Speed of response to dopaminergic agents in prolactinomas

Hage, Camille; Salvatori, Roberto

doi:10.1007/s12020-021-02953-1

Cited by 2 publications

(3 citation statements)

References 21 publications

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“…This peculiarity makes it difficult to differentiate between a cystic prolactinoma and a non-functioning cystic lesion causing hyperprolactinaemia by stalk compression. The rate at which prolactin declines after dopamine agonist therapy initiation is not always helpful in differentiating the two scenarios 130 . Dopamine agonist therapy demonstrated high efficacy in cyst reduction 131 and should therefore be considered, particularly in patients with no urgent need of chiasmatic decompression 125 .…”

Section: Cystic Prolactinomasmentioning

confidence: 99%

Diagnosis and management of prolactin-secreting pituitary adenomas: a Pituitary Society international Consensus Statement

Petersenn,

Fleseriu,

Casanueva

et al. 2023

Nat Rev Endocrinol

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117

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This Consensus Statement from an international, multidisciplinary workshop sponsored by the Pituitary Society offers evidence-based graded consensus recommendations and key summary points for clinical practice on the diagnosis and management of prolactinomas. Epidemiology and pathogenesis, clinical presentation of disordered pituitary hormone secretion, assessment of hyperprolactinaemia and biochemical evaluation, optimal use of imaging strategies and disease-related complications are addressed. In-depth discussions present the latest evidence on treatment of prolactinoma, including efficacy, adverse effects and options for withdrawal of dopamine agonist therapy, as well as indications for surgery, preoperative medical therapy and radiation therapy. Management of prolactinoma in special situations is discussed, including cystic lesions, mixed growth hormone-secreting and prolactin-secreting adenomas and giant and aggressive prolactinomas. Furthermore, considerations for pregnancy and fertility are outlined, as well as management of prolactinomas in children and adolescents, patients with an underlying psychiatric disorder, postmenopausal women, transgender individuals and patients with chronic kidney disease. The workshop concluded that, although treatment resistance is rare, there is a need for additional therapeutic options to address clinical challenges in treating these patients and a need to facilitate international registries to enable risk stratification and optimization of therapeutic strategies. Sections Clinical presentation Hyperprolactinaemia and hypogonadism• The presence of a sellar mass on imaging requires evaluation for hyperprolactinaemia (strong). • Galactorrhoea should trigger investigation for hyperprolactinaemia, except for known physiological reasons (for example, pregnant or lactating women) (strong). Importantly, absence of galactorrhoea does not exclude hyperprolactinaemia (strong).

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Section: Cystic Prolactinomasmentioning

confidence: 99%

Diagnosis and management of prolactin-secreting pituitary adenomas: a Pituitary Society international Consensus Statement

Petersenn,

Fleseriu,

Casanueva

et al. 2023

Nat Rev Endocrinol

Self Cite

117

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Section: Causes Of Hypopituitarism In the Elderlymentioning

confidence: 99%

“…Sometimes the differential diagnosis between prolactinoma and non-functioning mass is challenging, and the time of response to dopamine-agonist agent does not represent a useful criterion to help the differential diagnosis between prolactinoma and non-secreting adenoma. 11 Both primary and secondary (caused by various processes causing injury to the pituitary gland) empty sella, detected in 3-35% of the general population, with frequency directly proportional to age, also represents a possible cause of hypopituitarism in older people. The prevalence of hypopituitarism in empty sella ranges from 10% to 40%.…”

Section: Causes Of Hypopituitarism In the Elderlymentioning

confidence: 99%

Treating Hypopituitarism in the Over 65s: Review of Clinical Studies

Paragliola¹,

Locantore²,

Corsello³

et al. 2023

CIA

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The current increase of life expectancy is associated with the presence of endocrine diseases in the elderly. The management of hypopituitarism in this group of patients is a challenging task. A correct diagnosis, which represents an essential requisite for an appropriate medical treatment, can be difficult because of the physiological changes occurring in pituitary function with aging, which may lead to challenges in the interpretation of laboratory results. Furthermore, the treatment requires several careful considerations: the need to restore the hormonal physiology with replacement therapies must be balanced with the need to avoid the risks of the over-replacement, especially in the presence of concomitant cardiovascular and metabolic disease. Interactions with other drugs able to modify the absorption and/or the metabolism of hormonal replacement therapies should be considered, in particular for the treatment of hypoadrenalism and hypothyroidism. The most important challenges stem from the lack of specific studies focused on the management of hypopituitarism in older people.

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Speed of response to dopaminergic agents in prolactinomas

Cited by 2 publications

References 21 publications

Diagnosis and management of prolactin-secreting pituitary adenomas: a Pituitary Society international Consensus Statement

Diagnosis and management of prolactin-secreting pituitary adenomas: a Pituitary Society international Consensus Statement

Treating Hypopituitarism in the Over 65s: Review of Clinical Studies

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