Lasting Pituitary Hormone Deficiency after Traumatic Brain Injury

2012 ◽  
Vol 29 (1) ◽  
pp. 81-89 ◽  
Author(s):  
Odile Kozlowski Moreau ◽  
Edwige Yollin ◽  
Emilie Merlen ◽  
Walter Daveluy ◽  
Marc Rousseaux
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hormone Deficiency ◽  
Pituitary Hormone ◽  
Pituitary Hormone Deficiency

scholarly journals Growth Hormone Deficiency Following Traumatic Brain Injury

2019 ◽  
Vol 20 (13) ◽  
pp. 3323 ◽  
Author(s):  
Oratile Kgosidialwa ◽  
Osamah Hakami ◽  
Hafiz Muhammad Zia-Ul-Hussnain ◽  
Amar Agha
Keyword(s):  
Traumatic Brain Injury ◽  
Growth Hormone ◽  
Brain Injury ◽  
Growth Hormone Deficiency ◽  
Dynamic Testing ◽  
Recombinant Human Growth Hormone ◽  
Chronic Phase ◽  
Hormone Deficiency ◽  
Pituitary Hormone

Traumatic brain injury (TBI) is fairly common and annually affects millions of people worldwide. Post traumatic hypopituitarism (PTHP) has been increasingly recognized as an important and prevalent clinical entity. Growth hormone deficiency (GHD) is the most common pituitary hormone deficit in long-term survivors of TBI. The pathophysiology of GHD post TBI is thought to be multifactorial including primary and secondary mechanisms. An interplay of ischemia, cytotoxicity, and inflammation post TBI have been suggested, resulting in pituitary hormone deficits. Signs and symptoms of GHD can overlap with those of TBI and may delay rehabilitation/recovery if not recognized and treated. Screening for GHD is recommended in the chronic phase, at least six months to a year after TBI as GH may recover in those with GHD in the acute phase; conversely, it may manifest in those with a previously intact GH axis. Dynamic testing is the standard method to diagnose GHD in this population. GHD is associated with long-term poor medical outcomes. Treatment with recombinant human growth hormone (rhGH) seems to ameliorate some of these features. This review will discuss the frequency and pathophysiology of GHD post TBI, its clinical consequences, and the outcomes of treatment with GH replacement.

scholarly journals Hypogonadism after traumatic brain injury

2009 ◽  
Vol 53 (8) ◽  
pp. 908-914 ◽  
Author(s):  
Alexandre Hohl ◽  
Tânia Longo Mazzuco ◽  
Marisa Helena César Coral ◽  
Marcelo Schwarzbold ◽  
Roger Walz
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Life Quality ◽  
Hormone Deficiency ◽  
Common Finding ◽  
Pituitary Hormone ◽  
Potential Contribution ◽  
Negative Consequences ◽  
Cranial Trauma

Traumatic brain injury (TBI) is the most common cause of death and disability in young adults. Post-TBI neuroendocrine disorders have been increasingly acknowledged in recent years due to their potential contribution to morbidity and, probably, to mortality after trauma. Marked alterations of the hypothalamic-pituitary axis during the post-TBI acute and chronic phases have been reported. Prospective and longitudinal studies have shown that some abnormalities are transitory. On the other hand, there is a high frequency (15% to 68%) of pituitary hormone deficiency among TBI survivors in a long term setting. Post-TBI hypogonadism is a common finding after cranial trauma, and it is predicted to develop in 16% of the survivors in the long term. Post-TBI hypogonadism has been associated with adverse results in the acute and chronic phases after injury. These data reinforce the need for identification of hormonal deficiencies and their proper treatment, in order to optimize patient recovery, improve their life quality, and avoid the negative consequences of non-treated hypogonadism in the long term.

scholarly journals Experience of a Pituitary Clinic for US Military Veterans With Traumatic Brain Injury

2021 ◽  
Vol 5 (4) ◽  
Author(s):  
Jonathan Lee ◽  
Lindsey J Anderson ◽  
Dorota Migula ◽  
Kevin C J Yuen ◽  
Lisa McPeak ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Care Center ◽  
Hormone Replacement ◽  
Tertiary Care ◽  
Puget Sound ◽  
Symptom Burden ◽  
Hormone Deficiency ◽  
Pituitary Hormone ◽  
Pituitary Dysfunction

Abstract Context Traumatic brain injury (TBI) is considered the “signature” injury of veterans returning from wartime conflicts in Iraq and Afghanistan. While moderate/severe TBI is associated with pituitary dysfunction, this association has not been well established in the military setting and in mild TBI (mTBI). Screening for pituitary dysfunction resulting from TBI in veteran populations is inconsistent across Veterans Affairs (VA) institutions, and such dysfunction often goes unrecognized and untreated. Objective This work aims to report the experience of a pituitary clinic in screening for and diagnosis of pituitary dysfunction. Methods A retrospective analysis was conducted in a US tertiary care center of veterans referred to the VA Puget Sound Healthcare System pituitary clinic with a history of TBI at least 12 months prior. Main outcome measures included demographics, medical history, symptom burden, baseline hormonal evaluation, brain imaging, and provocative testing for adrenal insufficiency (AI) and adult-onset growth hormone deficiency (AGHD). Results Fatigue, cognitive/memory problems, insomnia, and posttraumatic stress disorder were reported in at least two-thirds of the 58 patients evaluated. Twenty-two (37.9%) were diagnosed with at least one pituitary hormone deficiency, including 13 (22.4%) AI, 12 (20.7%) AGHD, 2 (3.4%) secondary hypogonadism, and 5 (8.6%) hyperprolactinemia diagnoses; there were no cases of thyrotropin deficiency. Conclusion A high prevalence of chronic AI and AGHD was observed among veterans with TBI. Prospective, larger studies are needed to confirm these results and determine the effects of hormone replacement on long-term outcomes in this setting.

scholarly journals Hypothalamo-Pituitary Dysfunction in Patients With Chronic Subdural Hematoma

2012 ◽  
pp. 161-167 ◽  
Author(s):  
V. HÁNA ◽  
M. KOSÁK ◽  
V. MASOPUST ◽  
D. NETUKA ◽  
Z. LACINOVÁ ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Diabetes Insipidus ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Clinical Severity ◽  
Hormone Deficiency ◽  
Pituitary Hormone ◽  
Pituitary Dysfunction ◽  
One Year

Relatively frequent pituitary hormone deficiencies are observed after traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH) and according to the published studies the neuroendocrine consequenses of traumatic brain injury are underdiagnosed. In a cohort of 59 patients (49 males, mean age 68.3 years, 36-88 years) after evacuation of subdural hematoma (SDH) were evaluated hypothalamo-pituitary functions one week after surgery, after three months and after one year. Hypogonadism was present in 26 % of patients in an acute phase, but in the majority had a transient character. Less than half of patients was GH deficient (GHD) according to the GHRH+arginine test. We did not find any serious case of hypocortisolism, hypothyroidism, diabetes insipidus centralis nor syndrome of inappropriate secretion of ADH (SIADH). Transient partial hypocortisolism was present in two cases, but resolved. We did not find relation between extension of SDH or clinical severity and development of hypopituitarism. In conclusion, in some patients with SDH growth hormone deficiency or hypogonadism was present. No serious hypocortisolism, hypothyroidism, diabetes insipidus nor SIADH was observed. The possibility of neuroendocrine dysfunction should be considered in patients with SDH, although the deficits are less frequent than in patients after TBI or SAH.

Metabolic status of patients with combined pituitary hormone deficiency due to PROP1 mutation

2020 ◽  
Author(s):  
Damian Rogoziński ◽  
Aleksandra Gilis-Januszewska ◽  
Łukasz Kluczyński ◽  
Magdalena Godlewska ◽  
Alicja Hubalewska-Dydejczyk
Keyword(s):  
Metabolic Status ◽  
Hormone Deficiency ◽  
Pituitary Hormone ◽  
Pituitary Hormone Deficiency ◽  
Combined Pituitary Hormone Deficiency

scholarly journals MECHANISMS IN ENDOCRINOLOGY: An update in the genetic aetiologies of combined pituitary hormone deficiency

2016 ◽  
Vol 174 (6) ◽  
pp. R239-R247 ◽  
Author(s):  
Frederic Castinetti ◽  
Rachel Reynaud ◽  
Alexandru Saveanu ◽  
Nicolas Jullien ◽  
Marie Helene Quentien ◽  
...  
Keyword(s):  
Transcription Factors ◽  
G Protein Coupled Receptors ◽  
Hormone Deficiency ◽  
Immunoglobulin Superfamily ◽  
Pituitary Hormone ◽  
Pituitary Hormone Deficiency ◽  
Combined Pituitary Hormone Deficiency ◽  
Signalling Molecules ◽  
Genes Encoding ◽  
G Protein Coupled

Over the last 5 years, new actors involved in the pathogenesis of combined pituitary hormone deficiency in humans have been reported: they included a member of the immunoglobulin superfamily glycoprotein and ciliary G protein-coupled receptors, as well as new transcription factors and signalling molecules. New modes of inheritance for alterations of genes encoding transcription factors have also been described. Finally, actors known to be involved in a very specific phenotype (hypogonadotroph hypogonadism for instance) have been identified in a wider range of phenotypes. These data thus suggest that new mechanisms could explain the low rate of aetiological identification in this heterogeneous group of diseases. Taking into account the fact that several reviews have been published in recent years on classical aetiologies of CPHD such as mutations ofPOU1F1orPROP1, we focused the present overview on the data published in the last 5 years, to provide the reader with an updated review on this rapidly evolving field of knowledge.

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