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Measurement of height velocity is an useful marker for monitoring pituitary function in patients who had traumatic brain injury

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Abstract

To assess the incidence of abnormal neuroendocrine function post-traumatic brain injuriy (TBI) in a large group of paediatric patients and its correlations with clinical parameters (Glasgow coma scale—GCS, Glasgow outcome scale—GOS, TC marshall scale, height velocity). We evaluated 70 patients [58 M, 12 F; age at the time of TBI (mean ± SEM) 8.12 ± 4.23 years] previously hospitalized for TBI at the “Regina Margherita” Hospital, in Turin and “Maggiore della Carità Hospital” in Novara, Italy, between 1998 and 2008. All patients included underwent: auxological, clinical, hormonal and biochemical assessments at recall (after at least 1 year from TBI to T0); auxological visit after 6 months (T6) and hormonal assessments at 12 months (T12) in patients with height velocity (HV) below the 25th centile. At T0, 4 cases of hypothalamus-pituitary dysfunction had been diagnosed; At T6 20/70 patients had an HV <25th centile, but no one had HV < the 3rd centile limit. At T12, among the 20 patients with HV <25th centile, in 13 patients the HV was below the 25th centile and GHRH + Arginine test has been performed. Four subjects demonstrated an impaired GH peak and were classified as GH deficiency (GHD). Of these 4 subjects, 3 subjects showed isolated GHD, while one patient showed multiple hypopituitarism presenting also secondary hypocortisolism and hypothyroidism. The GCS at admission and GOS do not correlate with the onset of hypopituitarism. A simple measurement of the height velocity at least 1 year after the TBI, is enough to recognize patients with a pituitary impairment related to GH deficiency. We suggest to follow-up paediatric population who had TBI with auxological evaluations every 6 months, limiting hormonal evaluation in patients with a reduction of height velocity below the 25th centile limit.

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Acknowledgments

The work presented in this paper was partially supported by a grant from Pfizer (Rome, Italy).

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Authors and Affiliations

  1. Pediatrics, Department of Health Science, A. Avogadro, University, Novara, Italy

    S. Bellone, F. Prodam, S. Parlamento & G. Bona

  2. Pediatric Endocrinology, OIRM S. Anna, Turin, Italy

    S. Einaudi

  3. Endocrinology, Department of Translational Medicine, A. Avogadro, University, Via Solaroli 17, 28100, Novara, Italy

    M. Caputo, F. Prodam, A. Busti, S. Belcastro, M. Zavattaro & G. Aimaretti

  4. Department of Emergency, OIRM S. Anna, Turin, Italy

    F. Verna, C. Bondone & D. Tessaris

  5. Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Turin, Turin, Italy

    V. Gasco

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  1. S. Bellone
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  2. S. Einaudi
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  3. M. Caputo
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Correspondence to G. Aimaretti.

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Bellone, S., Einaudi, S., Caputo, M. et al. Measurement of height velocity is an useful marker for monitoring pituitary function in patients who had traumatic brain injury. Pituitary 16, 499–506 (2013). https://doi.org/10.1007/s11102-012-0446-0

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