Measurement of height velocity is an useful marker for monitoring pituitary function in patients who had traumatic brain injury

作者：Bellone S; Einaudi S; Caputo M; Prodam F; Busti A; Belcastro S; Parlamento S; Zavattaro M; Verna F; Bondone C; Tessaris D; Gasco V; Bona G; Aimaretti G^*

来源：Pituitary, 2013, 16(4): 499-506.

DOI：10.1007/s11102-012-0446-0

• Traumatic brain injury
• Hypopituitarism
• GH deficiency
• Reduced height velocity

To assess the incidence of abnormal neuroendocrine function post-traumatic brain injuriy (TBI) in a large group of paediatric patients and its correlations with clinical parameters (Glasgow coma scale-GCS, Glasgow outcome scale-GOS, TC marshall scale, height velocity). We evaluated 70 patients [58 M, 12 F; age at the time of TBI (mean +/- A SEM) 8.12 +/- A 4.23 years] previously hospitalized for TBI at the %26quot;Regina Margherita%26quot; Hospital, in Turin and %26quot;Maggiore della CaritA Hospital%26quot; in Novara, Italy, between 1998 and 2008. All patients included underwent: auxological, clinical, hormonal and biochemical assessments at recall (after at least 1 year from TBI to T0); auxological visit after 6 months (T6) and hormonal assessments at 12 months (T12) in patients with height velocity (HV) below the 25th centile. At T0, 4 cases of hypothalamus-pituitary dysfunction had been diagnosed; At T6 20/70 patients had an HV %26lt; 25th centile, but no one had HV %26lt; the 3rd centile limit. At T12, among the 20 patients with HV %26lt; 25th centile, in 13 patients the HV was below the 25th centile and GHRH + Arginine test has been performed. Four subjects demonstrated an impaired GH peak and were classified as GH deficiency (GHD). Of these 4 subjects, 3 subjects showed isolated GHD, while one patient showed multiple hypopituitarism presenting also secondary hypocortisolism and hypothyroidism. The GCS at admission and GOS do not correlate with the onset of hypopituitarism. A simple measurement of the height velocity at least 1 year after the TBI, is enough to recognize patients with a pituitary impairment related to GH deficiency. We suggest to follow-up paediatric population who had TBI with auxological evaluations every 6 months, limiting hormonal evaluation in patients with a reduction of height velocity below the 25th centile limit.

• 出版日期2013-12