Neuroendocrine Dysfunction in a Young Athlete With Concussion: A Case Report
Abstract
An 18-year-old female ringette and basketball player presented to our sport concussion clinic 27 months after concussion with fatigue, headache, exercise intolerance, polyuria, nocturia, and difficulties concentrating. Her history was remarkable for 4 previous concussions. Her neurologic examination was normal. Neuroendocrine screen including thyroid function, morning cortisol, glucose, and insulin-like growth factor-1 (screening test for growth hormone deficiency) were normal. Further testing for growth hormone deficiency with an insulin hypoglycemia test revealed severe growth hormone deficiency. Urine and serum electrolytes were borderline normal, suggesting partial diabetes insipidus. Treatments with growth hormone replacement lead to complete recovery. This case highlights the importance of maintaining a high index of suspicion for neuroendocrine abnormalities in athletes with persistent symptoms after sport concussion. Symptoms can be nonspecific and go undiagnosed for years, but appropriate recognition and treatment can restore function.
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There are increasing case reports of pituitary deficiencies after repetitive sports injury.
“There are also increasing case reports of pituitary deficiencies after repetitive sports injury [35-40].”
From Neuroendocrine Disruptions Following Head Injury (2023) · cites this paper as [36]
Cites
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Lithgow, K., Chin, A., Debert, C. T., & Kline, G. A. (2018) · BMC Endocrine Disorders · doi:10.1186/s12902-018-0247-1 · Cited by 26 · see citing works
Self-citationNeuroendocrine Disruptions Following Head Injury
Wexler, T. L. (2023) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-023-01263-5 · Cited by 23 · see citing works
- Authors
- Langelier, D. M., Kline, G. A., & Debert, C. T.
- Affiliations
- University of Calgary (CA)
- Corresponding author
- Langelier, David M.
- Debert, Chantel T.
- Venue
- Clinical Journal of Sport Medicine
- Published
- 2017-11
- Volume
- 27
- Issue
- 6
- Pages
- e78-e79
- ISSN
- 1050-642X (ISSN-L)
- OpenAlex
- W2572023390
- Cited by
- 11
- References
- 10
- Citations by year
- 2026: 1 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 1 · 2019: 1 · 2018: 4
- FWCI
- 1.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Journal of Sport Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Keywords
- sports-related concussion, neuroendocrine dysfunction, growth hormone deficiency, diabetes insipidus, persistent post-concussion symptoms, insulin hypoglycemia test, growth hormone replacement therapy, athletes, fatigue, polyuria, nocturia
- MeSH terms
- Adolescent, Athletic Injuries, Basketball, Female, Humans, Neurologic Examination, Neurosecretory Systems, Growth Hormone, Post-Concussion Syndrome, Athletes
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