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Hypopituitarism in pediatric survivors of inflicted traumatic brain injury. J Neurotrauma 2014 Feb 15;31(4):321-6

Date

09/14/2013

Pubmed ID

24028400

Pubmed Central ID

PMC3922245

DOI

10.1089/neu.2013.2916

Scopus ID

2-s2.0-84893984673   19 Citations

Abstract

Endocrine dysfunction is common after accidental traumatic brain injury (TBI). Prevalence of endocrine dysfunction after inflicted traumatic brain injury (iTBI) is not known. The aim of this study was to examine endocrinopathy in children after moderate-to-severe iTBI. Children with previous iTBI (n=14) were evaluated for growth/endocrine dysfunction, including anthropometric measurements and hormonal evaluation (nocturnal growth hormone [GH], thyrotropin surge, morning and low-dose adrenocorticotropin stimulated cortisol, insulin-like growth factor 1, IGF-binding protein 3, free thyroxine, prolactin [PRL], and serum/urine osmolality). Analysis used Fisher's exact test and Wilcoxon's rank-sum test, as appropriate. Eighty-six percent of subjects had endocrine dysfunction with at least one abnormality, whereas 50% had two or more abnormalities, significantly increased compared to an estimated 2.5% with endocrine abnormality in the general population (p<0.001). Elevated prolactin was common (64%), followed by abnormal thyroid function (33%), short stature (29%), and low GH peak (17%). High prolactin was common in subjects with other endocrine abnormalities. Two were treated with thyroid hormone and 2 may require GH therapy. In conclusion, children with a history of iTBI show high risk for endocrine dysfunction, including elevated PRL and growth abnormalities. This effect of iTBI has not been well described in the literature. Larger, multi-center, prospective studies would provide more data to determine the extent of endocrine dysfunction in iTBI. We recommend that any child with a history of iTBI be followed closely for growth velocity and pubertal changes. If growth velocity is slow, PRL level and a full endocrine evaluation should be performed.

Author List

Auble BA, Bollepalli S, Makoroff K, Weis T, Khoury J, Colliers T, Rose SR

Author

Bethany Auble MD Assistant Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Brain Injuries
Child
Child Abuse
Child, Preschool
Female
Growth Disorders
Growth Hormone
Hospitalization
Human Growth Hormone
Humans
Hypopituitarism
Magnetic Resonance Imaging
Male
Pilot Projects
Pituitary Function Tests
Pituitary Hormones
Prolactin
Shaken Baby Syndrome
Survival
Thyroid Diseases
Thyroid Hormones
Tomography, X-Ray Computed