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BMJ Case Rep. 2010; 2010: bcr1220092526.
Published online 2010 September 29. doi:  10.1136/bcr.12.2009.2526
PMCID: PMC3028089
Findings that shed new light on the possible pathogenesis of a disease or an adverse effect

Delayed diagnosis of hypopituitarism following severe traumatic brain injury


The following case illustrates a 10-year delay in the diagnosis of hypopituitarism after severe traumatic brain injury in a 22-year-old man crushed by a forklift truck. His symptoms of mood changes, headaches and sleep pattern disturbances were attributed to post traumatic brain injury syndrome resulting in a delay in diagnosing the underlying pathology. Following recurrent episodes of symptomatic hyponatraemia, hypopituitarism was diagnosed. When pituitary hormone replacement treatment was given, there was clinical and biochemical improvement. There is currently very limited evidence in the literature to routinely screen patients post traumatic brain injury for pituitary dysfunction.

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