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Growth Hormone Deficiency Following Traumatic Brain Injury

Kgosidialwa, Oratile, Hakami, Osamah, Zia-Ul-Hussnain, Hafiz Muhammad, Agha, Amar·2019·International Journal of Molecular Sciences

Abstract

Traumatic brain injury (TBI) is fairly common and annually affects millions of people worldwide. Post traumatic hypopituitarism (PTHP) has been increasingly recognized as an important and prevalent clinical entity. Growth hormone deficiency (GHD) is the most common pituitary hormone deficit in long-term survivors of TBI. The pathophysiology of GHD post TBI is thought to be multifactorial including primary and secondary mechanisms. An interplay of ischemia, cytotoxicity, and inflammation post TBI have been suggested, resulting in pituitary hormone deficits. Signs and symptoms of GHD can overlap with those of TBI and may delay rehabilitation/recovery if not recognized and treated. Screening for GHD is recommended in the chronic phase, at least six months to a year after TBI as GH may recover in those with GHD in the acute phase; conversely, it may manifest in those with a previously intact GH axis. Dynamic testing is the standard method to diagnose GHD in this population. GHD is associated with long-term poor medical outcomes. Treatment with recombinant human growth hormone (rhGH) seems to ameliorate some of these features. This review will discuss the frequency and pathophysiology of GHD post TBI, its clinical consequences, and the outcomes of treatment with GH replacement.

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Cited by

Metadata

Authors
Kgosidialwa, O., Hakami, O., Zia-Ul-Hussnain, H. M., & Agha, A.
Affiliations
Academic Department of Endocrinology, Beaumont Hospital, Royal College of Surgeons, Dublin D09V2N0, Ireland
Venue
International Journal of Molecular Sciences
Publisher
MDPI AG
Published
2019-07-06
Volume
20
Issue
13
Pages
3323
ISSN
1422-0067
Cited by
48
References
42
Language
en

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