Diagnosis and management of hyperprolactinemia: Results of a Brazilian multicenter study with 1234 patients

Vilar, Lúcio; Freitas, Manuhela Cintra de; Naves, Luciana Ansaneli; Casulari, Luíz Augusto; Azevedo, Monalisa F.; Montenegro, Renan Magalhães; Barros, Anastasia; Faria, Manuel dos Santos; Nascimento, Gilvan Cortês; Lima, Josivan Gomes de; Nóbrega, Lúcia Helena Coelho; Cruz, Theresa; Mota, A.; Ramos, Aline Sharlon Maciel Batista; Violante, A; Filho, Adilson Lamounier; Gadelha, Mônica R.; Czepielewski, Mauro Antônio; Glezer, Andréa; Bronstein, Marcello D.

doi:10.1007/bf03346388

Cited by 108 publications

(117 citation statements)

References 36 publications

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“…Clinical evidence indicates that hyperprolactinemia is a frequent cause of reproductive dysfunction and may lead to infertility in males and females (10)(11)(12)(13). Pathological hyperprolactinemia is mainly caused by the presence of a prolactinoma or is due to pharmacological effects induced by drugs that interact with the dopamine system.…”

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confidence: 99%

Interactions between prolactin and kisspeptin to control reproduction

Donato

Frazão²

2016

Arch. Endocrinol. Metab.

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Prolactin is best known for its effects of stimulating mammary gland development and lactogenesis. However, prolactin is a pleiotropic hormone that is able to affect several physiological functions, including fertility. Prolactin receptors (PRLRs) are widely expressed in several tissues, including several brain regions and reproductive tract organs. Upon activation, PRLRs may exert prolactin's functions through several signaling pathways, although the recruitment of the signal transducer and activator of transcription 5 causes most of the known effects of prolactin. Pathological hyperprolactinemia is mainly due to the presence of a prolactinoma or pharmacological effects induced by drugs that interact with the dopamine system. Notably, hyperprolactinemia is a frequent cause of reproductive dysfunction and may lead to infertility in males and females. Recently, several studies have indicated that prolactin may modulate the reproductive axis by acting on specific populations of hypothalamic neurons that express the Kiss1 gene. The Kiss1 gene encodes neuropeptides known as kisspeptins, which are powerful activators of gonadotropin-releasing hormone neurons. In the present review, we will summarize the current knowledge about prolactin's actions on reproduction. Among other aspects, we will discuss whether the interaction between prolactin and the Kiss1-expressing neurons can affect reproduction and how kisspeptins may become a novel therapeutic approach to treat prolactin-induced infertility. Arch Endocrinol Metab. 2016;60(6):587-95

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mentioning

confidence: 99%

Interactions between prolactin and kisspeptin to control reproduction

Donato

Frazão²

2016

Arch. Endocrinol. Metab.

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“…As mentioned earlier, 9%-30% of metastases detected by re-examining the lymph nodes with serial sections could not be detected in routine pathologic infertility testing (10,41) This insufficiency could be removed by reducing the cross-sectional area from the lymph node and by cytokeratin immunohistochemical staining (i.e., specific monoclonal antibody) (41, 42). A learning curve (19,32) was reported in many related studies. An experienced surgeon who applied both methods together had an SLN detection rate of 94%, whereas this rate was 86% for newly recruited surgeons (43).…”

Section: Discussionmentioning

confidence: 86%

“…In the National Surgical Adjuvant Breast and Bowel Project (NSABBP)-B04 study, the average number of lymph nodes removed was between 7 and 30 at different centers. This huge difference between the numbers was based on the surgical technique applied, the experience and tendency of the surgeon, and the ability of the pathologist to evaluate the dissection material (18,19,20,21). In the present study, the number of lymph nodes removed in 44 patients who underwent axillary dissection detected using the ISB method was minimum 7 and maximum 23 (average number 14.2).…”

Section: Discussionmentioning

confidence: 99%

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Comparison of the accuracy of isosulfan blue and technetium-99m lymphoscintigraphy to determine axillary lymph node metastasis in breast cancer

Albuz¹,

Akkurt²,

Ayan³

et al. 2017

Med J Islamic World Acad Sci

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Breast cancer is the most common malignant neoplasm in women, accounting for nearly 31% of all female cancers (1-3). Most patients in developed countries are diagnosed with stages I and II, of which about 65% have no axillary lymph node (ALN) metastasis (4). However, complications such as edema, seroma, injuries of veins and nerves passing through ALN, limitation of arm movements, and pain are noted (5-7). The presence and number of axillary metastatic lymph nodes are the most important prognostic factors in breast cancer (4-7). The results of clinical evaluation of the axillary region are often misleading in approximately one third of patients (7-11). It was determined in 1930 that the lymphatic drainage of the primary tumor was directed to a focal point, from where it spread to other lymph nodes. This first station of lymph node metastasis was called sentinel lymph node (SLN) (12,13). Systematic studies of breast cancer have shown that cancer spreads to one or more SLNs before spreading to other ALNs (14,15). The present study aimed to evaluate axillary sentinal lymph node metastasis for breast cancer diagnosis. The effectiveness of technetium-99 m sulfur colloid, isosulfan blue (ISB), and concomitant use of technetium-99 m sulfur colloid and ISB was compared. SUMMARYThis study aimed to compare the efficiency of isosulfan blue (ISB) and colloid methods in determining metastatic conditions of axillary lymph node in sentinel lymph node biopsy (SLNB). This prospective study was performed between April 2005 and July 2009 at Gulhane Medical Faculty, Department of General Surgery. A total of 102 female patients diagnosed with breast cancer were enrolled in the clinic of Gulhane School of Medicine. According to the diagnostic protocols of SLN, the patients were divided into three groups as follows: ISB (group I), colloid (group II), and ISB and colloid (group III). SLN was identified in 49 of 52 patients (94.2%) in the ISB group; the sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and false negativity (FN) ratio were found to be 90.9%, 75.8%, 96.1%, 55.5%, and 9.1%, respectively. On the contrary, the sentinel lymph node was identified in 38 of 38 (100%) patients in the colloid group; the sensitivity, specificity, PPV, NPV, and FN were found to be 88.2%, 100%, 100%, 91.3%, and 11.8%, respectively. In ISB and colloid groups; SLN was identified in 12 of 12 (100%) patients in the ISB and colloid groups; the sensitivity, specificity, PPV, NPV, and FN were found to be 100%, 100%, 100%, and 0%, respectively. This study showed that the combined methods applied to heterogeneous groups of patients for SLNB in breast cancer cases were minimally invasive and effective and hence could be used for evaluating nodal metastases.

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“…Some studies demonstrate that risperidone can increase PRL levels by more than 200 ng/mL; however, PRL levels in drug-associated hyperprolactinemia are generally in the range of 25-100 ng/mL (18). A study has shown that antidepressants (tricyclic antidepressants) and antipsychotics (haloperidol, phenothiazines, and risperidone) are responsible for the majority of cases with drug-associated hyperprolactinemia (19). Serum PRL level increases within hours after antipsychotic use and returns to normal within 2-4 days after discontinuation of chronic therapy (20).…”

Section: Pharmacological Causesmentioning

confidence: 99%