Eur J Endocrinol
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DOI: 10.1530/eje.1.02284
European Journal of Endocrinology, Vol 155, Issue 5, 663-669
Copyright © 2006 by European Society of Endocrinology
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REVIEW

Hypopituitarism in childhood and adolescence following traumatic brain injury: the case for prospective endocrine investigation

Carlo L Acerini, Robert C Tasker, Simonetta Bellone1, Gianni Bona1, Christopher J Thompson2 and Martin O Savage3

Department of Paediatrics, University of Cambridge, Cambridge, UK, 1 Department of Paediatrics, University of Novara, Novara, Italy, 2 Beaumont Hospital, Dublin, Ireland and 3 Department of Endocrinology, Barts and the London School of Medicine and Dentistry, John Vane Science Centre Charterhouse Square, London EC1M 6BQ, UK

(Correspondence should be addressed to M O Savage; Email: m.o.savage{at}qmul.ac.uk)

Abstract

Pituitary dysfunction is now well recognised after traumatic brain injury (TBI) in adults; however, little except anecdotal evidence is known about this potential complication in childhood and adolescence. Histopathological evidence exists for both hypothalamic and pituitary damage, but few data specific to children have been published. We review the available paediatric data, which shows that after both mild and severe TBI, hypopituitarism may occur, with GH and gonadotrophin deficiencies appearing to be most common. Precocious puberty has also been documented. Road-traffic accidents, falls, sport and child abuse are the most common aetiological factors for paediatric TBI. There are no published data on the incidence or prevalence, neither within a population of children with TBI, of hypopituitarism, nor on its natural history or response to hormone replacement. We urge paediatric endocrinologists, in collaboration with adult endocrinologists, to perform formal prospective research studies in patients suffering from TBI to clarify these questions.




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