Objectives: Acute bacterial or viral CNS infections have been shown to result in hypopituitarism during the acute phase, and 624 months after the event in a few studies. However, there are no data in the literature regarding the long term pituitary functions after acute CNS infections. This cross-sectional study was designed to evaluate the pituitary functions long-term after the acute bacterial or viral CNS infections.
Methods: 19 patients with ages 1865 (mean: 39.53±17.089 years; 11 male patients, eight patients female) were included in the study. There were seven patients with acute bacterial meningitis, nine patients with acute viral encephalitis, and three cases of acute meningoencephalitis. Basal pituitary hormone levels were measured and glucagon stimulation test was performed 1792 months (mean 48.47±25.19 months) after the acute CNS infections. MRI was performed to evaluate the pituitary gland volume and to rule out any co-incidental pituitary mass.
Results: There were a total of 5 patients out of 19 (26.3%) with hypopituitarism; 3 (15.7%) with isolated GH deficiency, 1 (5.2%) with isolated FSH-LH deficiency and 1 (5.2%) with combined FSH-LH and GH deficiency in the study group. Mean pituitary volume was substantially lower in patients with hypopituitarism when compared to the patients without hypopituitarism. But the difference was not statistically significant.
Conclusion: This study clearly demonstrated that high frequency hypopituitarism, GH deficiency in particular, was still present long term after the acute bacterial or viral CNS infections. Therefore, the patients with acute meningitis, meningoencephalitis and/or encephalitis need to be screened at least 45 years after the acute event.
20 - 23 May 2017
European Society of Endocrinology