Hypopituitarism induced by traumatic brain injury in the transition phase

• Published in: Journal of endocrinological investigation 2005-12, Vol.28 (11), p.984-989
• Main Authors: Aimaretti, G, Ambrosio, M R, Di Somma, C, Gasperi, M, Cannavò, S, Scaroni, C, De Marinis, L, Baldelli, R, Bona, G, Giordano, G, Ghigo, E
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Brain Injuries - blood; Brain Injuries - complications; Diabetes Insipidus - etiology; Female; Human Growth Hormone - blood; Human Growth Hormone - deficiency; Humans; Hyperprolactinemia - etiology; Hypopituitarism - diagnosis; Hypopituitarism - etiology; Insulin-Like Growth Factor I - analysis; Male; Pituitary Gland - physiopathology; Time Factors
• ISSN: 0391-4097; 1720-8386
• DOI: 10.1007/bf03345336

Traumatic brain injury (TBI) has been associated with hypopituitarism in general and GH deficiency (GHD) in particular; the consequences of this on growth and development are likely to be critical in children and adolescents in the so-called "transition phase". In order to verify the consequences of TBI on pituitary function in the transition phase, we studied a population of adolescents and young adults 3 and 12 months after brain injury [no. = 23, 9 females, 14 males; age: 16-25 yr; body mass index (BMI): 21.9 +/- 0.6 kg/m2]. At 3 months, hypopituitarism was present in 34.6%. Total, multiple and isolated deficits were present in 8.6, 4.3 and 21.7%, respectively. Diabetes insipidus (DI) was present in 8.6% patients and mild hyperprolactinemia in 4.3%. At 12 months, hypopituitarism was present in 30.3%. Total, multiple and isolated deficits were present in 8.6, 4.3 and 17.4%, respectively. DI was present in 4.3% of patients and mild hyperprolactinemia in 4.3%. Total hypopituitarism was always confirmed at retesting. Multiple and isolated hypopituitarism were confirmed in 0/1 and 2/5, respectively. Two/23 patients showed isolated hypopituitarism at 12 months only; 1 patient with isolated at 3 months showed multiple hypopituitarism at retesting. GHD and secondary hypogonadism were the most common acquired pituitary deficits. These results show the high risk of TBI-induced hypopituitarism also in the transition age. Thus it is recommended that pediatric endocrinologists follow-up pituitary function of children and adolescents after brain injuries.