Hypopituitarism in pediatric survivors of inflicted traumatic brain injury
Open accessAbstract
Endocrine dysfunction is common after accidental traumatic brain injury (TBI). Prevalence of endocrine dysfunction after inflicted traumatic brain injury (iTBI) is not known. The aim of this study was to examine endocrinopathy in children after moderate-to-severe iTBI. Children with previous iTBI (n=14) were evaluated for growth/endocrine dysfunction, including anthropometric measurements and hormonal evaluation (nocturnal growth hormone [GH], thyrotropin surge, morning and low-dose adrenocorticotropin stimulated cortisol, insulin-like growth factor 1, IGF-binding protein 3, free thyroxine, prolactin [PRL], and serum/urine osmolality). Analysis used Fisher's exact test and Wilcoxon's rank-sum test, as appropriate. Eighty-six percent of subjects had endocrine dysfunction with at least one abnormality, whereas 50% had two or more abnormalities, significantly increased compared to an estimated 2.5% with endocrine abnormality in the general population (p<0.001). Elevated prolactin was common (64%), followed by abnormal thyroid function (33%), short stature (29%), and low GH peak (17%). High prolactin was common in subjects with other endocrine abnormalities. Two were treated with thyroid hormone and 2 may require GH therapy. In conclusion, children with a history of iTBI show high risk for endocrine dysfunction, including elevated PRL and growth abnormalities. This effect of iTBI has not been well described in the literature. Larger, multi-center, prospective studies would provide more data to determine the extent of endocrine dysfunction in iTBI. We recommend that any child with a history of iTBI be followed closely for growth velocity and pubertal changes. If growth velocity is slow, PRL level and a full endocrine evaluation should be performed.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Cross-sectional studies documented 16%-61% prevalence of hypopituitarism at 1-5 years after injury in children.
“Cross-sectional studies documented 16%–61% prevalence of hypopituitarism at 1–5 years after injury [23,34,37,38,39,40,41,42,43].”
From Update of Endocrine Dysfunction following Pediatric Traumatic Brain Injury (2015) · cites this paper as [41]
In 14 children who had suffered severe inflicted injury in infancy, 29% had height shorter than the 10th percentile, and 57% demonstrated some endocrine dysfunction (excluding hyperprolactinemia).
“Of this group, 29% had height shorter than the 10%ile, and 57% demonstrated some endocrine dysfunction (excluding hyperprolactinemia) [41].”
From Update of Endocrine Dysfunction following Pediatric Traumatic Brain Injury (2015) · cites this paper as [41]
In pediatric survivors of inflicted TBI, testing of 14 children at median 3.1 years after TBI found six with blunted TSH surge.
“In pediatric survivors of inflicted TBI (shaken baby syndrome, SBS), testing of 14 children at median of 3.1 years after TBI found six of them to have blunted TSH surge [41].”
From Update of Endocrine Dysfunction following Pediatric Traumatic Brain Injury (2015) · cites this paper as [41]
Cites
Corticotropin tests for hypothalamic-pituitary- adrenal insufficiency: a metaanalysis
Kazlauskaite, R., Evans, A. T., Villabona, C. V., Abdu, T. A. M., Ambrosi, B., Atkinson, A. B., Choi, C. H., Clayton, R. N., Courtney, C. H., Gonc, E. N., et al. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2008-0710 · Cited by 385 · see citing works
Self-citationTanriverdi, F., Senyurek, H., Unluhizarci, K., Selcuklu, A., Casanueva, F. F., & Kelestimur, F. (2006) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2005-2476 · Cited by 336 · see citing works
Neuroendocrine disorders after traumatic brain injury
Behan, L. A., Phillips, J., Thompson, C. J., & Agha, A. (2008) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.2007.132837 · Cited by 141 · see citing works
Einaudi, S., Matarazzo, P., Peretta, P., Grossetti, R., Giordano, F., Aitare, F., Bondone, C., Andreo, M., Ivani, G., Genitori, L., et al. (2006) · Journal of Pediatric Endocrinology and Metabolism · doi:10.1515/jpem.2006.19.5.691 · Cited by 106 · see citing works
Abnormalities of pituitary function after traumatic brain injury in children
Niederland, T., Makovi, H., Gál, V., Andréka, B., Ábrahám, C. S., & Kovács, J. (2007) · Journal of Neurotrauma · doi:10.1089/neu.2005.369er · Cited by 105 · see citing works
Endocrine dysfunction following traumatic brain injury in children
Kaulfers, A.-M. D., Backeljauw, P. F., Reifschneider, K., Blum, S., Michaud, L., Weiss, M., & Rose, S. R. (2010) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2010.07.004 · Cited by 84 · see citing works
Self-citationHypopituitarism induced by traumatic brain injury in the transition phase
Aimaretti, G., Ambrosio, M. R., Di Somma, C., Gasperi, M., Cannavò, S., Scaroni, C., De Marinis, L., Baldelli, R., Bona, G., Giordano, G., et al. (2005) · Journal of Endocrinological Investigation · doi:10.1007/bf03345336 · Cited by 70 · see citing works
Pituitary function in paediatric survivors of severe traumatic brain injury
Poomthavorn, P., Maixner, W., & Zacharin, M. (2008) · Archives of Disease in Childhood · doi:10.1136/adc.2007.121137 · Cited by 63 · see citing works
Permanent hypopituitarism is rare after structural traumatic brain injury in early childhood
Heather, N. L., Jefferies, C., Hofman, P. L., Derraik, J. G. B., Brennan, C., Kelly, P., Hamill, J. K. M., Jones, R. G., Rowe, D. L., & Cutfield, W. S. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2011-2284 · Cited by 62 · cited 4× · see citing works
“series of 198 patients and found no cases of permanent hypopituitarism at least 1 year after injury.(3) However, our study is different from the previous work in several important ways.”
InfluentialIsolated central hypothyroidism in short stature
Rose, S. R. (1995) · Pediatric Research · doi:10.1203/00006450-199512000-00023 · Cited by 61 · see citing works
Self-citationRose, S., Lustig, R., Burstein, S., Pitukcheewanont, P., Broome, D., & Burghen, G. (1999) · Hormone Research in Paediatrics · doi:10.1159/000023438 · Cited by 60 · see citing works
Self-citationCircadian variation of thyrotropin in childhood
ROSE, S. R., & NISULA, B. C. (1989) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-68-6-1086 · Cited by 54 · see citing works
Carroll, C. P., Cochran, J. A., Price, J. P., et al. (2010) · PubMed · Cited by 44 · see citing works
Improved diagnosis of mild hypothyroidism using time-of-day normal ranges for thyrotropin
Rose, S. R. (2010) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2010.04.047 · Cited by 27 · see citing works
Self-citationSix-hour and four-hour nocturnal sampling for growth hormone
Rose, S. R., & Municchi, G. (1999) · Journal of Pediatric Endocrinology and Metabolism · doi:10.1515/jpem.1999.12.2.167 · Cited by 16 · see citing works
Self-citationEndocrine and metabolic testing manual
Dons, R. F. (1998) · Cited by 8 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Update of Endocrine Dysfunction following Pediatric Traumatic Brain Injury
Reifschneider, K., Auble, B., & Rose, S. (2015) · Journal of Clinical Medicine · doi:10.3390/jcm4081536 · Cited by 66 · see citing works
Self-citationDassa, Y., Crosnier, H., Chevignard, M., Viaud, M., Personnier, C., Flechtner, I., Meyer, P., Puget, S., Boddaert, N., Breton, S., et al. (2019) · European Journal of Endocrinology · doi:10.1530/eje-19-0034 · Cited by 34 · see citing works
Pituitary dysfunction after traumatic brain injury: Are there definitive data in children?
Casano-Sancho, P. (2017) · Archives of Disease in Childhood · doi:10.1136/archdischild-2016-311609 · Cited by 30 · see citing works
Wexler, T. L., Reifschneider, K., Backeljauw, P., Cárdenas, J. F., Hoffman, A. R., Miller, B. S., & Yuen, K. C. J. (2023) · Journal of Neurotrauma · doi:10.1089/neu.2022.0384 · Cited by 19 · see citing works
- Authors
- Auble, B. A., Bollepalli, S., Makoroff, K., Weis, T., Khoury, J., Colliers, T., & Rose, S. R.
- Affiliations
- Cincinnati Children's Hospital Medical Center (US)
- Corresponding author
- Auble, Bethany A.
- Venue
- Journal of Neurotrauma
- Publisher
- SAGE Publications
- Published
- 2014-02-15
- Volume
- 31
- Issue
- 4
- Pages
- 321-326
- ISSN
- 0897-7151 (ISSN-L)
- 1557-9042
- PMC
- PMC3922245
- OpenAlex
- W2021159550
- Cited by
- 38
- References
- 16
- Citations by year
- 2026: 1 · 2024: 6 · 2023: 4 · 2022: 4 · 2021: 2 · 2020: 5 · 2019: 5 · 2018: 1 · 2016: 3 · 2015: 5 · 2014: 2
- FWCI
- 2.62
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Neurotrauma (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Pfizer
- National Institutes of Health (UL1TR000077, TR000077)
- National Center for Research Resources
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Child Abuse and Related Trauma
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Keywords
- hypopituitarism, traumatic brain injury, pediatric brain injury, endocrine dysfunction, prolactin, short stature, growth hormone, thyroid function, insulin-like growth factor I, IGF binding protein-3, cortisol, osmolality
- MeSH terms
- Brain Injuries, Child, Child Abuse, Child, Preschool, Female, Growth Disorders, Hospitalization, Humans, Hypopituitarism, Magnetic Resonance Imaging, Male, Pilot Projects, Pituitary Function Tests, Pituitary Hormones, Prolactin, Growth Hormone, Survival, Thyroid Diseases, Thyroid Hormones, Tomography, X-Ray Computed, Human Growth Hormone, Shaken Baby Syndrome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
