Abnormal Lactation with Cushing's Syndrome—A Case Report<sup>1</sup>

Mahesh, Virendra B.; Pria, S. Dalla; Greenblatt, Robert B.

doi:10.1210/jcem-29-7-978

Cited by 24 publications

(4 citation statements)

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“…These are not distinct entities, however, since patients may progress from one syndrome to another and finally may develop acromegaly or Cushing's disease (Young et al, 1967;Mahesh et al, 1969). We have shown significant plasma prolactin activity in four out of six patients with the galactorrhoea-amenorrhoea-pituitary tumour syndrome and in half of the other patients with inappropriate lactation.…”

Section: Discussionmentioning

confidence: 65%

Plasma Prolactin Activity in Inappropriate Lactation

Forsyth¹,

Besser²,

Edwards³

et al. 1971

BMJ

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Section: Discussionmentioning

confidence: 65%

Plasma Prolactin Activity in Inappropriate Lactation

Forsyth¹,

Besser²,

Edwards³

et al. 1971

BMJ

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“…Complete bilateral adrenalectomy has been associated with subsequent emergence of an expanding ACTH-secreting pituitary tumor in some patients (27) and also necessarily leaves the patient dependent upon exogenous glucocorticoid and mineralocorticoid therapy. A transfrontal intracranial surgical approach was taken in some patients who had demonstrated obvious abnormalities of the sella turcica by standard radiographic techniques (28)(29)(30)(31)(32)(33)(34). The transfrontal approach allowed only limited visualization of the adenohypophysis, and selective tumor removal was virtually impossible.…”

Section: Discussionmentioning

confidence: 99%

Cushing' Disease: Management by Transsphenoidal Pituitary Microsurgery*

Bigos

Somma

Rasio

et al. 1980

The Journal of Clinical Endocrinology & Metabolism

153

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Over 15 yr, 24 patients underwent transsphenoidal pituitary surgery for Cushing's disease with a median follow-up of 12 months. Cures included 7 patients with normal sella turcicas (6 microadenomas), 6 patients with focal depressions (6 microadenomas) of the sella (grade I), and 3 patients (3 adenomas) with enlarged sellas (grade II). Three patients with sella destruction (grades III and IV), 2 with normal sellas, and 1 with focal sella depression (grade I) were not cured. Two apparent cures (microadenomas) recurred. Tumor histology revealed 19 basophilic adenomas; electron microscopy (14 tumors) and immunochemical studies (10 tumors) revealed only ACTH cells. Circadian rhythm returned in 6 cured patients. Impotence (in 2), amenorrhea (in 7), and galactorrhea (in 3) resolved in affected cured patients. The major surgical complication was hemorrhage at the operative site (3 patients). Transsphenoidal pituitary surgery is a valuable method for managing Cushing's disease in many patients.

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“…However, the reliability of these criteria is doubtful since lesions which appear clinically hypothalamic may evolve to frank pituitary adenomas (24)(25)(26)(27). Recent work has focused on the endocrine characterization of these lesions using prolactin measurements and appropriate stimulation tests in an attempt to identify them before they become radiologically apparent.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Hormonal Response To Bromocriptin (CB-154) in the Galactorrhea Syndromes

Pozo

Varga

Wyss

et al. 1974

The Journal of Clinical Endocrinology & Metabolism

187

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Nine female patients with galactorrhea were selected for treatment with Bromocriptin® (CB-154), a specific inhibitor of prolactin secretion. Elevated plasma prolactin (hPRL) was found in 7 of these cases, whereas 2 exhibited values within normal limits. LHRH (100 fig) stimulation elicited plasma LH/FSH increases in 6 of the women who were amenorrheic prior to therapy, indicating a suprasellar cause for the patients' failure to cycle. After TRH (250 fig) stimulation, 5 women out of 6 exhibited a blunted hPRL response and 4 of them failed to show any elevations after administration of chlorpromazine. It was only in one patient who exhibited basal hPRL within the normal range, that an average response to TRH was elicited. The possible mechanisms explaining the low levels of pituitary stimulation obtained are discussed.Treatment with CB-154 (3-5 mg/day) induced a fall in serum hPRL accompanied by cessation of milk secretion in 8 patients. Menses were restored in 7 amenorrheic women and corpora lutea formation was confirmed by elevated plasma progesterone levels in 6 of them. One patient exhibiting normal serum hPRL and amenorrhea following the discontinuation of an oral contraceptive failed to resume menses under CB-154 therapy despite a fall in hPRL, suggesting that the mechanisms involved were not prolactin-dependent.Hyperprolactinemia and galactorrhea tended to recur when therapy was withheld, indicating to a certain extent persistent autonomy of the mechanisms involved. Since CB-154 has been found to inhibit not only prolactin secretion but also hormone synthesis, it remains to be seen whether long-term therapy with this agent may induce permanent remissions in patients with galactorrheaamenorrhea. (/ Clin Endocrinol Metab 39: 18, 1974)

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Abnormal Lactation with Cushing's Syndrome—A Case Report¹

Cited by 24 publications

References 0 publications

Plasma Prolactin Activity in Inappropriate Lactation

Plasma Prolactin Activity in Inappropriate Lactation

Cushing' Disease: Management by Transsphenoidal Pituitary Microsurgery*

Clinical and Hormonal Response To Bromocriptin (CB-154) in the Galactorrhea Syndromes

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Abnormal Lactation with Cushing's Syndrome—A Case Report1

Cited by 24 publications

References 0 publications

Plasma Prolactin Activity in Inappropriate Lactation

Plasma Prolactin Activity in Inappropriate Lactation

Cushing' Disease: Management by Transsphenoidal Pituitary Microsurgery*

Clinical and Hormonal Response To Bromocriptin (CB-154) in the Galactorrhea Syndromes

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Product

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Abnormal Lactation with Cushing's Syndrome—A Case Report¹