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Introduction: Endocrine complications of neonatal meningitis is rare. We report such 2 varied presentations, one presenting as precocious puberty and other as delayed puberty. Case 1: A 7 years girl presented with premature menarche. She had thelarche and pubarche from 6 months with no growth spurt. Patient had a history of neonatal meningitis with obstructive hydrocephalus. On examination her height is 132 cm which is 50 centiles above the MPH in growth chart. SMR is B2A1P3. Her bone age corresponds to 12 years. Hormonal evaluation showed basal LH is 12.41 mIU/ml, FSH is 5.50 mIU/ml, Estradiol is 143 pg/ml. Thyroid function tests are normal. As the base line LH levels are high, the diagnosis of gonadotrophin dependent precocious puberty is made. CT brain showed normal sella and dilated ventricles and VP shunt insitu. She is started on GnRH analogue luperolide monthly injection and rensponded well. Case 2: A 15 years old boy presented with short stature and global developmental delay. He was born to non consanguineous parents, developed meningitis at age of 20 days and seizures on and off till 7 years. On examination found to had height -7 SD and no other dysmorphic features. Stimulated growth hormone is less than 1 ng/ml, Serum cortisol is 4.7 µg/dl, remaining other pituitary hormones are normal. CT sella showed partial empty sella. This is a case of combined pituitary hormone deficiency, a neonatal meningitis post sequlae. Conclusion: Children with a history of neonatal meningitis should be closely followed for complications in growth. [ABSTRACT FROM AUTHOR]

Introduction: Postmenopausal women constitute an ideal model for studying the extent of hypothalamo-pituitary-gonadal (HPG) axis suppression in critical illness as the gonadotropinsare normally high and non-cyclical in them. Objectives: The objective of this study is (i) to assess the impact of acute severe illness on the HPG axis in postmenopausal women, (ii) to correlate the severity of illness with (a) activity of the HPG axis, (b) the activity of the hypothalamo-pituitary-adrenal axis, (c) activity of the hypothalamo-pituitary-thyroid axis and (d) serum prolactin. Methods: A total of 35 postmenopausal women older than 60 years admitted to medical intensive care with a simplified acute physiology score II (SAPS II) more than 30, consistent with a predicted in-hospital mortality of greater than 10% were recruited. On day 5 of their hospital stay, blood samples were collected for estradiol, luteinizing hormone (LH), follicle stimulating hormone (FSH), cortisol, androstenedione and prolactin and thyroid profile. As controls, 35 apparently healthy postmenopausal women were recruited. Results: Levels of LH, FSH, free thyroxin (fT4) and triiodothyronine were lower while estradiol, cortisol and androstenedione were higher among patients in comparison with healthy controls. Prolactin levels were similar in patients and controls. Among sick patients both FSH and fT4 showed a negative correlation (P < 0.05) with the SAPS II score. Conclusions: Estrogens are paradoxically elevated despite gonadotropin suppression in critically ill postmenopausal women, suggesting a non-ovarian origin of the same. Prolactin remained unaltered despite illness in patients, possibly reflecting atrophy of lactotrophs in menopause. [ABSTRACT FROM AUTHOR]