Anterior pituitary function in patients of meningoencephalitis: An observational longitudinal study from eastern India
Saugata Dasgupta, Sumit Kumar Chakrabarti, Subir Sen, Alakendu Ghosh
Aim and Objective: To study the anterior pituitary functions in patients of meningoencephalitis and also the prevalence of anterior pituitary dysfunction at diagnosis and at six months follow up of patients of meningoencephalitis.
Materials and Methods: Observational, longitudinal, hospital-based, single centre study included 100 patients admitted in the medicine & neuro-medicine department of IPGME &R, Kolkata who diagnosed with meningoencephalitis. Blood investigations like Complete blood count., Blood urea and creatinine, Fasting and post prandial serum glucose, Lipid profile, Serum Sodium and potassium, Anterior pituitary hormone test-Thyroid stimulating hormone(TSH), FT4, FSH, LH, IGF1, Prolactin, Cortisol, ACTH, HbA1c and other relevant investigations was done.
Results: Anterior pituitary dysfunction is common with meningoencephalitis, most common being low IGF1 (47%) followed by low FSH (35%). Not much significant difference has been found among TBM and non TBM cases. Multiple hormone deficiency among 45.2% TBM Cases while 53.1% non TBM cases. Many patients with hormonal deficit at baseline found to recover at 6 month while new cases (two cases of central hypothyroidism & low IGF1, 7 cases of low FSH & LH, five cases of hypocortisolism) develop deficiency at 6 month.
Conclusion: A high index of clinical suspicion is required to identify HPI following CNS infections condition in both acute settings and in the long-term follow-up of patients.