Raised prolactin levels in myasthenia gravis: two case reports and a study of two patient populations

Tsinzerling, Natalie; Pirskanen, Ritva; Matell, G.; Zhulev, N. M.; Чухловина, М Л; Lefvert, Ann Kari

doi:10.1111/j.1600-0404.2006.00664.x

Cited by 8 publications

(3 citation statements)

References 16 publications

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“…The description of the stimulative effect of PRL on the autoimmune activation of MG was first reported by Cahill et al in 1980 [1, 6]. This was followed by Tsinzerling et al in 2006 who reported two case reports and a cohort study discussing the relationship between the severity of MG and serum PRL levels [1, 7, 8]. In 2013, Harris et al discussed the role of PRL and its potential therapeutic use for MG in the future [1, 8].…”

Section: Discussionmentioning

confidence: 99%

“…A growing body of evidence demonstrates a bi-directional relationship between immune functions and the neuroendocrine system. Many in vitro and animal studies described an important role of GH in the regulation of the immune system as it stimulates T and B cells proliferation and immunoglobulin synthesis [7, 8, 12]. It is important to note that the combination of these two diseases can be a mere coincidence.…”

Section: Discussionmentioning

confidence: 99%

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A Rare Association between Myasthenia Gravis and a Growth Hormone Secreting Pituitary Macroadenoma: A Single Case Report

Farfouti

Ghabally

Roumieh

et al. 2019

Oxford Medical Case Reports

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Myasthenia Gravis (MG) is a chronic autoimmune neuromuscular disease. Although it is well known that patients with myasthenia gravis have a higher incidence of other autoimmune disorders, however, its association with pituitary adenomas is extremely rare. We believe that our case represents the 8th of this association and the 2nd case involving a GH-secreting adenoma. Here we report a case of a 45-year old Syrian woman who presented with typical complaints of myasthenia gravis as she was suffering from variable painless and effort-related dysphagia and dysarthria. Her complaints became more evident at the end of the day, while acromegaly only manifested as a 4-month history of headache and a special facies that was noted by the physician. Brain MRI scan demonstrated a 3.21 x 2.42 x 2.35 cm pituitary mass for which the patient underwent a trans-sphenoidal pituitary tumor resection. In addition, postoperative histopathological investigations confirmed the diagnosis of a GH-secreting macroadenoma. On following up, it was observed that her myasthenic symptoms improved significantly on Pyridostigmin and Prednisolone. In conclusion, the presence of headache in a myasthenic patient should raise the attention for other underlying causes including pituitary tumors.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Rare Association between Myasthenia Gravis and a Growth Hormone Secreting Pituitary Macroadenoma: A Single Case Report

Farfouti

Ghabally

Roumieh

et al. 2019

Oxford Medical Case Reports

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“…Cahill et al published the first description of the stimulating effect of PRL on the autoimmune activation of MG in 1980. 7,8 Then, in 2006, Tsinzerling et al reported two case reports and a cohort research examining the correlation between serum PRL levels and the severity of MG. [7][8][9] The function of PRL and possible therapeutic applications for MG were discussed by Harris et al in 2013. 7,9 The differential diagnosis of neurological symptoms in individuals with macroprolactinoma should be considered as MG, according to Zoli et al in 2018.The literature is clear on the frequent link between endocrine dysfunction and myasthenia.…”

Section: Case Reportmentioning

confidence: 99%

Rare case of double seronegative ocular myasthenia gravis and non-functional pituitary macroadenoma

Vishwanatha¹,

Vaddepally²

2023

IJN

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Chronic autoimmune neuromuscular disorder known as Myasthenia Gravis (MG). The relationship of myasthenia gravis with pituitary adenomas is relatively uncommon, despite the fact that it is widely known that people with the condition have a higher prevalence of other autoimmune diseases. Here, we describe the case of a 45-year-old Indian man who had complained of severe cephalgia, associated with ocular pain, dizziness, diplopia, ptosis of the unilateral right eye. Although he has a history of severe headaches that started prior to 3 months, his complaints became more obvious at the end of the day. An MRI of the brain revealed an increased pituitary gland that measured 13.7 × 15.5 x 16. 9 mm. Furthermore, post admission histological examinations supported the diagnosis of a double seronegative ocular myasthenia gravis and non-functional pituitary macroadenoma. Following treatment, it was discovered that Pyridostigmin and Prednisolone considerably reduced his myasthenia symptoms. Finally, it should be noted that pituitary tumours are one potential underlying cause of headache in myasthenic patients.

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Concomitant myasthenia gravis and macroprolactinoma: the immunomodulatory role of prolactin and its potential therapeutic use

et al. 2013

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Considerable evidence attests to the role of the hypothalamic-pituitary endocrine axis (HPA) in the maintenance of normal immunocompetence. The immune and neuroendocrine systems are integrally linked and coordinated with bidirectional communication maintaining immune balance. Any disturbance of the normal function of the HPA may significantly alter native immunocompetence and therefore be associated with the development of disorders which have a clearly established autoimmune basis. Molecular and functional evidence shows prolactin, produced by the anterior pituitary, to be a cytokine, exerting its effect via both paracrine and endocrine mechanisms [1]. Its involvement in the activation of multiple immune responses may adversely upregulate certain autoimmune diseases. Myasthenia gravis (MG) has long been recognized as an autoimmune disorder. In this mini review, we present the coterminous presentation of MG and prolactin-secreting macroadenoma. We review published cases in the world literature, discuss pathological mechanism, and consider future targeted therapies.

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Raised prolactin levels in myasthenia gravis: two case reports and a study of two patient populations

Abstract: There is an association of MG with raised levels of PRL in women. PRL has stimulating effects on immune activation and the increased levels might thus be implied in the pathophysiology of MG.

Cited by 8 publications

References 16 publications

A Rare Association between Myasthenia Gravis and a Growth Hormone Secreting Pituitary Macroadenoma: A Single Case Report

A Rare Association between Myasthenia Gravis and a Growth Hormone Secreting Pituitary Macroadenoma: A Single Case Report

Rare case of double seronegative ocular myasthenia gravis and non-functional pituitary macroadenoma

Concomitant myasthenia gravis and macroprolactinoma: the immunomodulatory role of prolactin and its potential therapeutic use

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