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dc.contributor.authorBerg, C
dc.contributor.authorOeffner, A
dc.contributor.authorSchumm-Draeger, P-M
dc.contributor.authorBadorrek, F
dc.contributor.authorBrabant, Georg E
dc.contributor.authorGerbert, B
dc.contributor.authorBornstein, S
dc.contributor.authorZimmermann, A
dc.contributor.authorWeber, M
dc.contributor.authorBroecker-Preuss, M
dc.contributor.authorMann, K
dc.contributor.authorHerrmann, B L
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.
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
html.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.


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