Participation in a contact sport can rarely be associated with later development of hypopituitarism. The authors are from multiple institutions in France and Romania.
Mechanism: head trauma
Possible sites of injury:
(1) vascular supply to pituitary
(2) stalk
(3) hypothalamus
(4) hypotension
(5) hypoxemia
(6) direct trauma to the pituitary gland
Sports involved include boxing, kick boxing, American football, and rugby.
The hypopituitarism may be transient (with recovery after several months) or may become chronic.
Clinical features:
(1) history of head trauma, which may have been considered mild
(2) the patient may present with fatigue, decreased libido or evidence of a hormonal deficit (hypothyroidism, hypoadrenalism)
Diagnosis may be delayed if the possibility is not considered or if specific screening is not performed.
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