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Severe hypothalamopituitary dysfunction accompanied by influenza-associated encephalopathy: report of two pediatric

Hideaki Yagasaki1, Kisho Kobayashi, Tomohiro Saito

  • 1Department of Pediatrics, University of Yamanashi, Yamanashi, Japan. yagasaki@mwd.biglobe.ne.jp

Journal of Pediatric Endocrinology & Metabolism : JPEM
|March 5, 2013
PubMed

Insights

Severe influenza can cause brain damage (encephalopathy) and pituitary gland dysfunction in children. Prompt hormone replacement therapy can prolong survival in these critical cases.

Area of Science:

  • Neurology
  • Endocrinology
  • Pediatrics

Background:

  • Severe influenza infections can lead to serious neurological complications like encephalopathy.
  • Encephalopathy can result in acquired hypothalamopituitary dysfunction, increasing morbidity and mortality.
  • Hypopituitarism is a potential consequence of influenza-associated encephalopathy.

Observation:

  • Two pediatric cases of influenza-associated hypopituitarism are presented.
  • Both patients were diagnosed with distinct forms of encephalopathy: acute necrotizing encephalopathy and postresuscitation encephalopathy.
  • Clinical presentation included evidence of significant endocrine dysfunction.

Findings:

  • Influenza-associated encephalopathy can precipitate acquired hypopituitarism in children.
  • Hormone replacement therapy (adrenal, thyroid, antidiuretic hormones) was initiated.
  • Treatment resulted in sustained cardiac activity and prolonged survival.

Implications:

  • Early screening for endocrine dysfunction is vital in pediatric patients with severe central nervous system compromise.
  • Prompt diagnosis and management of hypopituitarism can improve outcomes in severe influenza cases.
  • This highlights the critical interplay between severe infections, neurological injury, and endocrine health in pediatrics.

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