or intermediate function for other pituitary hormones.
Norwood
Kenneth W
KW
University of Virginia, Charlottesville, USA.
Deboer
Mark D
MD
Gurka
Matthew J
MJ
Kuperminc
Michelle N
MN
Rogol
Alan D
AD
Blackman
James A
JA
Wamstad
Julia B
JB
Buck
Marcia L
ML
Patrick
Peter D
PD
D000293:Adolescent; D001120:Arginine / Q000008:administration & dosage; D001930:Brain Injuries / Q000150:complications* / Q000378:metabolism; D002648:Child; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D005934:Glucagon / Q000008:administration & dosage; D019382:Human Growth Hormone / Q000172:deficiency* / Q000378:metabolism; D006801:Humans; D007018:Hypopituitarism / Q000209:etiology; D008297:Male; D010902:Pituitary Gland / Q000378:metabolism*; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D013739:Testosterone / Q000097:blood; D013974:Thyroxine / Q000097:blood; D015430:Weight Gain; D055815:Young Adult
D019382:Human Growth Hormone; D013739:Testosterone; D005640:Follicle Stimulating Hormone; D005934:Glucagon; D001120:Arginine; D013974:Thyroxine