Isolated Adrenocorticotropic Hormone or Thyrotropin Deficiency Following Mild Traumatic Brain Injury: Three Cases with Long-Term Follow-Up

Abstract

Few studies have examined the clinical features and long-term outcomes of isolated pituitary hormone deficiencies after traumatic brain injury (TBI). Such deficiencies typically present at time intervals after TBI, especially after mild injuries such as concussions, which makes their diagnosis difficult without careful history taking. It is necessary to improve diagnosis and prevent life threatening or morbid conditions such as those that may occur in deficiencies of adrenocorticotropic hormone (ACTH) or thyroid-stimulating hormone (as known as thyrotropin, TSH), the two most important pituitary hormones in hypopituitarism treatment. Here, we report two cases of isolated ACTH deficiency and one case of isolated TSH deficiency. These patients presented at different time points after concussion and underwent long-term follow-ups.

Two cases of traumatic isolated ACTH deficiency

“…A patient presented in case 1 occurred clinical symptoms of hypopituitarism for 34 years after severe traumatic injury. Recent report indicated 3cases of isolated ACTH or TSH defi ciency following mild traumatic brain injury with long-term follow (10 days-20 years)[10], which was similar to our case 1. Sixty-fi ve yearsold man occurred both isolated ACTH defi ciency and Crhon's disease at the same time in case 1.…”