Residual pituitary function after brain injury-induced hypopituitarism: A prospective 12-month study

Gianluca Aimaretti, Maria Rosaria Ambrosio, Carolina Di Somma, Maurizio Gasperi, Salvatore Cannavò, Carla Scaroni, Alessandra Fusco, Patrizia Del Monte, Ernesto De Menis, Marco Faustini-Fustini, Franco Grimaldi, Francesco Logoluso, Paola Razzore, Silvia Rovere, Salvatore Benvenga, Ettore Ciro Degli Uberti, Laura De Marinis, Gaetano Lombardi, Franco Mantero, Enio MartinoGiulio Giordano, Ezio Ghigo

Research output: Contribution to journalArticle

Abstract

Context: Traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH) are conditions at high risk for the development of hypopituitarism. Objective: The objective of the study was to clarify whether pituitary deficiencies and normal pituitary function recorded at 3 months would improve or worsen at 12 months after the brain injury. Design and Patients: Pituitary function was tested at 3 and 12 months in patients who had TBI (n = 70) or SAH (n = 32). Results: In TBI, the 3-month evaluation had shown hypopituitarism (H) in 32.8%. Panhypopituitarism (PH), multiple (MH), and isolated (IH) hypopituitarism had been demonstrated in 5.7, 5.7, and 21.4%, respectively. The retesting demonstrated some degree of H in 22.7%. PH, MH, and IH were present in 5.7, 4.2, and 12.8%, respectively. PH was always confirmed at 12 months, whereas MH and IH were confirmed in 25% only. In 5.5% of TBI with no deficit at 3 months, IH was recorded at retesting. In 13.3% of TBI with IH at 3 months, MH was demonstrated at 12-month retesting. In SAH, the 3-month evaluation had shown H in 46.8%. MH and IH had been demonstrated in 6.2 and 40.6%, respectively. The retesting demonstrated H in 37.5%. MH and IH were present in 6.2 and 31.3%, respectively. Although no MH was confirmed at 12 months, two patients with IH at 3 months showed MH at retesting; 30.7% of SAH with IH at 3 months displayed normal pituitary function at retesting. In SAH, normal pituitary function was always confirmed. In TBI and SAH, the most common deficit was always severe GH deficiency. Conclusion: There is high risk for H in TBI and SAH patients. Early diagnosis of PH is always confirmed in the long term. Pituitary function in brain-injured patients may improve over time but, although rarely, may also worsen. Thus, brain-injured patients must undergo neuroendocrine follow-up over time.

Original languageEnglish
Pages (from-to)6085-6092
Number of pages8
JournalJournal of Clinical Endocrinology and Metabolism
Volume90
Issue number11
DOIs
Publication statusPublished - Nov 2005

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

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    Aimaretti, G., Ambrosio, M. R., Di Somma, C., Gasperi, M., Cannavò, S., Scaroni, C., Fusco, A., Del Monte, P., De Menis, E., Faustini-Fustini, M., Grimaldi, F., Logoluso, F., Razzore, P., Rovere, S., Benvenga, S., Degli Uberti, E. C., De Marinis, L., Lombardi, G., Mantero, F., ... Ghigo, E. (2005). Residual pituitary function after brain injury-induced hypopituitarism: A prospective 12-month study. Journal of Clinical Endocrinology and Metabolism, 90(11), 6085-6092. https://doi.org/10.1210/jc.2005-0504