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Pituitary function in paediatric survivors of severe traumatic brain injury
  1. Preamrudee Poomthavorn (rapptv{at}mahidol.ac.th)
  1. Department of Endocrinology and Diabetes, The Royal Children’s Hospital, Melbourne, Australia
    1. Wirginia Maixner (wirginia.maixner{at}rch.org.au)
    1. Department of Neurosurgery, The Royal Children’s Hospital, Melbourne, Australia
      1. Margaret Zacharin (margaret.zacharin{at}rch.org.au)
      1. Department of Endocrinology and Diabetes, The Royal Children’s Hospital, Melbourne, Australia

        Abstract

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

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

        Patients & Methods: One hundred and seventeen of 1,020 children who sustained a TBI and were admitted to the Royal Children's Hospital, Melbourne, Australia over 10 years were identified as severe TBI survivors. Fifty-four patients (31 males) were enrolled and administered questionnaires regarding quality of life and possible endocrine dysfunction. Where indicated, hormone testing was performed.

        Results: Twenty-nine of 54 patients underwent hormonal investigations while 21 patients who had satisfactory replied questionnaires did not. Four patients were already diagnosed with pituitary deficiencies. Of those 29 patients, TBI occurred at ages 0.25-16.80 years (median 9.7 years). Time from TBI to study ranged from 0.9-8.5 years (median 4.5 years). There were 9 of 54 patients with pituitary dysfunction, four with multiple pituitary hormone deficiencies.

        Conclusions: Our study confirms the possibility of developing pituitary dysfunction in paediatric survivors of severe traumatic brain injury. Pituitary function should be determined in these patients.

        • Growth hormone deficiency
        • Hypopituitarism
        • Traumatic brain injury

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