Prolactin-Secreting Pituitary Tumors in Amenorrheic Women: A Comprehensive Study*

Schlechte, Janet A.; Sherman, Barry M.; Halmi, N. S.; VanGilder, John C.; Chapler, Frederick K.; Dolan, Kenneth D.; Granner, Daryl K.; Duello, Theresa M.; Harris, Curtis E.

doi:10.1210/edrv-1-3-295

Cited by 112 publications

(32 citation statements)

References 72 publications

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“…Repeated CT scan of the brain showed a decrease in the density and size of the still persisting lesion. This patient demonstrates that hyperprolactinemia can cause delayed puberty with a particular inhibitory effect on uterine growth and development.During the past decade hyperprolacti nemia has been reported with increasing fre quency as a cause for hypogonadism in adults, in the female usually presenting as secondary amenorrhea with or without galac torrhea [1-4], There have, however, been few reports on hyperprolactinemia affecting pu bertal development in children and adoles cents [5][6][7], The large series of hyperprolacti nemic women reported in the literature in clude a few with primary amenorrhea [3,8,9], which can be regarded as an interference with normal puberty.Up to now no observations have been reported on the changes taking place in the internal genitalia in adolescent girls with hy- …”

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confidence: 99%

Delayed Puberty and Hypoplastic Uterus Associated with Hyperprolactinemia: Successful Treatment with Bromocriptine

Kauli¹,

Schoenfeld²,

Ovadia³

et al. 1985

Horm Res

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A 15-year-old girl referred because of primary amenorrhea was found to have a hypoplastic uterus and persistent hyperprolactinemia (72–110 ng/ml). The gonadotrophin-dependent pubertal signs, i.e. breast and vulvar development, were significantly retarded (Tanner stage 2–3) while sexual hair was well developed; bone age was 13 years. The endocrinological evaluation revealed gonadotrophin secretion (LH – basal: 0.85–1.25; peak after LH-RH: 10.4 mlU/ml; FSH – basal: 1.63–2.5; peak: 8.2 mlU/ml) and E₂ levels (26–68 pg/ml) which were appropriate for Tanner stage 3. The high basal levels of PRL were nonresponsive to either stimulatory (TRH) or inhibitory (nomifensine) agents. CT scan of the brain suggested the presence of a pituitary microadenoma. Following therapy with bromocriptine (2.5 mg/day) plasma PRL levels dropped to normal (5–6.8 ng/ml) with an accompanying catch-up of pubertal development and linear growth and a marked increase in size of the uterus as documented by repeated ultrasonographic examinations. Menarche occurred 5 months after initiation of therapy, followed by regular menses thereafter. Repeated CT scan of the brain showed a decrease in the density and size of the still persisting lesion. This patient demonstrates that hyperprolactinemia can cause delayed puberty with a particular inhibitory effect on uterine growth and development.

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confidence: 99%

Delayed Puberty and Hypoplastic Uterus Associated with Hyperprolactinemia: Successful Treatment with Bromocriptine

Kauli¹,

Schoenfeld²,

Ovadia³

et al. 1985

Horm Res

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“…However, an indirect mechanism implicating prolactin in the pathogenesis of endometrial carcinoma can be postulated. The clinical manifestations of hyperprolactinemia in premenopausal women include infertility, galactorrhea, oligomenorrhea, or amenorrhea and are due to prolactin-mediated inhibition of the release of gonadotropin-releasing hormone [9]. Thus luteinizing hormone and FSH secretion are in turn inhibited as was evident in this case.…”

Section: Discussionmentioning

confidence: 86%

Synchronous Endometrial Carcinoma and a Macroprolactinoma: Exploring a Causal Relationship

Sharma

Padua³

et al. 2007

Oncology

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Background: While unopposed estrogen hormone secretion is most commonly implicated in the pathogenesis of endometrial carcinoma, the role of prolactin has only recently been highlighted. The authors present a case of a synchronous endometrial carcinoma in a patient with a prolactin-secreting macroadenoma. Methods: A 29-year-old woman presented with a 4-year history of primary infertility, irregular periods and intermittent galactorrhea. Hormonal evaluation revealed elevated prolactin and subnormal luteinizing hormone and follicle-stimulating hormone (FSH) serum concentrations. An ultrasound of the pelvis revealed endometrial thickening. The MRI of the brain confirmed a pituitary macroadenoma. The patient underwent a resectoscopic polypectomy and dilation and curettage followed by transnasal transsphenoidal excision of the pituitary macroadenoma. Results: The biopsy of the endometrium revealed a well-differentiated endometrioid carcinoma while that of the pituitary tumor confirmed a prolactinoma. Conclusion: An indirect causal mechanism can be postulated to explain this association. Hyperprolactinemia inhibits gonadotropin-releasing hormone leading to subnormal FSH and luteinizing hormone levels. Though the patient is hypoestrogenic, chronic anovulation with unopposed estrogen secretion can increase the risk of endometrial carcinoma. Patients with prolactinomas and irregular menstrual bleeding should undergo endometrial sampling to rule out this possibility.

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“…Triiodothyronine T3 is formed chiefly by deiodination of T4, is the active hormone at the nuclear receptor, and it is generally accepted that deiodination is the major pathway regulating T3 bioavailability in mammalian tissues [21]. Central hypothyroidism due to hypothalamic or pituitary disorders, the amount of serum thyrotropin can be low because of decreased production or inappropriately normal or only modestly elevated as a result of synthesis of a thyrotropin molecule with reduced bioactivity [22,23].…”

Section: Discussionmentioning

confidence: 99%

Prolactin, Thyroid Stimulating Hormone and Thyroid Hormones (Ft3, Ft4) Concentrations in Female Patients with Inferility: An Observational Study

Subhan¹,

Sadiq²,

Subhan³

2017

J Clin Exp Pathol

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Objective: To determine the variations in thyroid hormones, thyroid stimulating hormone and prolactin levels in females of our population. Materials and methods:Subject characteristics: Patients aged 13 to 60 years were studied for their hormonal profile. The inclusion criteria had patients with complaints of mild reproductive and thyroid dysfunction. Patients with severe disorders and cancerous conditions were excluded from the study.Blood sampling: 3 ml blood was drawn and transferred to clean test tubes. Blood was centrifuged at 3000 rpm for 10-15 min. Serum was separated and stored at -20℃.Hormonal assay: Thyroid stimulating hormone (TSH), Prolactin, FT3 and FT4 were assayed in the serum. Equipment used in laboratory was Eclecsys 2010 (Roche). Principle of the hormonal test was based on ECL (Electrochemiluminescence). Standard kits by Roche were used for chemical analysis.The results were analyzed by using ANOVA in SPSS (version 10.0 for windows).Results: A total of 97 patients were tested. The patients were divided into four major groups, showed overall nonsignificant variation in hormonal level for Prolactin, FT3 and FT4 (p>0.05). About 80% patients were found normal, in TSH estimation. Women from age 16-35 years old were greater in number than any other age group. Means for each hormone were non-significant at p=0.05. Conclusion:Hyperprolactinemia causes reproductive disorders in women, early diagnosis and treatment of this disease is important. In conclusion estimation of prolactin and TSH levels might be considered essential in assessment of patient with fertility disorders.

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Prolactin-Secreting Pituitary Tumors in Amenorrheic Women: A Comprehensive Study*

Cited by 112 publications

References 72 publications

Delayed Puberty and Hypoplastic Uterus Associated with Hyperprolactinemia: Successful Treatment with Bromocriptine

Delayed Puberty and Hypoplastic Uterus Associated with Hyperprolactinemia: Successful Treatment with Bromocriptine

Synchronous Endometrial Carcinoma and a Macroprolactinoma: Exploring a Causal Relationship

Prolactin, Thyroid Stimulating Hormone and Thyroid Hormones (Ft3, Ft4) Concentrations in Female Patients with Inferility: An Observational Study

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