ESPE Yearbook of Paediatric Endocrinology

To read the full abstract: Eur J Endocrinol. 2019 May 1;180(5):281–290.

This longitudinal prospective study of 61 children with a 5-10 years follow-up post severe traumatic brain injury evaluates the prevalence of pituitary deficiency and precocious puberty.

In children, retrospective and prospective studies report variable rates of hypothyroidism and growth hormone deficiency (GHD) after severe traumatic brain injury (TBI) (1–5), but little is known about the long-term history of pituitary function post-TBI. Here, 61 children were followed up for 5–10 years post traumatic brain injury. At 1-year post-TBI 17 children had GHD, and of these GHD was confirmed 3–4 years post-TBI in 5/17 children. Four children developed CPP, on average 5.7 years post-TBI. Having a pituitary dysfunction at 1-year post-TBI was significantly associated with pituitary dysfunction or CPP at 5+ years post-TBI.

This study confirms that severe TBI in childhood can lead to permanent pituitary dysfunction and shows that GHD and CPP may appear many years after the traumatic injury. The authors recommend systematic hormonal assessment at 1-year post severe TBI and prolonged monitoring of growth and puberty.

References: 1. Einaudi S, Matarazzo P, Peretta P, Grossetti R, Giodano F, Altare F, Bondone C, Andreo M, Ivani G, Genitori L, De Sanctis C. 2006 Hypothalamo-hypopyseal dysfunction after traumatic brain injury in children and adolescents: a preliminary retrospective and prospective study. Journal of Pediatric Endocrinology and Metabolism 19: 691–703.

2. Niederland T, Makovi H, Gal V, Andreka B, Abraham CS & Kovacs J. 2007 Abnormalities of pituitary function after traumatic brain injury in children. Journal of Neurotrauma 24: 119–127.

3. Poomtavorn P, Maixner W, Zacharin M. 2008 function in paediatric survivors of severe traumatic brain injury. Archives of Disease in Childhood 93: 133–137.

4. Auble BA, Bollepalli S, Makoroff K, Weis T, Khoury J, Colliers T & Rose SR. 2014 Hypopituitarism in pediatric survivors of inflicted traumatic brain injury. Journal of Neurotrauma 31: 321–326.

5. Sancho P. 2017 Pituitary dysfunction after traumatic brain injury: are there definitive data in children? Archives of Disease in Childhood 102: 572–577.