Anterior Pituitary Dysfunction
Literature suggests that approximately one-third to one-half of adults who have sustained a moderate
or severe TBI have some hypothalamo-pituitary dysfunction (164). Children with TBI are at risk for hypo- thalamo-hypophyseal dysfunction, with one study identifying a rate of about 60% (168).
Another group of 48 pediatric patients were found to have a 10% incidence of hypothalamo-hypophyseal dysfunction 6 months after their brain injuries (169). The challenge in identifying which children to screen for anterior pituitary dysfunction is that many of the symptoms of anterior pituitary dysfunction mimic the effects of TBI. For instance, low levels of growth hormone are associated with symptoms such as fatigue, cognitive dysfunction, irritability, and DI (164). An individual who has sustained a TBI would commonly complain of these symptoms and have them dismissed as sequelae of the brain injury. In 2005, a consensus statement on screening for hypopituitarism after TBI recommended systematic screening for pituitary dysfunction for individuals with moderate to severe TBI who are at risk of developing pituitary dysfunction. They recommend screening for hypopituitarism if, while the patient was hospitalized, they had DI or hyponatremia and hypotension. If they had SIADH or hypothyroidism identified, screening for anterior pituitary dysfunction would also be indicated. Reasons noted for foregoing anterior pituitary function screening include the individual being in a persistent vegetative state at a very low level of consciousness. Since little is known about the incidence of hypothalamo-pituitary dysfunction in children after TBI, the majority of the recommendations are extrapolated from adult literature. The treating physician should be knowledgeable, however, of the presenting features of hypothalamo-pituitary dysfunction in children, which may include growth failure, arrested or delayed puberty, amenorrhea, decreased libido, and short stature (170).
More medical literature on Medic.Studio
More on the topic Anterior Pituitary Dysfunction:
- Endocrine System
- Chronic Allograft Dysfunction
- Thyroid gland
- Index
- TECHNICAL FACTORS OF NEEDLE ELECTROMYOGRAPHY
-
Infectious diseases -
Internal diseases -
Obstetrics and Gynaecology -
Pediatrics -
Veterinary medicine -
-
Conflictology -
Ecology -
Economy -
Finance -
History -
Law -
Medicine -
Philosophy -
Religious studies -