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Treatment of hyperprolactinemia

Bao Yang, Chenlong Yang, Yilin Sun, Jiang Du, Pinan Liu, Guijun Jia, Wang Jia, Yazhuo Zhang, Jisheng Wang, Yulun Xu, Shuo Wang
BACKGROUND: Mixed gangliocytoma-pituitary adenoma is an extremely rare tumor occurring in the sellar region, histologically composed of both gangliocytic and pituitary adenomatous architectures. The histogenesis of these tumors remains unknown, and the diagnosis, treatment, and prognosis are yet to be fully understood. METHODS: We retrospectively reviewed the clinical, radiological, and histopathological profiles from a series of 20 patients with sellar mixed gangliocytoma-pituitary adenomas...
August 14, 2018: Acta Neurochirurgica
Omar A Mazher, Eleni Maneta, William Hall
No abstract text is available yet for this article.
August 14, 2018: Journal of Clinical Psychopharmacology
Manuel Delgado-Alvarado, Diana Tordesillas-Gutierrez, Rosa Ayesa-Arriola, Manuel Canal, Victor Ortiz-García de la Foz, Javier Labad, Benedicto Crespo-Facorro
Patients with schizophrenia frequently present hyperprolactinemia as a consequence of antipsychotic treatment. However, an increase in circulating prolactin levels has also been shown in patients without previous treatment. Our objective was to compare prolactin levels between antipsychotic-naive first-episode psychosis (AN-FEP) patients and healthy controls (HC). As part of an FEP program (Programa Asistencial Fases Iniciales de Psicosis [PAFIP]), 270 AN-FEP patients and 153 HC were eligible for this study...
August 10, 2018: Archives of Women's Mental Health
Renata S Auriemma, Dario De Alcubierre, Rosa Pirchio, Rosario Pivonello, Annamaria Colao
Hyperprolactinaemia has been implicated in the pathogenesis of obesity and glucose intolerance and is reportedly associated with impaired metabolic profile and metabolic syndrome in approximately one third of patients. Area covered: Suppression of dopaminergic tone has been proposed as a potential mechanism responsible for weight gain and metabolic abnormalities in such patients. Dopamine receptor type 2 (D2 R) is abundantly expressed on human pancreatic β-cell and adipocytes, suggesting a regulatory role for peripheral dopamine in insulin and adipose functions...
March 2018: Expert Review of Endocrinology & Metabolism
Zhongjian Xie, Lusha Li, Wei Liu, Shiping Liu, Jianguang Luo, Eryuan Liao
Ovarian cysts are one of the most common gynecologic affections for females. The most effective therapy is surgery, but not for all conditions. An 18-year-old woman was referred to our hospital because of menstruation disorder and abdominal distension. Ultrasound and computer tomography of the abdomen revealed a giant ovarian cyst. Magnetic resonance imaging revealed profound pituitary enlargement. Laboratory studies showed severe hypothyroidism, mild anemia, hyperlipidemia, hyperprolactinemia and an elevated level of cancer antigen-125...
July 26, 2018: Journal of Obstetrics and Gynaecology Research
Garni Barkhoudarian, Sheri K Palejwala, Ronke Ogunbameru, Hua Wei, Amalia Eisenberg, Daniel F Kelly
OBJECTIVE: Invasive, medically-refractory, and multiply-recurrent pituitary adenomas pose a rare but nevertheless significant challenge to conventional management modalities. Temozolomide (TMZ) has been reported to be useful as an adjunctive treatment in some patients. We describe the efficacy of TMZ when used early in the management of invasive prolactinoma. CASE PRESENTATION: A 56-year-old male with presented with an invasive, refractory macroprolactinoma who had failed long-term dopamine agonists, stereotactic radiosurgery and multiple transsphenoidal surgical resections, with persistent hyperprolactinemia and tumor progression...
July 18, 2018: World Neurosurgery
Thomas Dodsworth, David D Kim, Ric M Procyshyn, Colin J Ross, William G Honer, Alasdair M Barr
The second generation antipsychotic drug risperidone is widely used in the field of child and adolescent psychiatry to treat conditions associated with disruptive behavior, aggression and irritability, such as autism spectrum disorders. While risperidone can provide symptomatic relief for many patients, there is considerable individual variability in the therapeutic response and side-effect profile of the medication. One well established biological factor that contributes to these individual differences is genetic variation in the cytochrome P450 enzyme 2D6...
2018: Child and Adolescent Psychiatry and Mental Health
Justin Seltzer, Michelle A Wedemeyer, Phillip A Bonney, John D Carmichael, Martin Weiss, Gabriel Zada
OBJECTIVE Incidental pituitary adenomas (IPAs) are commonly discovered during cranial imaging evaluations obtained for unrelated indications. The optimal management of IPA remains controversial. The authors investigated the outcomes and safety of the surgical treatment of IPAs at their institution. METHODS Clinical outcome data for 1692 patients surgically treated for pituitary adenomas at the Keck Medical Center of USC/USC Pituitary Center over a 17-year period (1999-2016) were reviewed to identify all cases with surgically managed IPAs...
June 1, 2018: Journal of Neurosurgery
Mohammad Rafi, Chhaya Goyal, Pooja Reddy, Shrikanth Reddy
The U.S. Food and Drug Administration (FDA) has approved a supplemental new drug application Lurasidone (Latuda, Sunovion Pharmaceuticals), an atypical antipsychotic, for the treatment of schizophrenia in adolescents 13-17 years of age. Lurasidone was previously indicated in the U.S. for the treatment of adults with schizophrenia and major depressive episodes with bipolar I disorder as monotherapy. We present a case of a 29-year-old male patient who was hospitalized with thrombocytopenia (WHO grade-3 toxicity) (unlabeled) along with extrapyramidal disorder, gastritis, and hyperprolactinemia within 2-3 months of initiation of tablet lurasidone 80 mg/day (Lurasid, Intas Pharmaceuticals) in bipolar depression...
March 2018: Indian Journal of Psychological Medicine
Luiza Tizziotti Cottas, Maria de Fátima Borges, Lívia Prata Santos Oliveira, Ana Luísa Mantovani Resende, Meire Soares Ataíde, Elisabete Aparecida Mantovani Rodrigues Resende
Polyglandular autoimmune syndrome type II (PGA-II) is a rare immunoendocrinopathy syndrome characterized by the occurrence of autoimmune Addison disease along with diabetes mellitus type 1 and/or autoimmune thyroid disease. Here, we report the case of a 23-year-old female with PGA-II who was followed up at the dermatology and endocrinology clinics of the Universidade Federal do Triângulo Mineiro, located in the state of Minas Gerais, Brazil. First, the patient presented diffuse skin hyperpigmentation, vitiligo; and in sequence, due to vomiting, appetite and weight loss, hypoglycemia, amenorrhea, and galactorrhea, the patient was then diagnosed with PGA-II...
July 2018: Revista Brasileira de Ginecologia e Obstetrícia
Ernesto Sosa-Eroza, Etual Espinosa, Claudia Ramírez-Rentería, Victoria Mendoza, Rocío Arreola, Moises Mercado
BACKGROUND AND OBJECTIVES: Dopamine agonist (DA)-resistant prolactinomas are rare but they constitute a real challenge, since there are few therapeutic alternatives left for these patients. DESIGN AND SETTING: Proof-of-concept study at a tertiary care, referral center. PATIENTS AND METHODS: The studied population consisted of five patients (one female and four males, mean age at diagnosis 23.5 ± 19) with macroprolactinomas with persistent hyperprolactinemia and/or tumor mass despite high doses of cabergoline (CBG) and pituitary surgery, to whom 20 mg monthly of octreotide LAR was added for 6-13 months...
August 2018: Endocrine
Rita Bettencourt-Silva, Josué Pereira, Sandra Belo, Daniela Magalhães, Joana Queirós, Davide Carvalho
Introduction: The diagnosis of pituitary carcinoma is very rare, requires the evidence of metastatic disease, and has a poor overall survival. Malignant prolactinoma frequently requires dopamine agonist therapy, pituitary surgery, radiotherapy, and even chemotherapy. Case description: A 19-year-old female presented with galactorrhea, primary amenorrhea, and left hemianopsia. Complementary study detected hyperprolactinemia and a pituitary macroadenoma with cavernous sinus invasion and suprasellar growth...
2018: Frontiers in Endocrinology
Chakrapani Balijepalli, Eric Druyts, Michael J Zoratti, Ping Wu, Salmaan Kanji, Kiran Rabheru, Kevin Yan, Kristian Thorlund
Background: Treatment of schizophrenia with first- and second-generation antipsychotics has been associated with elevated prolactin levels, which may increase the risk for prolactin-related adverse events. Methods: Randomized controlled trials (RCTs) included in a recent systematic review were considered for this analysis. A Bayesian network meta-analysis was used to compare changes in prolactin levels in pediatric patients diagnosed with schizophrenia or schizophrenia spectrum disorders treated with second-generation antipsychotics (SGAs)...
2018: Schizophrenia Research and Treatment
Elisa Sala, Justin M Moore, Alvaro Amorin, Giulia Carosi, Hector Martinez, Griffith R Harsh, Maura Arosio, Giovanna Mantovani, Laurence Katznelson
OBJECTIVE: Rathke's cleft cyst (RCC) is a common sellar lesion which may cause visual impairment, hypopituitarism and headaches from mass effect. The natural history of these lesions is currently unclear. We investigated the natural history of RCCs and compared surgically treated patients with those treated conservatively. METHODS: We performed a retrospective cohort study of patients diagnosed with a RCC between 1996 and 2016 at Stanford University and Ospedale Maggiore Policlinico di Milano...
May 21, 2018: Clinical Endocrinology
A N Johnston, W Bu, S Hein, S Garcia, L Camacho, L Xue, L Qin, C Nagi, S G Hilsenbeck, J Kapali, K Podsypanina, J Nangia, Y Li
BACKGROUND: Psychiatric medications are widely prescribed in the USA. Many antipsychotics cause serum hyperprolactinemia as an adverse side effect; prolactin-Janus kinase 2 (JAK2)-signal transducer and activator of transcription 5 (STAT5) signaling both induces cell differentiation and suppresses apoptosis. It is controversial whether these antipsychotics increase breast cancer risk. METHODS: We investigated the impact of several antipsychotics on mammary tumorigenesis initiated by retrovirus-mediated delivery of either ErbB2 or HRas or by transgenic expression of Wnt-1...
May 19, 2018: Breast Cancer Research: BCR
Lucio Vilar, Julio Abucham, José Luciano Albuquerque, Luiz Antônio Araujo, Monalisa F Azevedo, Cesar Luiz Boguszewski, Luiz Augusto Casulari, Malebranche B C Cunha Neto, Mauro A Czepielewski, Felipe H G Duarte, Manuel Dos S Faria, Monica R Gadelha, Heraldo M Garmes, Andrea Glezer, Maria Helane Gurgel, Raquel S Jallad, Manoel Martins, Paulo A C Miranda, Renan M Montenegro, Nina R C Musolino, Luciana A Naves, Antônio Ribeiro-Oliveira Júnior, Cíntia M S Silva, Camila Viecceli, Marcello D Bronstein
Prolactinomas are the most common pituitary adenomas (approximately 40% of cases), and they represent an important cause of hypogonadism and infertility in both sexes. The magnitude of prolactin (PRL) elevation can be useful in determining the etiology of hyperprolactinemia. Indeed, PRL levels > 250 ng/mL are highly suggestive of the presence of a prolactinoma. In contrast, most patients with stalk dysfunction, drug-induced hyperprolactinemia or systemic diseases present with PRL levels < 100 ng/mL. However, exceptions to these rules are not rare...
March 2018: Archives of Endocrinology and Metabolism
Patricia Gassó, Sergi Mas, Miquel Bioque, Bibiana Cabrera, Antonio Lobo, Ana González-Pinto, Covadonga M Díaz-Caneja, Iluminada Corripio, Eduard Vieta, Josefina Castro-Fornieles, Salvador Sarró, Anna Mané, Julio Sanjuan, Adrián Llerena, Amalia Lafuente, Jerónimo Saiz-Ruiz, Miguel Bernardo
BACKGROUND: Hyperprolactinemia is a common side-effect of antipsychotics (APs), which may trigger serious secondary problems and compromise the adherence to treatment which is crucial for prognosis, especially in patients presenting with a first-episode of psychosis (FEP). AIMS: We evaluated, in some cases for the first time, the effect of polymorphisms in multiple candidate genes on serum prolactin (PRL) levels in an AP-treated FEP cohort recruited in the multicenter PEPs study (Phenotype - genotype and environmental interaction; Application of a predictive model in first psychotic episodes)...
June 2018: Journal of Psychopharmacology
Mario Antunes, Marcella Schiavone, Damiano Pizzol, Francesco Di Gennaro, Rossana Ludovico, Angela De Palma
Gynecomastia is a common finding in males, with an incidence that varies widely globally. In 10-25% of cases, it is caused by drugs. Its pathophysiologic mechanism includes exposure to exogenous estrogens and medications that cause hypogonadism, antiandrogenic effects and hyperprolactinemia. Gynecomastia is associated with exposure to antiretroviral therapy (ART), particularly efavirenz. Sometimes surgery may be required as treatment. We report a case of a 46-year-old man receiving ART presenting with a marked bilateral breast enlargement who underwent bilateral mastectomy as the only successful treatment in a low-income setting...
May 11, 2018: Drug Safety—Case Reports
Amit Akirov, Yona Greenman, Benjamin Glaser, Irena S'chigol, Yossi Mansiterski, Yoav Eizenberg, Ilana Shraga-Slutzky, Ilan Shimon
OBJECTIVE: Hyperprolactinemia is common in acromegaly and in these patients, insulin-like growth factor (IGF)-1 level may decrease with dopamine agonist. We report a series of patients with prolactinoma and a paradoxical increase of IGF-1 levels during cabergoline treatment. METHODS: Clinical characteristics and response to treatment of patients with prolactinomas, in whom normal or slightly elevated baseline IGF-1 levels increased with cabergoline. RESULTS: The cohort consisted of ten prolactinoma patients (nine males, mean age 48 ± 14 years)...
August 2018: Pituitary
Jason R Bisson, Kelly J Chan, Joshua D Safer
OBJECTIVE: Existing transgender treatment guidelines suggest that there is a need to monitor prolactin levels in patients receiving transfeminine hormone treatment. Also, recent studies suggest that use of cyproterone acetate as an adjunctive anti-androgen during transgender hormone treatment may elevate serum prolactin. We sought to determine whether the reported relationship between transfeminine estradiol treatment and hyperprolactinemia would be evident when the regimen used spironolactone as the adjunctive anti-androgen...
July 2018: Endocrine Practice
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