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Cited by 29Pituitary Gland Disorders and TreatmentsTraumatic Brain Injury ResearchTraumatic Brain Injury and Neurovascular Disturbances

Symptoms of gonadal dysfunction are more predictive of hypopituitarism than nonspecific symptoms in screening for pituitary dysfunction following moderate or severe traumatic brain injury

Cuesta, Martín, Hannon, Mark J., Crowley, Rachel K., Behan, Lucy Ann, Tormey, William, Rawluk, Daniel, Delargy, Mark, Agha, Amar +1 more·2016·Clinical Endocrinology
DOI 10.1111/cen.12874
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Abstract

OBJECTIVE: The economic and logistic burden of screening for hypopituitarism following moderate/severe traumatic brain injury (TBI) is considerable. A key recommendation in published guidelines is to prioritize for screening those patients with symptoms suggestive of pituitary dysfunction. The purpose of this study was to evaluate the utility of targeted screening for hypopituitarism in long-term survivors after moderate/severe TBI using referrals on the basis of symptoms. DESIGN: In group 1 (G1), consecutive, unselected patients were screened from the Irish National Neurosurgery Centre, whereas in group 2 (G2) patients were targeted based on the presence of symptoms suggestive of pituitary dysfunction. PATIENTS: A total of 137 patients (113 male) were systematically screened (G1) and compared to 112 patients (77 male) referred for pituitary evaluation on the basis of suggestive symptoms (G2). MAIN OUTCOME MEASURES: The rate of GH, ACTH, gonadotrophin (GT), TSH and ADH deficiency was compared among groups. RESULTS: Patients referred with menstrual dysfunction had more GH (50% vs 11%, P = 0·001), ACTH (60% vs 14%, P < 0·0001), GT (90% vs 16%, P < 0·0001) deficiency and any pituitary hormone deficit (80% vs 33%, P = 0·003) than G1. Men with symptoms of hypogonadism had more GH (33% vs 11%, P = 0·003), GT (58% vs 16%, P < 0·0001) and TSH (16% vs 1%, P = 0·03) deficiency than G1. Patients with nonspecific symptoms were no more likely to have hypopituitarism than those consecutively screened. CONCLUSIONS: Symptoms of hypogonadism are sufficiently predictive of hypopituitarism to justify screening for hypopituitarism after moderate/severe TBI. Nonspecific symptoms of hypopituitarism are no more predictive than unselected screening.

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Crossref · 10.1111/cen.12874

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Authors
Cuesta, M., Hannon, M. J., Crowley, R. K., Behan, L. A., Tormey, W., Rawluk, D., Delargy, M., Agha, A., & Thompson, C. J.
Affiliations
Royal College of Surgeons in Ireland (IE)
Corresponding author
Thompson, Christopher J.
ORCID
Venue
Clinical Endocrinology
Publisher
Wiley
Published
2015-09-23
Volume
84
Issue
1
Pages
92-98
ISSN
  • 0300-0664 (ISSN-L)
  • 1365-2265
DOI
10.1111/cen.12874
OpenAlex
W2140190076
Cited by
29
References
33
Citations by year
2026: 1 · 2025: 2 · 2024: 5 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 3 · 2019: 1 · 2018: 6 · 2017: 3 · 2016: 1
FWCI
2.90
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Clinical Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Pfizer
  • Novo Nordisk
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
Keywords
hypopituitarism, traumatic brain injury, targeted screening, gonadal dysfunction, hypogonadism, growth hormone deficiency, ACTH deficiency, gonadotropin deficiency, TSH deficiency, long-term survivors
MeSH terms
Adolescent, Adult, Aged, Brain Injuries, Female, Gonadotropins, Humans, Hypogonadism, Hypopituitarism, Male, Mass Screening, Middle Aged, Pituitary Gland, Pituitary Hormones, Prognosis, Trauma Severity Indices, Survivors, Young Adult

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