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Cited by 34Growth Hormone and Insulin-like Growth FactorsPituitary Gland Disorders and TreatmentsTraumatic Brain Injury and Neurovascular Disturbances

Pituitary deficiency and precocious puberty after childhood severe traumatic brain injury: A long-term follow-up prospective study

Dassa, Yamina, Crosnier, Hélène, Chevignard, Mathilde, Viaud, Magali, Personnier, Claire, Flechtner, Isabelle, Meyer, Philippe, Puget, Stéphanie +3 more·2019·European Journal of Endocrinology
DOI 10.1530/eje-19-0034
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Abstract

Objectives Childhood traumatic brain injury (TBI) is a public health issue. Our objectives were to determine the prevalence of permanent pituitary hormone deficiency and to detect the emergence of other pituitary dysfunctions or central precocious puberty several years after severe TBI. Design Follow-up at least 5 years post severe TBI of a prospective longitudinal study. Patients Overall, 66/87 children, who had endocrine evaluation 1 year post severe TBI, were included (24 with pituitary dysfunction 1 year post TBI). Main outcome measures In all children, the pituitary hormones basal levels were assessed at least 5 years post TBI. Growth hormone (GH) stimulation tests were performed 3-4 years post TBI in children with GH deficiency (GHD) 1 year post TBI and in all children with low height velocity (<-1 DS) or low IGF-1 (<-2 DS). Central precocious puberty (CPP) was confirmed by GnRH stimulation test. Results Overall, 61/66 children were followed up 7 (5-10) years post TBI (median; (range)); 17/61 children had GHD 1 year post TBI, and GHD was confirmed in 5/17 patients. For one boy, with normal pituitary function 1 year post TBI, GHD was diagnosed 6.5 years post TBI. 4/61 patients developed CPP, 5.7 (2.4-6.1) years post-TBI. Having a pituitary dysfunction 1 year post TBI was significantly associated with pituitary dysfunction or CPP more than 5 years post TBI. Conclusion Severe TBI in childhood can lead to permanent pituitary dysfunction; GHD and CPP may appear after many years. We recommend systematic hormonal assessment in children 1 year after severe TBI and a prolonged monitoring of growth and pubertal maturation. Recommendations should be elaborated for the families and treating physicians.

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  • Studies indicate that the majority of children diagnosed with TBI-related GHD show onset of symptoms between 6 months and 2 years post-injury, with some cases taking longer.

    “Studies indicate that the majority of children diagnosed with TBI-related GHD show onset of symptoms between 6 months and 2 years post-injury, with some cases taking longer to manifest [24,25,26,27].”

    From Endocrine Dysfunctions After Pediatric Traumatic Brain Injury: Present Insights and Future Directions (2025) · cites this paper as [27]

  • Longitudinal follow-up studies indicate that GH secretion may normalize within 1 to 2 years after injury in some children, especially when the initial injury was less severe and no major structural damage to the HPA occurred.

    “Longitudinal follow-up studies have indicated that GH secretion may normalize within 1 to 2 years after the injury in some children, especially when the initial injury was less severe and no major structural damage to the HPA occurred [24,27].”

    From Endocrine Dysfunctions After Pediatric Traumatic Brain Injury: Present Insights and Future Directions (2025) · cites this paper as [27]

  • Dassa et al. reported GHD in 17 of 61 children one year after TBI, with one case diagnosed 6.5 years post-injury.

    “In another study, Dassa et al. reported GHD in 17 of 61 children one year after TBI, with one case diagnosed 6.5 years post-injury [27].”

    From Endocrine Dysfunctions After Pediatric Traumatic Brain Injury: Present Insights and Future Directions (2025) · cites this paper as [27]

  • Research suggests that persistence of GHD beyond two years is more common in cases of significant hypothalamic or pituitary trauma.

    “Research suggests that the persistence of GHD beyond two years is more common in cases of significant hypothalamic or pituitary trauma [24,27].”

    From Endocrine Dysfunctions After Pediatric Traumatic Brain Injury: Present Insights and Future Directions (2025) · cites this paper as [27]

  • The presence of pituitary dysfunction one year after TBI was significantly associated with increased likelihood of persistent pituitary abnormalities or subsequent CPP more than five years after the initial trauma.

    “Importantly, the presence of pituitary dysfunction one year after TBI was significantly associated with increased likelihood of persistent pituitary abnormalities or subsequent CPP more than five years after the initial trauma [6,27].”

    From Endocrine Dysfunctions After Pediatric Traumatic Brain Injury: Present Insights and Future Directions (2025) · cites this paper as [27]

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Authors
Dassa, Y., Crosnier, H., Chevignard, M., Viaud, M., Personnier, C., Flechtner, I., Meyer, P., Puget, S., Boddaert, N., Breton, S., & Polak, M.
Affiliations
  • Hôpital Necker-Enfants Malades (FR)
  • Sorbonne Université (FR)
  • Centre Hospitalier Intercommunal de Poissy (FR)
Corresponding author
Crosnier, Hélène
ORCID
Venue
European Journal of Endocrinology
Publisher
Oxford University Press (OUP)
Published
2019-05
Volume
180
Issue
5
Pages
281-290
ISSN
  • 0804-4643 (ISSN-L)
  • 1479-683X
DOI
10.1530/eje-19-0034
OpenAlex
W2923531367
Semantic Scholar
cb6f162c1de8db73d0c39fbfccda522709c68dfa
Cited by
34
References
60
Citations by year
2026: 2 · 2025: 5 · 2024: 5 · 2023: 5 · 2022: 4 · 2021: 2 · 2020: 8 · 2019: 3
FWCI
2.93
Type
journal article
Language
en
Open access
closed
Locations
  • European Journal of Endocrinology (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 › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
Keywords
pediatric traumatic brain injury, pituitary dysfunction, growth hormone deficiency, central precocious puberty, long-term follow-up, endocrine assessment, insulin-like growth factor I, growth rate, pubertal development, delayed diagnosis
MeSH terms
Brain Injuries, Traumatic, Adolescent, Adrenocorticotropic Hormone, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Hypopituitarism, Infant, Male, Prospective Studies, Puberty, Precocious, Thyrotropin, Human Growth Hormone

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