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Traumatic brain injury is a rarely reported cause of growth hormone deficiency

Anna McDonald1, Margaretha Lindell, David B Dunger

  • 1Department of Pediatrics, University of Cambridge, Cambridge, UK.

The Journal of Pediatrics
|March 19, 2008
PubMed

Insights

Traumatic brain injury (TBI) can cause growth hormone deficiency (GHD) in children. This study found TBI-related GHD is likely underdiagnosed, with affected children showing distinct clinical features compared to idiopathic GHD.

Area of Science:

  • Pediatric Endocrinology
  • Neuroendocrinology
  • Childhood Growth Disorders

Background:

  • Growth hormone deficiency (GHD) impacts childhood development.
  • Traumatic brain injury (TBI) is a potential, yet often overlooked, cause of GHD.
  • Idiopathic growth hormone deficiency (IGHD) is the most common diagnosis.

Purpose of the Study:

  • To determine the frequency of TBI-related GHD in a large cohort of GHD patients.
  • To compare the clinical characteristics of children with TBI-induced GHD versus IGHD.

Main Methods:

  • Retrospective analysis of a large registry of growth hormone-deficient subjects.
  • Comparison of clinical data between TBI-induced GHD (n=141) and IGHD (n=23,722) cohorts.
  • Analysis of patient demographics, height velocity, and pituitary hormone deficiencies.

Main Results:

  • TBI-induced GHD was found to be significantly less frequent in the registry compared to IGHD.
  • Children with TBI-induced GHD were older at treatment onset and had lower baseline height velocity.
  • TBI-induced GHD patients exhibited more pituitary hormone deficiencies and a greater response in height velocity to recombinant human GH treatment.

Conclusions:

  • TBI-induced GHD may be an underrecognized condition in pediatric populations.
  • Clinical presentation and treatment response differ between TBI-induced GHD and IGHD.
  • Further prospective studies are recommended to elucidate the natural history and prevalence of TBI-related GHD.

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