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Alterations in neuroendocrine axes in brain-dead patients

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Abstract

Purpose

To identify changes in anterior pituitary gland hormone levels in brain-dead patients and alterations in free triiodothyronine (fT3), free thyroxine, cortisol, testosterone, and estradiol levels.

Methods

Ten postmenopausal women and 22 men with brain death (BD) were included. The first blood sample for determination of hormones (pre-BD) was collected when the clinician observed the first signs of BD. The second blood sample (BD day) was drawn after BD certification.

Results

Female patients exhibited lower follicle-stimulating hormone and prolactin levels pre-BD and luteinizing hormone, follicle-stimulating hormone, and prolactin levels on BD day than the age-matched controls. Male patients’ sex hormone levels were similar to those of the age-matched controls, except for testosterone levels, which were low in both consecutive measurements. All gonadotropins and prolactin levels were above the tests’ lower detection limits (LDLs), except for one male patient with gonadotropin levels below the LDLs of the tests. Estradiol levels in both sexes ranged from normal to elevated. FT3 levels were significantly decreased in the two measurements. Thyroid-stimulating hormone (TSH) levels were low in eight patients and all low TSH levels were above the test’s LDL. The remaining patients had normal or elevated TSH levels. The median adrenocorticotropic hormone (ACTH) and cortisol levels were within normal limits. All cortisol and ACTH levels were above the tests’ LDLs, except for one patient with ACTH levels below the LDL in both measurements.

Conclusion

This study supports the hypothesis that the anterior pituitary gland continues to function in the brain-dead state.

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Funding

The authors declare that no funding was received for the publication of this manuscript.

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Authors and Affiliations

  1. School of Medicine, Department of Internal Medicine, Division of Intensive Care, Düzce University, Merkez, Konuralp Yerleşkesi, Beciyörükler Mevkii, Düzce, Türkiye

    Türkay Akbaş

  2. Düzce University Department of Neurology, School of Medicine, Düzce University, Düzce, Türkiye

    Ayhan Öztürk

Authors
  1. Türkay Akbaş
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Contributions

Conception and design: T Akbaş and A Öztürk; analysis and interpretation of data: T Akbaş and A Öztürk; drafting of the article or critical revision for important intellectual content: T Akbaş and A Öztürk; final approval of the version to be published: T Akbaş and A Öztürk; agreement to be accountable for all aspects of the work: T Akbaş and A Öztürk.

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Correspondence to Türkay Akbaş.

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Conflict of interest

No potential conflict of interest relevant to this article was reported.

Ethics committee approval

The study protocol was approved by the ethics review board of Düzce University under approval number 2017/05 dated 20.02.2017. Informed consent was obtained from the patients’ next of kin.

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Prior presentation

The part of this study was presented at the XXIII World Congress of Neurology, September 16-21, 2017, Kyoto, Japan.

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Cite this article

Akbaş, T., Öztürk, A. Alterations in neuroendocrine axes in brain-dead patients. Hormones 22, 539–546 (2023). https://doi.org/10.1007/s42000-023-00489-9

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