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Growth Hormone Deficiency Following Traumatic Brain Injury

Traumatic brain injury (TBI) is fairly common and annually affects millions of people worldwide. Post traumatic hypopituitarism (PTHP) has been increasingly recognized as an important and prevalent clinical entity. Growth hormone deficiency (GHD) is the most common pituitary hormone deficit in long-...

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Autores principales: Kgosidialwa, Oratile, Hakami, Osamah, Muhammad Zia-Ul-Hussnain, Hafiz, Agha, Amar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6651180/
https://www.ncbi.nlm.nih.gov/pubmed/31284550
http://dx.doi.org/10.3390/ijms20133323
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author Kgosidialwa, Oratile
Hakami, Osamah
Muhammad Zia-Ul-Hussnain, Hafiz
Agha, Amar
author_facet Kgosidialwa, Oratile
Hakami, Osamah
Muhammad Zia-Ul-Hussnain, Hafiz
Agha, Amar
author_sort Kgosidialwa, Oratile
collection PubMed
description Traumatic brain injury (TBI) is fairly common and annually affects millions of people worldwide. Post traumatic hypopituitarism (PTHP) has been increasingly recognized as an important and prevalent clinical entity. Growth hormone deficiency (GHD) is the most common pituitary hormone deficit in long-term survivors of TBI. The pathophysiology of GHD post TBI is thought to be multifactorial including primary and secondary mechanisms. An interplay of ischemia, cytotoxicity, and inflammation post TBI have been suggested, resulting in pituitary hormone deficits. Signs and symptoms of GHD can overlap with those of TBI and may delay rehabilitation/recovery if not recognized and treated. Screening for GHD is recommended in the chronic phase, at least six months to a year after TBI as GH may recover in those with GHD in the acute phase; conversely, it may manifest in those with a previously intact GH axis. Dynamic testing is the standard method to diagnose GHD in this population. GHD is associated with long-term poor medical outcomes. Treatment with recombinant human growth hormone (rhGH) seems to ameliorate some of these features. This review will discuss the frequency and pathophysiology of GHD post TBI, its clinical consequences, and the outcomes of treatment with GH replacement.
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spelling pubmed-66511802019-08-07 Growth Hormone Deficiency Following Traumatic Brain Injury Kgosidialwa, Oratile Hakami, Osamah Muhammad Zia-Ul-Hussnain, Hafiz Agha, Amar Int J Mol Sci Review Traumatic brain injury (TBI) is fairly common and annually affects millions of people worldwide. Post traumatic hypopituitarism (PTHP) has been increasingly recognized as an important and prevalent clinical entity. Growth hormone deficiency (GHD) is the most common pituitary hormone deficit in long-term survivors of TBI. The pathophysiology of GHD post TBI is thought to be multifactorial including primary and secondary mechanisms. An interplay of ischemia, cytotoxicity, and inflammation post TBI have been suggested, resulting in pituitary hormone deficits. Signs and symptoms of GHD can overlap with those of TBI and may delay rehabilitation/recovery if not recognized and treated. Screening for GHD is recommended in the chronic phase, at least six months to a year after TBI as GH may recover in those with GHD in the acute phase; conversely, it may manifest in those with a previously intact GH axis. Dynamic testing is the standard method to diagnose GHD in this population. GHD is associated with long-term poor medical outcomes. Treatment with recombinant human growth hormone (rhGH) seems to ameliorate some of these features. This review will discuss the frequency and pathophysiology of GHD post TBI, its clinical consequences, and the outcomes of treatment with GH replacement. MDPI 2019-07-06 /pmc/articles/PMC6651180/ /pubmed/31284550 http://dx.doi.org/10.3390/ijms20133323 Text en © 2019 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 (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Kgosidialwa, Oratile
Hakami, Osamah
Muhammad Zia-Ul-Hussnain, Hafiz
Agha, Amar
Growth Hormone Deficiency Following Traumatic Brain Injury
title Growth Hormone Deficiency Following Traumatic Brain Injury
title_full Growth Hormone Deficiency Following Traumatic Brain Injury
title_fullStr Growth Hormone Deficiency Following Traumatic Brain Injury
title_full_unstemmed Growth Hormone Deficiency Following Traumatic Brain Injury
title_short Growth Hormone Deficiency Following Traumatic Brain Injury
title_sort growth hormone deficiency following traumatic brain injury
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6651180/
https://www.ncbi.nlm.nih.gov/pubmed/31284550
http://dx.doi.org/10.3390/ijms20133323
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