Baldelli Roberto, Bellone Simonetta, Corneli Ginevra, Savastio Silvia, Petri Antonella, Bona Gianni
Unit of Pediatrics, Department of Medical Sciences, University of Piemonte Orientale Amedeo Avogadro, Novara, Italy.
Pituitary. 2005;8(3-4):255-7. doi: 10.1007/s11102-006-6050-4.
Childhood hypopituitarism may be present at birth or may be acquired. Young children and teenagers are particularly susceptible to TBI; in fact TBI is one of the first causes of death and disability in children older than one month of age since the most common cause of TBI is car crashes, including pedestrian-car and bicycle-car encounters, falls, child abuse, violence and sports injuries. Furthermore younger kids are more likely to have TBI due to falls while teenagers have more TBI than any other population from motor vehicle crashes. As reported for the adult patients hypopituitarism in adolescence should be suspected within an appropriate clinical context. In adolescents affected by TBI no experience about this condition has been reported but it is well known that treatment of hypopituitarism, in particular of GH deficiency, has multiple beneficial effects in addition to its promotion of linear growth and in particular in the transition phase. These include maintenance of normal body composition, structure function and metabolism through adult life. Therefore, the onset of TBI-induced GH deficiency in this particular phase of life should be strictly evaluated and corrected for the possible adult health consequences.
儿童垂体功能减退可能在出生时就存在，也可能是后天获得的。幼儿和青少年特别容易发生创伤性脑损伤（TBI）；事实上，TBI是1个月以上儿童死亡和残疾的首要原因之一，因为TBI最常见的原因是车祸，包括行人与汽车、自行车与汽车相撞、跌倒、虐待儿童、暴力和运动损伤。此外，年幼的孩子因跌倒更易发生TBI，而青少年因机动车碰撞导致的TBI比其他任何人群都多。正如针对成年患者所报道的那样，在适当的临床背景下应怀疑青少年垂体功能减退。在受TBI影响的青少年中，尚未有关于这种情况的报道，但众所周知，垂体功能减退的治疗，尤其是生长激素缺乏的治疗，除了促进线性生长外，特别是在过渡阶段，还有多种有益作用。这些作用包括在成年期维持正常的身体成分、结构功能和新陈代谢。因此，在生命的这个特定阶段，应严格评估TBI诱发的生长激素缺乏的发生情况，并对可能的成人健康后果进行纠正。
