Original articles

Pituitary function in paediatric survivors of severe traumatic brain injury

P Poomthavorn^1,2, W Maixner³, M Zacharin¹

¹ Department of Endocrinology and Diabetes, The Royal Children’s Hospital, Melbourne, Australia
² Division of Endocrinology and Metabolism, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand
³ Department of Neurosurgery, The Royal Children’s Hospital, Melbourne, Australia

Dr Margaret Zacharin, Department of Endocrinology and Diabetes, The Royal Children’s Hospital, Parkville, Victoria 3052, Australia; margaret.zacharin{at}rch.org.au

Background: Traumatic brain injury (TBI)-mediated hypopituitarism is an increasingly recognised problem. Paediatric survivors of TBI may be vulnerable to the possible effects of pituitary deficits as pituitary hormones control normal growth and development. Research concerning pituitary dysfunction following childhood TBI is limited.

Aim: To identify pituitary dysfunction in paediatric survivors of severe TBI.

Methods: Of 1020 children who sustained a TBI and were admitted to the Royal Children’s Hospital, Melbourne, Australia over 10 years, 117 were identified as survivors of severe TBI. 54 patients (31 males) were enrolled and administered questionnaires regarding quality of life and possible endocrine dysfunction. Where indicated, hormone testing was performed.

Results: 29 of the 54 patients underwent hormonal investigations, while 21 who had satisfactory questionnaires did not (four patients had already been diagnosed with pituitary deficiencies). In those 29 patients, TBI occurred at ages ranging from 0.25 to 16.80 years (median 9.7 years). Time from TBI to study ranged from 0.9 to 8.5 years (median 4.5 years). Of the 54 patients, nine had pituitary dysfunction, of whom four had multiple pituitary hormone deficiencies.

Conclusions: Our study that confirms that paediatric survivors of severe TBI may develop pituitary dysfunction. Pituitary function should therefore be determined in these patients.

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This article has been cited by other articles:

• Moon, R J, Wilson, P, Kirkham, F J, Davies, J H (2009). Growth monitoring following traumatic brain injury. Arch. Dis. Child. 94: 699-701 [Abstract] [Full Text]  
• Acerini, C. L (2008). Head-injury-induced pituitary dysfunction. An old curiosity rediscovered. Arch. Dis. Child. 93: 364-365 [Full Text]