Prevalence of anterior pituitary dysfunction in patients following traumatic brain injury in a German multi-centre screening program.

2.50
Hdl Handle:
http://hdl.handle.net/10541/109060
Title:
Prevalence of anterior pituitary dysfunction in patients following traumatic brain injury in a German multi-centre screening program.
Authors:
Berg, C; Oeffner, A; Schumm-Draeger, P-M; Badorrek, F; Brabant, Georg E; Gerbert, B; Bornstein, S; Zimmermann, A; Weber, M; Broecker-Preuss, M; Mann, K; Herrmann, B L
Abstract:
INTRODUCTION: We determined the prevalence of anterior pituitary dysfunction in a multi-centre screening program across five German endocrine centres in patients rehabilitating from TBI (GCS<13). PATIENTS & METHODS: 246 patients (39+/-14 yrs; 133 males, 12+/-8 months after TBI) underwent a series of baseline endocrine tests with central assessment of TSH, free T4, prolactin, LH, FSH, testosterone (m), estradiol (f), cortisol, GH, and IGF-I. If IGF-I was <-2 SDS dynamic testing was performed. GHD was defined according to BMI-dependent cut-off values for GH response to GHRH+arginine of <4.2, <8.0 and <11.5 ng/ml in obese, overweight and lean subjects, respectively, or <3 micro g/l in ITT. Hypocortisolism was suggested when basal cortisol was <200 nmol/l and confirmed by ITT (peak<500 nmol/l). RESULTS: In TBI patients some degree of impaired pituitary function was shown in 21% (n=52/246). Total, multiple and isolated deficits were present in 1%, 2% and 18%, respectively. 19% had an IGF-I of <-1 SDS, 9% of <-2 SDS. In 5% GHD was confirmed. 9% had hypogonadism. 4% had hypocortisolism and 1% of patients had confirmed ACTH-deficiency. 12% had TSH-deficiency. SUMMARY: In summary, in this large series carried out on an unselected group of TBI survivors we have found hypopituitarism in every fifth patient with predominantly secondary hypogonadism and hypothyreosis. Regarding somatotrope insufficiency IGF-I is decreased in 50% of GHD patients. CONCLUSION: These findings strongly suggest that patients who suffer head trauma should routinely undergo endocrine evaluation.
Affiliation:
Clinic of Endocrinology, University Hospital of Essen, Germany. christian.berg@uni-essen.de
Citation:
Prevalence of anterior pituitary dysfunction in patients following traumatic brain injury in a German multi-centre screening program. 2010, 118 (2):139-44 Exp Clin Endocrinol Diabetes
Journal:
Experimental and Clinical Endocrinology & Diabetes
Issue Date:
Feb-2010
URI:
http://hdl.handle.net/10541/109060
DOI:
10.1055/s-0029-1225611
PubMed ID:
19691014
Type:
Article
Language:
en
ISSN:
1439-3646
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorBerg, Cen
dc.contributor.authorOeffner, Aen
dc.contributor.authorSchumm-Draeger, P-Men
dc.contributor.authorBadorrek, Fen
dc.contributor.authorBrabant, Georg Een
dc.contributor.authorGerbert, Ben
dc.contributor.authorBornstein, Sen
dc.contributor.authorZimmermann, Aen
dc.contributor.authorWeber, Men
dc.contributor.authorBroecker-Preuss, Men
dc.contributor.authorMann, Ken
dc.contributor.authorHerrmann, B Len
dc.date.accessioned2010-08-04T14:00:32Z-
dc.date.available2010-08-04T14:00:32Z-
dc.date.issued2010-02-
dc.identifier.citationPrevalence of anterior pituitary dysfunction in patients following traumatic brain injury in a German multi-centre screening program. 2010, 118 (2):139-44 Exp Clin Endocrinol Diabetesen
dc.identifier.issn1439-3646-
dc.identifier.pmid19691014-
dc.identifier.doi10.1055/s-0029-1225611-
dc.identifier.urihttp://hdl.handle.net/10541/109060-
dc.description.abstractINTRODUCTION: We determined the prevalence of anterior pituitary dysfunction in a multi-centre screening program across five German endocrine centres in patients rehabilitating from TBI (GCS<13). PATIENTS & METHODS: 246 patients (39+/-14 yrs; 133 males, 12+/-8 months after TBI) underwent a series of baseline endocrine tests with central assessment of TSH, free T4, prolactin, LH, FSH, testosterone (m), estradiol (f), cortisol, GH, and IGF-I. If IGF-I was <-2 SDS dynamic testing was performed. GHD was defined according to BMI-dependent cut-off values for GH response to GHRH+arginine of <4.2, <8.0 and <11.5 ng/ml in obese, overweight and lean subjects, respectively, or <3 micro g/l in ITT. Hypocortisolism was suggested when basal cortisol was <200 nmol/l and confirmed by ITT (peak<500 nmol/l). RESULTS: In TBI patients some degree of impaired pituitary function was shown in 21% (n=52/246). Total, multiple and isolated deficits were present in 1%, 2% and 18%, respectively. 19% had an IGF-I of <-1 SDS, 9% of <-2 SDS. In 5% GHD was confirmed. 9% had hypogonadism. 4% had hypocortisolism and 1% of patients had confirmed ACTH-deficiency. 12% had TSH-deficiency. SUMMARY: In summary, in this large series carried out on an unselected group of TBI survivors we have found hypopituitarism in every fifth patient with predominantly secondary hypogonadism and hypothyreosis. Regarding somatotrope insufficiency IGF-I is decreased in 50% of GHD patients. CONCLUSION: These findings strongly suggest that patients who suffer head trauma should routinely undergo endocrine evaluation.en
dc.language.isoenen
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshBrain Injuries-
dc.subject.meshChemiluminescent Measurements-
dc.subject.meshEstradiol-
dc.subject.meshFemale-
dc.subject.meshGermany-
dc.subject.meshHumans-
dc.subject.meshHydrocortisone-
dc.subject.meshInsulin-Like Growth Factor I-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshPituitary Diseases-
dc.subject.meshPituitary Hormones, Anterior-
dc.subject.meshPrevalence-
dc.subject.meshTestosterone-
dc.titlePrevalence of anterior pituitary dysfunction in patients following traumatic brain injury in a German multi-centre screening program.en
dc.typeArticleen
dc.contributor.departmentClinic of Endocrinology, University Hospital of Essen, Germany. christian.berg@uni-essen.deen
dc.identifier.journalExperimental and Clinical Endocrinology & Diabetesen

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