An Approach to Traumatic Brain Injury-Related Hypopituitarism: Overcoming the Pediatric Challenges
Traumatic brain injury (TBI)-related hypopituitarism is a rare polymorphic complication of brain injury, with very little data, particularly concerning children and teenagers. This is a comprehensive review of the literature regarding this pathology, starting from a new pediatric case. The research...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-01-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/2/212 |
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| author | Raluca Maria Vlad Alice Ioana Albu Irina Delia Nicolaescu Ruxandra Dobritoiu Mara Carsote Florica Sandru Dragos Albu Daniela Păcurar |
| author_facet | Raluca Maria Vlad Alice Ioana Albu Irina Delia Nicolaescu Ruxandra Dobritoiu Mara Carsote Florica Sandru Dragos Albu Daniela Păcurar |
| author_sort | Raluca Maria Vlad |
| collection | DOAJ |
| description | Traumatic brain injury (TBI)-related hypopituitarism is a rare polymorphic complication of brain injury, with very little data, particularly concerning children and teenagers. This is a comprehensive review of the literature regarding this pathology, starting from a new pediatric case. The research was conducted on PubMed and included publications from the last 22 years. We identified nine original studies on the pediatric population (two case reports and seven studies; only four of these seven were prospective studies). TBI-related hypopituitarism is associated with isolated hormonal deficits ranging from 22.5% to 86% and multiple hormonal deficiencies from 5.9% to 50% in the studied pediatric population. Growth hormone (GH) deficiency is most often found, including the form with late occurrence after TBI; it was described as persistent in half of the studies. Thyroid-stimulating hormone (TSH) deficiency is identified as a distant complication following TBI; in all three studies, we identified this complication was found to be permanent. Adrenocorticotropic hormone (ACTH) deficiency did not relate to a certain type of brain trauma, and it was transient in reported cases. Hyperprolactinemia was the most frequent hormonal finding, also occurring late after injury. Central diabetes insipidus was encountered early post-TBI, typically with a transient pattern and did not relate to a particular type of injury. TBI-related hypopituitarism, although rare in children, should be taken into consideration even after a long time since the trauma. A multidisciplinary approach is needed if the patient is to safely overcome any acute condition. |
| first_indexed | 2024-03-09T13:04:08Z |
| format | Article |
| id | doaj.art-cd070d4e3560435ea96bd057dcf554c7 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T13:04:08Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-cd070d4e3560435ea96bd057dcf554c72023-11-30T21:51:32ZengMDPI AGDiagnostics2075-44182023-01-0113221210.3390/diagnostics13020212An Approach to Traumatic Brain Injury-Related Hypopituitarism: Overcoming the Pediatric ChallengesRaluca Maria Vlad0Alice Ioana Albu1Irina Delia Nicolaescu2Ruxandra Dobritoiu3Mara Carsote4Florica Sandru5Dragos Albu6Daniela Păcurar7Department of Pediatrics, “Grigore Alexandrescu” Emergency Children’s Hospital, 011743 Bucharest, RomaniaDepartment of Endocrinology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaSt. Mary Medical Clinic, 011172 Bucharest, RomaniaDepartment of Pediatrics, “Grigore Alexandrescu” Emergency Children’s Hospital, 011743 Bucharest, RomaniaDepartment of Endocrinology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Dermatovenerology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania2nd Clinical Department Obstetrics Gynecology, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Pediatrics, “Grigore Alexandrescu” Emergency Children’s Hospital, 011743 Bucharest, RomaniaTraumatic brain injury (TBI)-related hypopituitarism is a rare polymorphic complication of brain injury, with very little data, particularly concerning children and teenagers. This is a comprehensive review of the literature regarding this pathology, starting from a new pediatric case. The research was conducted on PubMed and included publications from the last 22 years. We identified nine original studies on the pediatric population (two case reports and seven studies; only four of these seven were prospective studies). TBI-related hypopituitarism is associated with isolated hormonal deficits ranging from 22.5% to 86% and multiple hormonal deficiencies from 5.9% to 50% in the studied pediatric population. Growth hormone (GH) deficiency is most often found, including the form with late occurrence after TBI; it was described as persistent in half of the studies. Thyroid-stimulating hormone (TSH) deficiency is identified as a distant complication following TBI; in all three studies, we identified this complication was found to be permanent. Adrenocorticotropic hormone (ACTH) deficiency did not relate to a certain type of brain trauma, and it was transient in reported cases. Hyperprolactinemia was the most frequent hormonal finding, also occurring late after injury. Central diabetes insipidus was encountered early post-TBI, typically with a transient pattern and did not relate to a particular type of injury. TBI-related hypopituitarism, although rare in children, should be taken into consideration even after a long time since the trauma. A multidisciplinary approach is needed if the patient is to safely overcome any acute condition.https://www.mdpi.com/2075-4418/13/2/212hypopituitarismtraumatic brain injurygrowth hormone deficiencydelayed pubertyACTHheight |
| spellingShingle | Raluca Maria Vlad Alice Ioana Albu Irina Delia Nicolaescu Ruxandra Dobritoiu Mara Carsote Florica Sandru Dragos Albu Daniela Păcurar An Approach to Traumatic Brain Injury-Related Hypopituitarism: Overcoming the Pediatric Challenges Diagnostics hypopituitarism traumatic brain injury growth hormone deficiency delayed puberty ACTH height |
| title | An Approach to Traumatic Brain Injury-Related Hypopituitarism: Overcoming the Pediatric Challenges |
| title_full | An Approach to Traumatic Brain Injury-Related Hypopituitarism: Overcoming the Pediatric Challenges |
| title_fullStr | An Approach to Traumatic Brain Injury-Related Hypopituitarism: Overcoming the Pediatric Challenges |
| title_full_unstemmed | An Approach to Traumatic Brain Injury-Related Hypopituitarism: Overcoming the Pediatric Challenges |
| title_short | An Approach to Traumatic Brain Injury-Related Hypopituitarism: Overcoming the Pediatric Challenges |
| title_sort | approach to traumatic brain injury related hypopituitarism overcoming the pediatric challenges |
| topic | hypopituitarism traumatic brain injury growth hormone deficiency delayed puberty ACTH height |
| url | https://www.mdpi.com/2075-4418/13/2/212 |
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