Pituitary function at long-term follow up of childhood traumatic brain injury
Pituitary function at long-term follow up of childhood traumatic brain injury
Pituitary dysfunction is a recognised sequel of traumatic brain injury (TBI), occurring in 10-83% of adult patients, but there are few data on the prevalence or natural history in childhood. Our objective was to determine pituitary function in children and young adults at least 4 years after TBI requiring paediatric intensive care unit (PICU) admission. The effects of TBI and hypopituitarism on height, adiposity and quality of life (QOL) were also evaluated. Unselected patients discharged from the regional PICU with TBI (age <18years at injury) from 1999-2004 were recruited. Blood and urine samples were collected for baseline pituitary function testing. Height and weight were measured. Adiposity was assessed by mid-upper arm and waist circumferences and body fat percentage estimation using four-site skinfold thickness and bioelectrical impedance. Auxology and adiposity data were compared to local age and sex matched healthy control data. QOL questionnaires (PedsQL 4.0 and QOL-AGHDA) were completed. Twenty subjects (median age 16.7 years (range 9.2 - 23.3 years), 13 male) of 127 eligible agreed to participate at a median of 6.8 years (range 4.2 - 10.3 years) since TBI; markers of injury were higher in those recruited than those who were not. Biochemical evidence of hypopituitarism was identified in only one case, possibly related to co-morbid pre-existing attention deficit hyperactivity disorder. Height, weight and adiposity were similar to healthy controls. Poor QOL was seen in patients with chronic functional deficits or co-morbidities. Overall, pituitary dysfunction was less prevalent than previous studies in adults and children. This study does not support the use of routine endocrine evaluation of children following TBI.
1827-1835
Moon, Rebecca Jane
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Sutton, Timothy
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Wilson, Peter Murray
b75ca67a-f483-43a8-a227-cd7733238dce
Kirkham, Fenella Jane
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Davies, Justin Huw
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October 2010
Moon, Rebecca Jane
954fb3ed-9934-4649-886d-f65944985a6b
Sutton, Timothy
d759b154-a3a1-4379-9105-fcd5cd2220f3
Wilson, Peter Murray
b75ca67a-f483-43a8-a227-cd7733238dce
Kirkham, Fenella Jane
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Davies, Justin Huw
9f18fcad-f488-4c72-ac23-c154995443a9
Moon, Rebecca Jane, Sutton, Timothy, Wilson, Peter Murray, Kirkham, Fenella Jane and Davies, Justin Huw
(2010)
Pituitary function at long-term follow up of childhood traumatic brain injury.
Journal of Neurotrauma, 27 (10), .
(doi:10.1089/neu.2010.1408).
(PMID:20684673)
Abstract
Pituitary dysfunction is a recognised sequel of traumatic brain injury (TBI), occurring in 10-83% of adult patients, but there are few data on the prevalence or natural history in childhood. Our objective was to determine pituitary function in children and young adults at least 4 years after TBI requiring paediatric intensive care unit (PICU) admission. The effects of TBI and hypopituitarism on height, adiposity and quality of life (QOL) were also evaluated. Unselected patients discharged from the regional PICU with TBI (age <18years at injury) from 1999-2004 were recruited. Blood and urine samples were collected for baseline pituitary function testing. Height and weight were measured. Adiposity was assessed by mid-upper arm and waist circumferences and body fat percentage estimation using four-site skinfold thickness and bioelectrical impedance. Auxology and adiposity data were compared to local age and sex matched healthy control data. QOL questionnaires (PedsQL 4.0 and QOL-AGHDA) were completed. Twenty subjects (median age 16.7 years (range 9.2 - 23.3 years), 13 male) of 127 eligible agreed to participate at a median of 6.8 years (range 4.2 - 10.3 years) since TBI; markers of injury were higher in those recruited than those who were not. Biochemical evidence of hypopituitarism was identified in only one case, possibly related to co-morbid pre-existing attention deficit hyperactivity disorder. Height, weight and adiposity were similar to healthy controls. Poor QOL was seen in patients with chronic functional deficits or co-morbidities. Overall, pituitary dysfunction was less prevalent than previous studies in adults and children. This study does not support the use of routine endocrine evaluation of children following TBI.
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Accepted/In Press date: 4 August 2010
Published date: October 2010
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Local EPrints ID: 162265
URI: http://eprints.soton.ac.uk/id/eprint/162265
ISSN: 0897-7151
PURE UUID: af38f322-4681-4d58-80ce-dc5519f0951a
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Date deposited: 17 Aug 2010 16:40
Last modified: 14 Mar 2024 02:45
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Author:
Rebecca Jane Moon
Author:
Timothy Sutton
Author:
Peter Murray Wilson
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