Hyperprolactinemia

Fig. 6.1

Diagnosis of hyperprolactinemia algorithm

Fig. 6.2

(a) Before treatment. Sellar T1-weighted MRI after gadolinium enhancement, coronal (left) and sagittal (right) depicted a sellar mass impinging optic chiasma. (b) After 1 year of treatment with CAB. Sellar T1-weighted MRI after gadolinium enhancement, coronal (left) and sagittal (right) depicted an important reduction of tumor dimensions, with optic chiasma free of compression

Fig. 6.3

Prolactinoma treatment algorithm

A sellar MRI was performed in a 11-year-old male patient complaining of headache and a sellar mass was depicted (Fig. 6.2a). Serum PRL level was 1,130 ng/ml. The patient also had pubertal impairment development. Neurophthalmologic evaluation was normal. After 4 years of treatment with BRC, there was tumoral reduction without normalization of serum PRL levels. In our department, BRC was substituted for CAB and dosage was gradually augmented until 3.5 mg a week. After 1 year of treatment with CAB, serum PRL levels were normal and an additional tumoral reduction occurred (Fig. 6.2b).

References

Bronstein MD. Disorders of prolactin secretion and prolactinomas. In: DeGroot LJ, Jameson JL, editors. Endocrinology. 6th ed. Philadelphia, PA: Saunders; 2010. p. 333–57.

Bernichtein S, Touraine P, Goffin V. New concepts in prolactin biology. J Endocrinol. 2010;206(1):1–11.PubMedCrossRef

Batrinos ML, Panitsa-Faflia C, Tsiganou E, Pitoulis G, Liapi C. Contribution to the problem of hyperprolactinaemia: experience with 4,199 prolactin assays and 117 prolactinomas. Int J Fertil Menopausal Stud. 1994;39(2):120–7.PubMed

Colao A. Pituitary tumours: the prolactinoma. Best Pract Res Clin Endocrinol Metab. 2009;23(5):575–96.PubMedCrossRef

Vieira JGHV, Oliveira JH, Tachibana T, Maciel RMB, Hauache OM. Avaliação dos níveis de prolactina sérica: é necessário repouso antes da coleta? Arq Bras Endocrinol Metabol. 2006;50(3):569.PubMedCrossRef

Glezer A, Bronstein MD. Approach to the patient with persistent hyperprolactinemia and negative sellar imaging. J Clin Endocrinol Metab. 2012;97(7):2211–6.PubMedCrossRef

Glezer A, Bronstein MD. Pituitary autoimune disease: nuances in clinical presentation. Endocrine. 2012;42(1):74–9.PubMedCrossRef

Molitch ME. Drugs and prolactin. Pituitary. 2008;11:209–18.PubMedCrossRef

Hekimsoy Z, Kafesçiler S, Güçlü F, Özmen B. The prevalence of hyperprolactinemia in overt and subclinical hypothyroidism. Endocr J. 2010;57(12):1011–5.PubMedCrossRef

10.

Robin G, Catteau-Jonard S, Young J, Dewailly D. Physiopathological link between polycystic ovary syndrome and hyperprolactinemia: myth or reality? Gynecol Obstet Fertil. 2011;39(3):141–5.PubMedCrossRef

11.

Faubion WA, Nader S. Spinal cord surgery and galactorrhea: a case report. Am J Obstet Gynecol. 1997;177:465–6.PubMedCrossRef

12.

Saraç F, Tütüncüoğlu P, Ozgen AG, Saygili F, Yilmaz C, Bilgen I, Memiş A. Prolactin levels and examination with breast ultrasound or mammography. Adv Ther. 2008;25(1):59–66.PubMedCrossRef

13.

Glezer A, Soares CR, Vieira JG, Giannella-Neto D, Ribela MT, Goffin V, Bronstein MD. Human macroprolactin displays low biological activity via its homologous receptor in a new sensitive bioassay. J Clin Endocrinol Metab. 2006;91(3):1048–55.PubMedCrossRef

Only gold members can continue reading. Log In or Register to continue