Prevalence of Pituitary Dysfunction After Severe Traumatic Brain Injury in Children and Adolescents: A Large Prospective Study
| Autor: | Mathilde Chevignard, Isabelle Flechtner, Sylvain Breton, Yamina Dassa, Nathalie Boddaert, Caroline Mignot, Hélène Crosnier, Stéphanie Puget, Claire Personnier, Philippe Meyer, Magali Viaud, Jean-Philipe Jais, Kathleen Laborde, Christian Sainte-Rose, Michel Polak, Jean-Claude Souberbielle, Marie Piketty |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Longitudinal study Pediatrics Adolescent Traumatic brain injury Endocrinology Diabetes and Metabolism Clinical Biochemistry Poison control Neuroimaging Context (language use) Severity of Illness Index Biochemistry Hypopituitarism Endocrinology Internal medicine Injury prevention Severity of illness Prevalence Humans Medicine Longitudinal Studies Child Prospective cohort study medicine.diagnostic_test business.industry Biochemistry (medical) Infant Newborn Infant Magnetic resonance imaging medicine.disease Brain Injuries Child Preschool Physical therapy Female France business |
| Zdroj: | The Journal of Clinical Endocrinology & Metabolism. 99:2052-2060 |
| ISSN: | 1945-7197 0021-972X |
| DOI: | 10.1210/jc.2013-4129 |
| Popis: | Context: Traumatic brain injury (TBI) in childhood is a major public health issue. Objective: We sought to determine the prevalence of pituitary dysfunction in children and adolescents after severe TBI and to identify any potential predictive factors. Design: This was a prospective longitudinal study. Setting: The study was conducted at a university hospital. Patients: Patients, hospitalized for severe accidental or inflicted TBI, were included. The endocrine assessment was performed between 6 and 18 months after the injury. Main Outcome Measures: Basal and dynamic tests of pituitary function were performed in all patients and GH dynamic testing was repeated in patients with low stimulated GH peak ( Results: We studied 87 children and adolescents [60 males, median age 6.7 y (range 0.8–15.2)] 9.5 ± 3.4 months after the TBI (73 accidental, 14 inflicted). The second GH peak, assessed 4.9 ± 0.1 months after the first evaluation, remained low in 27 children and adolescents. Fifteen patients had a GH peak less than 5 ng/mL (mean IGF-I SD score −1.3 ± 1.5) and five (5.7%) strict criteria for severe GHD. Two children had mild central hypothyroidism and one had ACTH deficiency. We did not find any predictive factors associated with existence of GHD (demographic characteristics, growth velocity, trauma severity, and radiological parameters). Conclusion: At 1 year after the severe TBI, pituitary dysfunction was found in 8% of our study sample. We recommend systematic hormonal assessment in children and adolescents 12 months after a severe TBI and prolonged clinical endocrine follow-up. |
| Databáze: | OpenAIRE |
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