title: Evaluation of hypothalamic-pituitary function in children following acute bacterial meningitis.
abstract: BACKGROUND
  Previous studies in adults and case reports in children have shown increased frequency of hypothalamo-pituitary dysfunction after infectious diseases of the central nervous system. The aim of this study was to evaluate the function of hypothalamo-pituitary axis in children with a history of bacterial meningitis.
  
  
  METHODS
  Patients diagnosed with bacterial meningitis between April 2000 and June 2011 was included. Baseline and stimulated hormonal tests were performed as required for hormonal evaluations following a diagnosis of meningitis.
  
  
  RESULTS
  Pituitary function was assessed following a period of 8-135 months (mean 53 months) after bacterial meningitis. Thirty-seven cases (27 male, 15 pubertal) with mean age of 11.1 ± 4.4 years were included. Mean height SDS was 0.01 ± 1.07 and mean BMI SDS was 0.54 ± 1.15 all patients had a SDS above -2 SD. Baseline cortisol and low dose ACTH stimulation revealed normal adrenal functions in all patients. Gonadotropin deficiency was not detected in any of the pubertal cases. Four cases (10.8%) had low IGF1 and IGFBP3 z-scores (<-2 SD) according to age, sex and Tanner stage, but peak GH response in clonidin test was >10 ng/ml in three of them suggesting neurosecretary dysfunction of GH in these cases. The fourth case has died before the test. No one had TSH deficiency and diabetes insipidus, only one case had mild hyperprolactinemia.
  
  
  CONCLUSIONS
  Our findings suggest that hypothalamo-pituitary dysfunction is not as common in childhood as in adulthood. The most remarkable finding was neurosecretary dysfunction of GH in some cases.
authors.affiliation: Department of Pediatric Infectious Disease, Faculty of Medicine, Hacettepe University, Sıhhiye, 06100, Ankara, Turkey, dredakaradag@gmail.com.
authors.forename: Eda
authors.initials: E
authors.lastname: Karadag-Oncel
authors.forename: Meltem
authors.initials: M
authors.lastname: Cakir
authors.forename: Ates
authors.initials: A
authors.lastname: Kara
authors.forename: Nazli
authors.initials: N
authors.lastname: Gonc
authors.forename: Ali Bulent
authors.initials: AB
authors.lastname: Cengiz
authors.forename: Alev
authors.initials: A
authors.lastname: Ozon
authors.forename: Ergin
authors.initials: E
authors.lastname: Ciftci
authors.forename: Ayfer
authors.initials: A
authors.lastname: Alikasifoglu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ceyhan
authors.forename: Nurgun
authors.initials: N
authors.lastname: Kandemir
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006062:Gonadotropins / Q000378:metabolism; D006801:Humans; D007018:Hypopituitarism / Q000378:metabolism / Q000503:physiopathology*; D007031:Hypothalamus / Q000378:metabolism / Q000503:physiopathology*; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000378:metabolism; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D016920:Meningitis, Bacterial / Q000378:metabolism / Q000503:physiopathology*; D010902:Pituitary Gland / Q000378:metabolism / Q000503:physiopathology*
chemical_list: D006062:Gonadotropins; C515497:IGFBP3 protein, human; D018972:Insulin-Like Growth Factor Binding Protein 3; D007334:Insulin-Like Growth Factor I