title: Measurement of height velocity is an useful marker for monitoring pituitary function in patients who had traumatic brain injury.
abstract: To assess the incidence of abnormal neuroendocrine function post-traumatic brain injuriy (TBI) in a large group of paediatric patients and its correlations with clinical parameters (Glasgow coma scale-GCS, Glasgow outcome scale-GOS, TC marshall scale, height velocity). We evaluated 70 patients [58 M, 12 F; age at the time of TBI (mean ± SEM) 8.12 ± 4.23 years] previously hospitalized for TBI at the "Regina Margherita" Hospital, in Turin and "Maggiore della Carità Hospital" in Novara, Italy, between 1998 and 2008. All patients included underwent: auxological, clinical, hormonal and biochemical assessments at recall (after at least 1 year from TBI to T0); auxological visit after 6 months (T6) and hormonal assessments at 12 months (T12) in patients with height velocity (HV) below the 25th centile. At T0, 4 cases of hypothalamus-pituitary dysfunction had been diagnosed; At T6 20/70 patients had an HV <25th centile, but no one had HV < the 3rd centile limit. At T12, among the 20 patients with HV <25th centile, in 13 patients the HV was below the 25th centile and GHRH + Arginine test has been performed. Four subjects demonstrated an impaired GH peak and were classified as GH deficiency (GHD). Of these 4 subjects, 3 subjects showed isolated GHD, while one patient showed multiple hypopituitarism presenting also secondary hypocortisolism and hypothyroidism. The GCS at admission and GOS do not correlate with the onset of hypopituitarism. A simple measurement of the height velocity at least 1 year after the TBI, is enough to recognize patients with a pituitary impairment related to GH deficiency. We suggest to follow-up paediatric population who had TBI with auxological evaluations every 6 months, limiting hormonal evaluation in patients with a reduction of height velocity below the 25th centile limit.
authors.affiliation: Pediatrics, Department of Health Science, A. Avogadro, University, Novara, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Bellone
authors.forename: S
authors.initials: S
authors.lastname: Einaudi
authors.forename: M
authors.initials: M
authors.lastname: Caputo
authors.forename: F
authors.initials: F
authors.lastname: Prodam
authors.forename: A
authors.initials: A
authors.lastname: Busti
authors.forename: S
authors.initials: S
authors.lastname: Belcastro
authors.forename: S
authors.initials: S
authors.lastname: Parlamento
authors.forename: M
authors.initials: M
authors.lastname: Zavattaro
authors.forename: F
authors.initials: F
authors.lastname: Verna
authors.forename: C
authors.initials: C
authors.lastname: Bondone
authors.forename: D
authors.initials: D
authors.lastname: Tessaris
authors.forename: V
authors.initials: V
authors.lastname: Gasco
authors.forename: G
authors.initials: G
authors.lastname: Bona
authors.forename: G
authors.initials: G
authors.lastname: Aimaretti
mesh_terms: D001827:Body Height / Q000502:physiology*; D001930:Brain Injuries / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D013006:Growth Hormone / Q000172:deficiency / Q000378:metabolism; D006801:Humans; D008297:Male; D010902:Pituitary Gland / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology*; D011446:Prospective Studies
chemical_list: D013006:Growth Hormone