Citation

Langelier DM, Kline GA, Debert CT. Clin. J. Sport. Med. 2017; 27(6): e78-e79.

Affiliation

*Division of Physical Medicine and Rehabilitation, Department of Clinical Neurosciences, Foothills Medical Centre, University of Calgary, Calgary, AB, Canada; and †Division of Endocrinology, Department of Internal Medicine, University of Calgary, Calgary, AB, Canada.

Copyright

(Copyright © 2017, Canadian Academy of Sport Medicine, Publisher Lippincott Williams and Wilkins)

DOI

10.1097/JSM.0000000000000408

PMID

28114247

Abstract

An 18-year-old female ringette and basketball player presented to our sport concussion clinic 27 months after concussion with fatigue, headache, exercise intolerance, polyuria, nocturia, and difficulties concentrating. Her history was remarkable for 4 previous concussions. Her neurologic examination was normal. Neuroendocrine screen including thyroid function, morning cortisol, glucose, and insulin-like growth factor-1 (screening test for growth hormone deficiency) were normal. Further testing for growth hormone deficiency with an insulin hypoglycemia test revealed severe growth hormone deficiency. Urine and serum electrolytes were borderline normal, suggesting partial diabetes insipidus. Treatments with growth hormone replacement lead to complete recovery. This case highlights the importance of maintaining a high index of suspicion for neuroendocrine abnormalities in athletes with persistent symptoms after sport concussion. Symptoms can be nonspecific and go undiagnosed for years, but appropriate recognition and treatment can restore function.

Language: en