ISSN 1662-4009 (Online)

ESPE Yearbook of Paediatric Endocrinology (2019) 16 7.14 | DOI: 10.1530/ey.16.7.14

Pituitary deficiency and precocious puberty after childhood severe traumatic brain injury: a long-term follow-up prospective study

Dassa Y, Crosnier H, Chevignard M, Viaud M, Personnier C, Flechtner I, Meyer P, Puget S, Boddaert N, Breton S & Polak M

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.

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