Abstract:
CONTEXT:A wide range (15-56%) of prevalences of anterior pituitary insufficiency are reported in patients after traumatic brain injury (TBI). However, different study populations, study designs, and diagnostic procedures were used. No data are available on emergency-department-based cohorts of TBI patients. OBJECTIVE:To assess the prevalence of pituitary dysfunction in an emergency-department-based cohort of TBI patients using strict endocrinological diagnostic criteria. METHODS:Of all the patients presenting in the emergency department with TBI over a 2-year period, 516 matched the inclusion criteria. One hundred and seven patients (77 with mild TBI and 30 with moderate/severe TBI) agreed to participate. They were screened for anterior pituitary insufficiency by GHRH-arginine testing, evaluation of fasting morning hormone levels (cortisol, TSH, free thyroxine, FSH, LH, and 17beta-estradiol or testosterone), and menstrual history 3-30 months after TBI. Abnormal screening results were defined as low peak GH to GHRH-arginine, or low levels of any of the end-organ hormones with low or normal pituitary hormone levels. Patients with abnormal screening results were extensively evaluated, including additional hormone provocation tests (insulin tolerance test, ACTH stimulation test, and repeated GHRH-arginine test) and assessment of free testosterone levels. RESULTS:Screening results were abnormal in 15 of 107 patients. In a subsequent extensive endocrine evaluation, anterior pituitary dysfunction was diagnosed in only one patient (partial hypocortisolism). CONCLUSION:By applying strict diagnostic criteria to an emergency-department-based cohort of TBI patients, it was shown that anterior pituitary dysfunction is rare (<1%). Routine pituitary screening in unselected patients after TBI is unlikely to be cost-effective.
journal_name
Eur J Endocrinoljournal_title
European journal of endocrinologyauthors
van der Eerden AW,Twickler MT,Sweep FC,Beems T,Hendricks HT,Hermus AR,Vos PEdoi
10.1530/EJE-09-0436subject
Has Abstractpub_date
2010-01-01 00:00:00pages
19-28issue
1eissn
0804-4643issn
1479-683Xpii
EJE-09-0436journal_volume
162pub_type
杂志文章abstract::Design Hypercortisolism during pregnancy is a risk factor for prematurity. Long-term exposure to hypercortisolism may lead to permanent comorbidities, such as hypertension or diabetes, even after remission. Our aim was to determine whether women with a history of Cushing's disease (and being eu-, hypo- or hypercortiso...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-20-1224
更新日期:2021-01-01 00:00:00
abstract::The mineralocorticoid receptor (MR), a member of the steroid receptor family, acts as a transcription factor and mediates both aldosterone and cortisol effects. Aldosterone specificity in some tissues results from the inactivation of competing cortisol into cortisone by 11beta-hydroxysteroid dehydrogenase. In other ti...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1380702
更新日期:1998-06-01 00:00:00
abstract::Congenital generalized lipoatrophy (CGL) is a syndrome with multiple clinical manifestations and complete atrophy of adipose tissue. The exact mechanism of this disease remains unknown. One hypothesis presupposes an abnormal development of adipocytes. Leptin, the adipocyte-specific product of the ob gene, acts as a re...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1400107
更新日期:1999-01-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章,随机对照试验
doi:10.1530/EJE-11-0575
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVE:The intrarenal renin-angiotensin system (RAS) activation plays a pivotal role in immunoglobulin A nephropathy (IgAN) pathogenesis, which is still largely undefined. Recently, vasopressin (AVP) has been advocated to contribute to the genesis and progression of chronic kidney diseases (CKD) directly, and indire...
journal_title:European journal of endocrinology
pub_type: 杂志文章
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更新日期:2011-10-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1460881
更新日期:2002-06-01 00:00:00
abstract:UNLABELLED:Chronic exposure to hypercortisolism has significant impact on patient's health and health-related quality of life (HRQoL), as demonstrated with generic questionnaires. We have developed a disease-generated questionnaire to evaluate HRQoL in patients with Cushing's syndrome (CS; CushingQoL). OBJECTIVE:Valid...
journal_title:European journal of endocrinology
pub_type: 杂志文章
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更新日期:2008-05-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-10-0979
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVE:The current guidelines for the management of adrenal incidentaloma advise hormonal and radiological follow-up of patients for 2-5 years after the initial diagnosis. However, the vast majority of adrenal incidentaloma are non-functional benign cortical adenomas that require no treatment, so the routine applica...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-15-0199
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVE:Autosomal dominant hypocalcemia (ADH) is characterized by hypocalcemia and inappropriately low PTH concentrations. ADH type 1 is caused by activating mutations in the calcium-sensing receptor (CASR), a G-protein-coupled receptor signaling through α11 (Gα11) and αq (Gαq) subunits. Heterozygous activating mutat...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-16-0109
更新日期:2016-09-01 00:00:00
abstract:CONTEXT:McCune-Albright syndrome (MAS) is a disorder caused by a post-zygotic gain-of-function mutation in the gene encoding the Gs-alpha protein. Sexual precocity, common in girls, has been reported in only 15% of boys, and little is known on the long-term evolution of MAS in males. OBJECTIVE:In a boy with MAS, we st...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-07-0494
更新日期:2008-06-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-18-0254
更新日期:2018-12-01 00:00:00
abstract::We examined excretion of urinary insulin-like growth factors I and II (IGF-I and IGF-II) and their major binding protein IGFBP-3 in comparison to their respective serum concentration in nine healthy female volunteers (median age 25 years, range 22-27) under baseline conditions and after stimulation with recombinant hu...
journal_title:European journal of endocrinology
pub_type: 临床试验,杂志文章
doi:10.1530/eje.0.1320433
更新日期:1995-04-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1360649
更新日期:1997-06-01 00:00:00
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pub_type: 杂志文章
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更新日期:2002-07-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-14-0994
更新日期:2015-06-01 00:00:00
abstract::Tall stature is defined as a height of more than 2 standard deviations (s.d.) above average for same sex and age. Tall individuals are usually referred to endocrinologists so that hormonal disorders leading to abnormal growth are excluded. However, the majority of these patients have familial tall stature or constitut...
journal_title:European journal of endocrinology
pub_type: 杂志文章,评审
doi:10.1530/EJE-16-1054
更新日期:2017-06-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-09-0069
更新日期:2009-05-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 临床试验,杂志文章
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更新日期:2000-09-01 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:1999-06-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1300502
更新日期:1994-05-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章,评审
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更新日期:2014-06-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章,多中心研究
doi:10.1530/EJE-10-0602
更新日期:2010-12-01 00:00:00
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pub_type: 杂志文章
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更新日期:2011-05-01 00:00:00
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pub_type: 杂志文章
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更新日期:2008-03-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2013-05-02 00:00:00
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pub_type: 杂志文章
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更新日期:2009-10-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章,随机对照试验
doi:10.1530/EJE-11-0577
更新日期:2011-11-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-12-0521
更新日期:2012-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1530/EJE-09-0732
更新日期:2010-03-01 00:00:00