Management of prolactinomas: a survey of physicians from the Middle East and North Africa

Beshyah, Salem A.; Sherif, Ibrahim H.; Chentli, F.; Hamrahian, Amir H.; Khalil, Aly B; Raef, Hussein; El-Fikki, Mohamed; Jambart, S

doi:10.1007/s11102-016-0767-5

Cited by 24 publications

(29 citation statements)

References 21 publications

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“…Beshyah et al [31] conducted a survey on the management of prolactinomas by physicians from the Middle East and North Africa. Some of the practices are not in line with the latest Endocrine and Pituitary Societies guidelines.…”

Section: What Are the Current Trends In The Management Of Prolactinommentioning

confidence: 99%

“…65 % and 38 % respectively of respondents advocated discontinuation of treatment with dopamine agonists for patients with microprolactinomas and macroprolactinomas. Finally, 48 % would allow breast-feeding without restriction, 28 % would restrict it to patients with microprolactinomas and 25 % would not recommend it for women with prolactinomas [31].…”

Section: What Are the Current Trends In The Management Of Prolactinommentioning

confidence: 99%

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Pregnancy and Tumor Outcomes in Women with Prolactinoma

Araújo

Belo

Carvalho

2017

Exp Clin Endocrinol Diabetes

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Management of prolactinomas during pregnancy has always been a challenge. There is a concern about the risk of tumor growth, as well as the effects of the treatment on the developing fetus. Another issue that has been less studied is the outcome of women with prolactinoma after pregnancy and lactation. To evaluate remission of hyperprolactinaemia after pregnancy and lactation in women with prolactinoma. To describe the safety of dopamine agonists for the fetus and pregnancy outcomes. A retrospective study of 32 pregnancies in women with prolactinoma was conducted in a single-centre. Other causes of hyperprolactinemia were excluded. Prolactin level was recorded at the time of diagnosis, during treatment, and during follow-up. The pregnancies resulted in one spontaneous abortion (3.1%) and 31 live births (96.9%). No stillbirths, multiple or ectopic pregnancies or trophoblastic disease were recorded. There was only one malformation (club foot) recorded (3.1%) and normalisation of prolactin after pregnancy without medical treatment occurred in 12% of patients. Fetal exposure to bromocriptine or cabergoline during pregnancy is not associated with an increased risk of adverse neonatal or pregnancy disclosures. There is considerable diversity among endocrinologists in the management of prolactinomas during pregnancy and after birth, which indicates that there is a need for better consensus and for carefully drawn-up guidelines to follow.

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Section: What Are the Current Trends In The Management Of Prolactinommentioning

confidence: 99%

Section: What Are the Current Trends In The Management Of Prolactinommentioning

confidence: 99%

Pregnancy and Tumor Outcomes in Women with Prolactinoma

Araújo

Belo

Carvalho

2017

Exp Clin Endocrinol Diabetes

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“… The data of Brazil and MENA are derived from Ref. ( 4 , 5 ) respectively. P values using the Chi-square test (or Fisher’s exact test).…”

Section: Resultsmentioning

confidence: 99%

“…However, in the current clinical practice, there are still controversies concerning appropriate diagnosis and treatment of prolactinoma, such as the identification of hyperprolactinemia, the choice of treatment methods, the duration of drug treatment and management of pregnancy and breastfeeding. In recent years, two studies have conducted questionnaire surveys of clinicians’ management of prolactinomas reflecting self-reported clinical diagnoses and treatment ( 4 , 5 ). However, no similar data are available from China.…”

Section: Introductionmentioning

confidence: 99%

Management of prolactinoma: a survey of endocrinologists in China

Zhang

et al. 2018

Endocrine Connections

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ObjectiveTo assess the current management of prolactinoma among endocrinologists in China.MethodsAn online survey of a large sample of endocrinologists was conducted in China. The questionnaire included 21 questions related to controversial issues about the management of prolactinomas. Doctors in the endocrinology department of a university-affiliated hospital or a comprehensive secondary hospital in 12 cities from East, West, South, North and Middle China were surveyed.ResultsA total of 290 valid questionnaires were collected, and the response rate was 40%. When hyperprolactinemia occurred, 97% of the respondents would test thyroid-stimulating hormone routinely. 22% of the respondents considered that prolactin levels <100 ng/mL exclude the presence of a prolactinoma. Only 9% of the respondents believed that prolactin >250 ng/mL could occur in all the following situations as macroprolactinoma, mircoprolactinoma, macroprolactinemia and drug-induced hyperprolactinemia. Surgery was not recommended by 272 (94%) endocrinologists as the first choice for treating microprolactinomas. 58% and 92% of endocrinologists would start drug treatment for microprolactinomas and macroprolactinomas at diagnosis. 70% and 40% chose to withdraw treatment after 2–3 years of prolactin normalization in microprolactinomas and macroprolactinomas. In case of pregnancy, 57% of the respondents considered bromocriptine as choice for women patients. Drug discontinuation after pregnancy was advocated in 63% and 27% for microprolactinoma and macroprolactinoma. Moreover, 44% of endocrinologists believed that breastfeeding was allowable in both micro- and macroprolactinoma.ConclusionThis is the first study to investigate the management of prolactinomas among endocrinologists in China. We found that the current clinical treatment was not uniform. Therefore, it is necessary to strengthen the training of endocrinologists to improve clinical diagnosis and treatment practices.

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“…Opinions on the infl uence of breastfeeding in the case of a pre-existing prolactinoma are divided. A survey of 468 doctors showed that 47% of them would allow unrestricted breastfeeding, 28% would allow breastfeeding only by patients with microprolactinomas and 25% would not recommend breastfeeding at all 37 .…”

Section: Prolactinomamentioning

confidence: 99%

Contraindications to Breastfeeding - Current Issues at the Border Between Myth and Reality

Stanescu¹,

Totan²,

Mircescu³

et al. 2019

Rev. Med. Mod.

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Breast milk is recommended as an optimal and exclusive source of early nutrition for all infants from birth to at least 6 months of age. Despite all the benefi ts of breastfeeding, there are situations where breastfeeding is contraindicated. There are differences of opinion regarding the contraindications of breastfeeding, the current research bringing more knowledge in this area. It is important to know the differences of opinion for the correct approach of the breastfeeding patient.

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Management of prolactinomas: a survey of physicians from the Middle East and North Africa

Abstract: This is the first study of the clinical management of prolactinomas in the MENA region. Some of the practices are not in line with the latest Endocrine and Pituitary Societies guidelines. These warrant further discussions of contemporary guidelines in regional forums.

Cited by 24 publications

References 21 publications

Pregnancy and Tumor Outcomes in Women with Prolactinoma

Pregnancy and Tumor Outcomes in Women with Prolactinoma

Management of prolactinoma: a survey of endocrinologists in China

Contraindications to Breastfeeding - Current Issues at the Border Between Myth and Reality

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