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2004, Number 5

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Gac Med Mex 2004; 140 (5)

The best approach to treat prolactinoma.

Zárate A, Saucedo R, Basurto L
Full text How to cite this article

Language: Spanish
References: 8
Page: 567-569
PDF size: 31.11 Kb.


Key words:

prolactinoma, hyperprolactinemia, galactorrheaamenorrhea syndrome, bromocriptine, ergolines.

ABSTRACT

The prolactinoma is the most frequent pituitary tumor; the clinical presentation in women is characterized by menstrual disorders, amenorrhea, galactorrhea and/or sterility; neurological symptoms are present only when the tumor exceeds the sella turcica which is exceptional. Prolactin levels over 100 ng/mL are usually diagnostic of prolactinoma, as long as there are no pregnancy and/or hypothyroidism. The first therapeutical option is dopamine agonist drugs, thus surgery has been practically eliminated. Dopaminergic drugs suppress both synthesis and prolactin secretion, which in turn restores the ovarian function and induces tumor shrinkage. In conclusion, dopamine agonists constitute the prolactinoma treatment; in addition drug withdrawal is followed by remission of prolactinoma activity. In men, the size of the prolactinoma is larger, macroprolactinoma which usually presents extrasellar extension accompanied of neurological and visual symptoms; however the prolactinoma exhibits a favorable response with dopaminergic drugs.


REFERENCES

  1. Schlechte JA. Prolactinoma. N Engl J Med 2003;349:2035-2041.

  2. Zárate A, Canales ES, Jacobs LS, Soria J, Daughaday WH. Restoration of ovarian function in patients with the amenorrhea-galactorrhea syndrome after long-term therapy with L-Dopa. Fertil Steril 1973;24:340.

  3. Tyson JE, Carter JN, Andreassen B, Huth J, Smith B. Nursing mediated prolactin and luteinizing hormone secretion during puerperal lactation. Fertil Steril 1978;30:154.

  4. Schlechte JA, Sherman BM, Chapler FK, VanGilder J. Long-term followup of women with surgically treated prolactin-secreting pituitary tumors. J Clin Endocrinol Metab 1986;62:1296-301.

  5. Losa M, Mortini P, Barzaghi R, Gioia L, Giovanelli M. Surgical treatment of prolactin-secreting pituitary adenomas: early results and long-term outcome. J Clin Endocrinol Metab 2002;87:3180-3186.

  6. Zárate A, Canales ES, Cano C, Pilonieta CJ. Follow-up of patients with prolactinomas after discontinuation of long-term therapy with bromocriptine. Acta Endocrinol 1983;104:139-42.

  7. Zárate A, Canales ES, Alger M. The effect of pregnancy and lactation on pituitary prolactin secreting tumors. Acta Endocrinol 1979;92:407-11.

  8. Bevan JS, Webster J, Hburke J, Scanlon MF. Dopamine agonists and pituitary tumor shrinkage. Endocr Rev 1992;13:220-240.




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C?MO CITAR (Vancouver)

Gac Med Mex. 2004;140