Spontaneous recovery from isolated post-traumatic central hypogonadism in a woman
Open accessAbstract
Objective Hypopituitarism is a recognized complication of Traumatic Brain Injury (TBI). Resolution of established anterior pituitary hormones deficiency is rare.Case report A woman was initially presented at the age of 22 years with amenorrhoea. Two years earlier she had been involved in a car accident with consequent TBI. At our evaluation, serum oestradiol (E2) was low (3 pmol/l), Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH) were borderline low [1.7 and 2.5 mIU/l, normal range (NR) for 20-35 yr old women being 1.4-13 and 2.5-13, respectively] with poor response to Gonadotropin Releasing Hormone (GnRH) (ΔLH = 2.4 and, ΔFSH = 4.0 mIU/l), while serum Prolactin (PRL) was elevated (951 mIU/l; NR: 102-496). No other pituitary hormone deficiencies were observed. Magnetic resonance imaging (MRI) showed a partially empty sella and very thin stalk. Ten years later a new endocrine evaluation was performed. On day 4 of her menstrual cycle, serum values of PRL (196 mIU/l), FSH (4.7 mIU/l), LH (4.8 mIU/l) and E2 (103 pmol/l) were within normal limits for women aged 20-35. Six months after this evaluation (that is, 12 years after trauma), the patient became pregnant and delivered a healthy baby.Conclusions Our case shows that spontaneous resolution of post-head trauma anterior hypopituitarism occur even many years after head injury. Medicolegal implications are self-evident.
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In a case report, after 10 years, when patient discontinued drug for 6 months, spontaneous menstrual cycles returned.
“After 10 years, she was re-evaluated in the same endocrinology clinic, and when she discontinued her drug for 6 months, spontaneous menstrual cycles returned.”
From Pituitary Dysfunction After Traumatic Brain Injury: A Clinical and Pathophysiological Approach (2015) · cites this paper as [260]
Pituitary function may recover as long as 12 years after head trauma.
“Although this is a single case report, the findings suggest that pituitary function may recover as long as 12 years after head trauma.”
From Pituitary Dysfunction After Traumatic Brain Injury: A Clinical and Pathophysiological Approach (2015) · cites this paper as [260]
She had a spontaneous pregnancy 6 months after recovery.
“Moreover, she had a spontaneous pregnancy 6 months after recovery (260).”
From Pituitary Dysfunction After Traumatic Brain Injury: A Clinical and Pathophysiological Approach (2015) · cites this paper as [260]
Her hormonal profile was compatible with recovery from gonadotropin deficiency.
“Her hormonal profile was compatible with the recovery from gonadotropin deficiency.”
From Pituitary Dysfunction After Traumatic Brain Injury: A Clinical and Pathophysiological Approach (2015) · cites this paper as [260]
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- Authors
- Ruggeri, R. M., Smedile, G., Granata, F., Longo, M., Cannaíò, S., Sarlis, N. J., Trimarchi, F., & Benvenga, S.
- Affiliations
- University of Messina (IT)
- Sanofi (France) (FR)
- Venue
- Hormones
- Published
- 2010-10
- Volume
- 9
- Issue
- 4
- Pages
- 332-337
- ISSN
- 1109-3099 (ISSN-L)
- 2520-8721
- OpenAlex
- W1989263674
- Semantic Scholar
- 4771cba0d0c6eaafd99cc3486b78351c4ee1ae6b
- Cited by
- 12
- References
- 26
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 1 · 2021: 1 · 2020: 1 · 2017: 2 · 2016: 1 · 2015: 1 · 2014: 1
- FWCI
- 0.24
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- HORMONES (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- central hypogonadism, traumatic brain injury, hypopituitarism, spontaneous recovery, amenorrhea, prolactinoma, empty sella syndrome, gonadotropin deficiency, pregnancy, long-term follow-up
- MeSH terms
- Brain Injuries, Female, Follicle Stimulating Hormone, Humans, Hypogonadism, Luteinizing Hormone, Gonadotropin-Releasing Hormone, Pituitary Function Tests, Pituitary Gland, Prolactin, Radionuclide Imaging, Young Adult
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