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Article: Hypopituitarism after tuberculous meningitis in childhood

TitleHypopituitarism after tuberculous meningitis in childhood
Authors
Issue Date1993
PublisherAmerican College of Physicians. The Journal's web site is located at http://www.annals.org
Citation
Annals Of Internal Medicine, 1993, v. 118 n. 9, p. 701-706 How to Cite?
AbstractObjective: To study the prevalence and pathogenesis of hypopituitarism following tuberculous meningitis in childhood. Design: A retrospective cross- sectional study. Setting: A university teaching hospital and a tuberculosis referral center. Patients: Forty-nine patients, aged 23.4 ± 6.0 years (mean ± SD), who had tuberculous meningitis in childhood (age at diagnosis, 5.9 ± 5.0 years) were studied. Measurements: A detailed assessment of hypothalamic- pituitary function, including conventional stimulation tests and responses to four hypothalamic releasing hormones, was done. Magnetic resonance imaging of the hypothalamic-pituitary region was performed in patients with abnormal endocrine function. Results: Ten patients were found to have abnormal pituitary function: Seven had growth hormone deficiency, four of whom also had gonadotropin deficiency; the other three had gonadotropin deficiency, corticotropin deficiency, and mild hyperprolactinemia, respectively; none had diabetes insipidus. Among those with growth hormone deficiency, a significant correlation (r = 0.749, P < 0.05) was found between the height standard deviation score and the age at diagnosis of tuberculous meningitis. Growth hormone, corticotropin, and gonadotropin responses to growth hormone releasing hormone, corticotropin releasing hormone, and gonadotropin releasing hormone, respectively, suggested a hypothalamic defect in five patients. Magnetic resonance imaging scans of the hypothalamic-pituitary region were abnormal in five patients. Conclusions: Hypopituitarism was documented in 20% of a small subset of patients years after recovery from tuberculous meningitis in childhood. The cause appears to be tuberculous lesions affecting the hypothalamus, pituitary stalk and, directly or indirectly, the pituitary itself. Early recognition and treatment can be beneficial.
Persistent Identifierhttp://hdl.handle.net/10722/161992
ISSN
2015 Impact Factor: 16.44
2015 SCImago Journal Rankings: 5.378
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLam, KSLen_US
dc.contributor.authorSham, MMKen_US
dc.contributor.authorTam, SCFen_US
dc.contributor.authorNg, MMTen_US
dc.contributor.authorMa, HTGen_US
dc.date.accessioned2012-09-05T05:16:30Z-
dc.date.available2012-09-05T05:16:30Z-
dc.date.issued1993en_US
dc.identifier.citationAnnals Of Internal Medicine, 1993, v. 118 n. 9, p. 701-706en_US
dc.identifier.issn0003-4819en_US
dc.identifier.urihttp://hdl.handle.net/10722/161992-
dc.description.abstractObjective: To study the prevalence and pathogenesis of hypopituitarism following tuberculous meningitis in childhood. Design: A retrospective cross- sectional study. Setting: A university teaching hospital and a tuberculosis referral center. Patients: Forty-nine patients, aged 23.4 ± 6.0 years (mean ± SD), who had tuberculous meningitis in childhood (age at diagnosis, 5.9 ± 5.0 years) were studied. Measurements: A detailed assessment of hypothalamic- pituitary function, including conventional stimulation tests and responses to four hypothalamic releasing hormones, was done. Magnetic resonance imaging of the hypothalamic-pituitary region was performed in patients with abnormal endocrine function. Results: Ten patients were found to have abnormal pituitary function: Seven had growth hormone deficiency, four of whom also had gonadotropin deficiency; the other three had gonadotropin deficiency, corticotropin deficiency, and mild hyperprolactinemia, respectively; none had diabetes insipidus. Among those with growth hormone deficiency, a significant correlation (r = 0.749, P < 0.05) was found between the height standard deviation score and the age at diagnosis of tuberculous meningitis. Growth hormone, corticotropin, and gonadotropin responses to growth hormone releasing hormone, corticotropin releasing hormone, and gonadotropin releasing hormone, respectively, suggested a hypothalamic defect in five patients. Magnetic resonance imaging scans of the hypothalamic-pituitary region were abnormal in five patients. Conclusions: Hypopituitarism was documented in 20% of a small subset of patients years after recovery from tuberculous meningitis in childhood. The cause appears to be tuberculous lesions affecting the hypothalamus, pituitary stalk and, directly or indirectly, the pituitary itself. Early recognition and treatment can be beneficial.en_US
dc.languageengen_US
dc.publisherAmerican College of Physicians. The Journal's web site is located at http://www.annals.orgen_US
dc.relation.ispartofAnnals of Internal Medicineen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshChilden_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshCross-Sectional Studiesen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshHypopituitarism - Blood - Etiology - Pathologyen_US
dc.subject.meshHypothalamus - Pathologyen_US
dc.subject.meshInfanten_US
dc.subject.meshMagnetic Resonance Imagingen_US
dc.subject.meshMaleen_US
dc.subject.meshMultivariate Analysisen_US
dc.subject.meshPituitary Hormones, Anterior - Blooden_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshTuberculosis, Meningeal - Complicationsen_US
dc.titleHypopituitarism after tuberculous meningitis in childhooden_US
dc.typeArticleen_US
dc.identifier.emailLam, KSL:ksllam@hku.hken_US
dc.identifier.authorityLam, KSL=rp00343en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid8460856-
dc.identifier.scopuseid_2-s2.0-0027408871en_US
dc.identifier.volume118en_US
dc.identifier.issue9en_US
dc.identifier.spage701en_US
dc.identifier.epage706en_US
dc.identifier.isiWOS:A1993KY50200007-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridLam, KSL=8082870600en_US
dc.identifier.scopusauthoridSham, MMK=36658827400en_US
dc.identifier.scopusauthoridTam, SCF=7202037323en_US
dc.identifier.scopusauthoridNg, MMT=24322089300en_US
dc.identifier.scopusauthoridMa, HTG=7403096173en_US

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