Evaluation of pituitary function after infectious meningitis in childhood

BMC Endocrine Disorders

Susanna Esposito¹  Paolo Beck-Peccoz²  Anna Spada²  Giulia Rodari²  Silvia Bergamaschi²  Laura Senatore¹  Eriselda Profka²  Claudia Tagliabue¹  Claudia Giavoli² 

[1] Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via Commenda 9, 20122 Milan, Italy;Endocrinology and Diabetology Unit, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy

关键词: Pediatric infectious diseases;    Hypodrenalism;    GH deficiency;    Meningitis;    Hypopituitarism;   

Others  :  1084932
DOI  :  10.1186/1472-6823-14-80

 received in 2014-08-02, accepted in 2014-09-29,  发布年份 2014

【 摘 要 】

Background

A number of studies of adults have shown that pituitary deficiencies can develop in a considerable proportion of subjects during the acute phase of meningitis or years after the infection has disappeared. The results of the very few studies of the impact of pediatric meningitis on hypothalamic-pituitary function are conflicting.

Methods

In order to determine the incidence of pituitary dysfunction in children with central nervous system infection, we evaluated pituitary function and anthropometric parameters in 19 children with meningitis of different etiologies (15 males; mean age ± standard deviation [SD] at pituitary evaluation, 5.9 ± 4.0 years; mean time from the acute event ± SD, 18 ± 10 months).

Results

All of the subjects had a normal stature and growth velocity for their age and gender, and none of them was obese. On the basis of Tanner’s reference charts, 17 subjects (13 boys and all four girls) were pre-pubertal; two boys were in Tanner stage 2. None of the subjects had central hypothyroidism. All of the patients had normal serum of insulin growth factor (IGF)-I and prolactin. Their sex steroid and gonadotropin levels were concordant with their age and pubertal status. Early morning urine osmolality and serum electrolyte levels showed no signs of diabetes insipidus. All of the patients had normal plasma adrenocorticotropic hormone (ACTH) levels. Peak cortisol responses to the standard dose Synacthen test (SDST) were normal in all cases.

Conclusions

The results showed that hypopituitarism following infectious meningitis appears to be infrequent in childhood and children’s pituitary glands seem to be less vulnerable to damage than those of adults.

【 授权许可】

   
2014 Giavoli et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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