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Traumatic brain injury in children and adolescents: surveillance for pituitary dysfunction
Kenneth W Norwood1, Mark D Deboer, Matthew J Gurka
1University of Virginia, Charlottesville, USA.
Insights
Growth hormone deficiency (GHD) is common after traumatic brain injury (TBI) in children. Monitoring height and weight is crucial for early detection and management of GHD in pediatric TBI survivors.
Area of Science:
- Pediatric Endocrinology
- Neuroscience
- Traumatology
Background:
- Traumatic brain injury (TBI) in children can lead to hypopituitarism.
- Growth hormone deficiency (GHD) is the most frequent endocrine complication following pediatric TBI.
Purpose of the Study:
- To determine the prevalence of GHD in children and adolescents post-TBI.
- To identify associated features of GHD in this population.
Main Methods:
- Study included 32 pediatric patients from a TBI clinic.
- GHD diagnosis was based on insufficient growth hormone release during provocative testing.
Main Results:
- GHD was diagnosed in 16% (5/32) of participants.
- GHD patients showed faster weight gain and lower free thyroxine and FSH levels.
- Males with GHD had reduced testosterone levels.
Conclusions:
- GHD is a significant concern following pediatric TBI.
- Regular assessment of height and weight velocity is recommended for TBI patients.
- GHD may coexist with other pituitary hormone deficiencies.
Background:
Children who sustain traumatic brain injury (TBI) are at risk for developing hypopituitarism, of which growth hormone deficiency (GHD) is the most common manifestation.
Objective:
To determine the prevalence of GHD and associated features following TBI among children and adolescents.
Study Design:
A total of 32 children and adolescents were recruited from a pediatric TBI clinic. Participants were diagnosed with GHD based on insufficient growth hormone release during both spontaneous overnight testing and following arginine/glucagon administration.
Results:
GHD was diagnosed in 5/32 participants (16%). Those with GHD exhibited more rapid weight gain following injury than those without GHD and had lower levels of free thyroxine and follicle-stimulating hormone. Males with GHD had lower testosterone levels.
Conclusions:
GHD following TBI is common in children and adolescents, underscoring the importance of assessing for GHD, including evaluating height and weight velocities after TBI. Children and adolescents with GHD may further exhibit absence or intermediate function for other pituitary hormones.
