Pituitary function after moderate or severe traumatic brain injury in two pediatric reference centers in Bogotá D.C, Colombia.

Traumatic brain injury (TBI) is a major cause of morbidity and mortality in children worldwide. Hypopituitarism (HPPT) has been described as a potential long-term complication following moderate or severe TBI, with widely variable prevalence rates. The aim of this study was to evaluate pituitary function and to estimate the prevalence of hypopituitarism in pediatric patients with moderate or severe TBI followed at two referral centers in Bogotá, Colombia. A total of 53 patients with moderate (n = 23) or severe (n = 30) TBI were included. The mean age was 10.4 ± 5.5 years, and severe TBI was more frequent in males. Baseline pituitary hormone concentrations, including thyroid-stimulating hormone (TSH), free thyroxine (FT4), insulin-like growth factor 1 (IGF-1), morning cortisol, and prolactin, were assessed at least 6 months after the traumatic event. Growth hormone deficiency (GHD) was suspected in patients with IGF-1 levels ≤ - 2 standard deviations and confirmed using dynamic stimulation testing. Hormonal alterations consistent with hypopituitarism were identified in 3 of 53 patients (5.66%), all corresponding to growth hormone deficiency. Two of these patients had experienced severe TBI. No clinically relevant abnormalities were detected in the remaining pituitary axes.

conclusionsIn this cohort, hypopituitarism was identified in a small proportion of pediatric patients evaluated beyond the acute phase of moderate or severe TBI. These findings support the consideration of targeted endocrine evaluation as part of the long-term multidisciplinary follow-up of this population. WHAT IS KNOWN: • Hypopituitarism may develop after moderate or severe traumatic brain injury (TBI) in children and adolescents, with widely variable prevalence rates reported in the literature. • Growth hormone deficiency is the most frequent endocrine alteration during the chronic phase following pediatric TBI. WHAT IS NEW: • This is the first study conducted in a Colombian pediatric population to systematically evaluate pituitary function after moderate or severe TBI in referral centers. • What is new: A prevalence of hypopituitarism of 5.66%, exclusively due to growth hormone deficiency, was identified at least 6 months after the traumatic event, highlighting the importance of structured pituitary follow-up to reduce morbidity and improve long-term outcomes.