Hyperprolactinemia: Etiology, Diagnosis, and Management

Mah, Peak Mann; Webster, Jonathan

doi:10.1055/s-2002-36709

Cited by 125 publications

(85 citation statements)

References 37 publications

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“…Selective degeneration of DA neurons in the SN but not in the VTA or the hypothalamus leads to Parkinson's disease (PD) (3)(4)(5)(6)(7), whereas abnormal function of the VTA DA neurons has been linked to schizophrenia, attention deficit, addiction, and hyperactivity disorders (8)(9)(10)(11). In addition, dysfunction of hypothalamic DA neurons can cause hyperprolactinemia, an endocrine disorder of the reproductive system (12), whereas changes in the activity of the NA system have been linked to depression as well as sleep disorders (13,14).…”

mentioning

confidence: 99%

Molecular basis for catecholaminergic neuron diversity

Grimm

Mueller

Hefti

et al. 2004

Proc. Natl. Acad. Sci. U.S.A.

134

141

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Catecholaminergic neurons control diverse cognitive, motor, and endocrine functions and are associated with multiple psychiatric and neurodegenerative disorders. We present global gene-expression profiles that define the four major classes of dopaminergic (DA) and noradrenergic neurons in the brain. Hypothalamic DA neurons and noradrenergic neurons in the locus coeruleus display distinct group-specific signatures of transporters, channels, transcription, plasticity, axon-guidance, and survival factors. In contrast, the transcriptomes of midbrain DA neurons of the substantia nigra and the ventral tegmental area are closely related with <1% of differentially expressed genes. Transcripts implicated in neural plasticity and survival are enriched in ventral tegmental area neurons, consistent with their role in schizophrenia and addiction and their decreased vulnerability in Parkinson's disease. The molecular profiles presented provide a basis for understanding the common and population-specific properties of catecholaminergic neurons and will facilitate the development of selective drugs.C atecholaminergic (CA) neurons producing the neurotransmitters dopamine (DA) and noradrenalin (NA) are organized in anatomically discrete groups and constitute Ϸ1 of 10 7 cells in the vertebrate CNS (1, 2). The most prominent groups of DA neurons reside in the substantia nigra (SN; A9 cell group; Ϸ10,000 neurons in the rat) and the ventral tegmental area (VTA; A10; Ϸ25,000 neurons) of the midbrain. The SN neurons provide the nigrostriatal ascending inputs to the telencephalon and comprise a key component of the extrapyramidal motor system controlling postural reflexes and initiation of movement. DA neurons in the adjacent VTA give rise to mesocortical and mesolimbic pathways that are implicated in control of emotional balance, reward-associated behavior, attention, and memory. Additional groups of DA neurons reside in the medial zona incerta of the hypothalamus (A13; Ϸ900 neurons) and participate in the regulation of endocrine functions. The largest collection of NA neurons resides in the pontine locus coeruleus (LC; Ϸ1,500 neurons). These neurons form a modulatory projection system to most CNS areas and contribute to the regulation of emotional status, sensory perception, arousal, sleepwake patterns, and most autonomic functions.Consistent with their varied functions, the CA neurons are associated with multiple neurodegenerative, psychiatric, and endocrine disorders. Selective degeneration of DA neurons in the SN but not in the VTA or the hypothalamus leads to Parkinson's disease (PD) (3-7), whereas abnormal function of the VTA DA neurons has been linked to schizophrenia, attention deficit, addiction, and hyperactivity disorders (8-11). In addition, dysfunction of hypothalamic DA neurons can cause hyperprolactinemia, an endocrine disorder of the reproductive system (12), whereas changes in the activity of the NA system have been linked to depression as well as sleep disorders (13,14).The drugs currently available for therapy reflec...

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mentioning

confidence: 99%

Molecular basis for catecholaminergic neuron diversity

Grimm

Mueller

Hefti

et al. 2004

Proc. Natl. Acad. Sci. U.S.A.

134

141

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“…Moreover, removal and examination of level l and level ll lymph nodes yields desired results due to axillary dissection; Table 4A: Number of metastatic and non metastatic total lymph node and distrubition in Tc 99m sulfur colloid group. however, the morbidity is close to that of complete axillary dissection when it is performed with radiotherapy (17). The number of lymph nodes removed during axillary dissection depends on a number of factors, most notably the extent of dissection.…”

Section: Discussionmentioning

confidence: 97%

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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“…In other studies, the prevalence of hyperprolactinemia varied from approximately 0.2% in an unselected normal adult population to 15%-20% among women with reproductive disorders, whereas a study of women with a wider age range (15-45 years) found that 61% of patients with abnormal bleeding had hyperprolactinemia, whereas in our study only 18% of patients with abnormal uterine bleeding had hyperprolactenemia and 2% of women without abnormal uterine bleeding had hyperprolactenemia. [24][25][26] Most of thegynaecologists today will investigate for prolactin levels only among patientswith symptoms of galactorrhea or galactorrhea associated with oligomenorrhea or amenorrhea. In the current study, galactorrhea was present in 18% of the patients with AUB overall.…”

Section: Discussionmentioning

confidence: 99%

Assessment of thyroid and prolactin levels among the women with abnormal uterine bleeding

John

Damodaran

Radhakrishnan

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Thyroid disorders are 10 times more common in women than men.1 Menstrual disturbances usually accompany clinical alterations in thyroid function and every clinician would have encountered altered menstrual pattern among women suffering from either hypo or hyper thyroidism. A high serum prolactin level can distrurb the follicular maturation and corpus luteum function, and leads to inhibition of normal pulsatile secretion of gonadotrophin-releasing hormone in hypothalamus resulting in anovulation. The aim of the study was to assess the thyroid and the prolactin levels among the women with abnormal uterine bleeding and to evaluate the association between them by comparing with normal females.Methods: A cross sectional study was conducted for a period of one year between Jan 2016 and December 2016 in our institution at the gynaecology OPD. Patients in the age group of 15 to 45 with the complaints of abnormal uterine bleeding and with the ultrasound findings showing normal uterus and ovary were included in the study. Hundred age and sex matched controls without any complaints of abnormal uterine bleeding in the age group of 15 – 45 years were also included in the study. Free T3, Free T4, TSH and prolactin estimation was done by chemiluminescent immunoassay for both the patients and the controls.Results: The mean TSH levels among the cases were much higher than that of the controls and the difference in the levels found to be statistically significant. Similarly, hyperprolactinemia was found in 18 cases when compared to 2 cases in controls and the mean prolactin levels were higher in cases. The serum prolactin levels and the serum TSH levels showed a perfect positive correlation which indicates that as the TSH level increases prolactin levels also increases with the R value >0.5.Conclusions: Early detection of hypothyroidism in such subjects saves the patient from recurrent curettage and at times hysterectomy. The ﬁnancial implications of screening for prolactin/thyroid hormone abnormalities will have to be evaluated before a general recommendation can be made.

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Hyperprolactinemia: Etiology, Diagnosis, and Management

Cited by 125 publications

References 37 publications

Molecular basis for catecholaminergic neuron diversity

Molecular basis for catecholaminergic neuron diversity

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

Assessment of thyroid and prolactin levels among the women with abnormal uterine bleeding

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