Update of Endocrine Dysfunction following Pediatric Traumatic Brain Injury

Traumatic brain injuries (TBI) are common occurrences in childhood, often resulting in long term, life altering consequences. Research into endocrine sequelae following injury has gained attention; however, there are few studies in children. This paper reviews the pathophysiology and current literat...

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Main Authors:	Reifschneider, Kent, Auble, Bethany A., Rose, Susan R.
Format:	Online
Language:	English
Published:	MDPI 2015
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4555075/

id	pubmed-4555075
recordtype	oai_dc
spelling	pubmed-45550752015-09-01 Update of Endocrine Dysfunction following Pediatric Traumatic Brain Injury Reifschneider, Kent Auble, Bethany A. Rose, Susan R. Review Traumatic brain injuries (TBI) are common occurrences in childhood, often resulting in long term, life altering consequences. Research into endocrine sequelae following injury has gained attention; however, there are few studies in children. This paper reviews the pathophysiology and current literature documenting risk for endocrine dysfunction in children suffering from TBI. Primary injury following TBI often results in disruption of the hypothalamic-pituitary-adrenal axis and antidiuretic hormone production and release, with implications for both acute management and survival. Secondary injuries, occurring hours to weeks after TBI, result in both temporary and permanent alterations in pituitary function. At five years after moderate to severe TBI, nearly 30% of children suffer from hypopituitarism. Growth hormone deficiency and disturbances in puberty are the most common; however, any part of the hypothalamic-pituitary axis can be affected. In addition, endocrine abnormalities can improve or worsen with time, having a significant impact on children’s quality of life both acutely and chronically. Since primary and secondary injuries from TBI commonly result in transient or permanent hypopituitarism, we conclude that survivors should undergo serial screening for possible endocrine disturbances. High indices of suspicion for life threatening endocrine deficiencies should be maintained during acute care. Additionally, survivors of TBI should undergo endocrine surveillance by 6–12 months after injury, and then yearly, to ensure early detection of deficiencies in hormonal production that can substantially influence growth, puberty and quality of life. MDPI 2015-07-31 /pmc/articles/PMC4555075/ /pubmed/26287247 http://dx.doi.org/10.3390/jcm4081536 Text en © 2015 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/4.0/).
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Reifschneider, Kent Auble, Bethany A. Rose, Susan R.
spellingShingle	Reifschneider, Kent Auble, Bethany A. Rose, Susan R. Update of Endocrine Dysfunction following Pediatric Traumatic Brain Injury
author_facet	Reifschneider, Kent Auble, Bethany A. Rose, Susan R.
author_sort	Reifschneider, Kent
title	Update of Endocrine Dysfunction following Pediatric Traumatic Brain Injury
title_short	Update of Endocrine Dysfunction following Pediatric Traumatic Brain Injury
title_full	Update of Endocrine Dysfunction following Pediatric Traumatic Brain Injury
title_fullStr	Update of Endocrine Dysfunction following Pediatric Traumatic Brain Injury
title_full_unstemmed	Update of Endocrine Dysfunction following Pediatric Traumatic Brain Injury
title_sort	update of endocrine dysfunction following pediatric traumatic brain injury
description	Traumatic brain injuries (TBI) are common occurrences in childhood, often resulting in long term, life altering consequences. Research into endocrine sequelae following injury has gained attention; however, there are few studies in children. This paper reviews the pathophysiology and current literature documenting risk for endocrine dysfunction in children suffering from TBI. Primary injury following TBI often results in disruption of the hypothalamic-pituitary-adrenal axis and antidiuretic hormone production and release, with implications for both acute management and survival. Secondary injuries, occurring hours to weeks after TBI, result in both temporary and permanent alterations in pituitary function. At five years after moderate to severe TBI, nearly 30% of children suffer from hypopituitarism. Growth hormone deficiency and disturbances in puberty are the most common; however, any part of the hypothalamic-pituitary axis can be affected. In addition, endocrine abnormalities can improve or worsen with time, having a significant impact on children’s quality of life both acutely and chronically. Since primary and secondary injuries from TBI commonly result in transient or permanent hypopituitarism, we conclude that survivors should undergo serial screening for possible endocrine disturbances. High indices of suspicion for life threatening endocrine deficiencies should be maintained during acute care. Additionally, survivors of TBI should undergo endocrine surveillance by 6–12 months after injury, and then yearly, to ensure early detection of deficiencies in hormonal production that can substantially influence growth, puberty and quality of life.
publisher	MDPI
publishDate	2015
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4555075/
_version_	1613471019968757760

Update of Endocrine Dysfunction following Pediatric Traumatic Brain Injury

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