Abstract
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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Ruggeri, R.M., Smedile, G., Granata, F. et al. Spontaneous recovery from isolated post-traumatic central hypogonadism in a woman. Hormones 9, 332–337 (2010). https://doi.org/10.14310/horm.2002.1285
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DOI: https://doi.org/10.14310/horm.2002.1285