Document Detail


Cerebrospinal fluid leakage as complication of treatment with cabergoline for macroprolactinomas.
MedLine Citation:
PMID:  17259798     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Treatment of patients with prolactinomas consists primarily of dopamine agonists (DA). Cerebrospinal fluid (CSF) leakage has sporadically been reported in patients with macroprolactinomas treated with short-acting DA such as bromocriptine. Little is known on the incidence of this complication in patients treated with the long-acting D2 specific DA cabergoline. We report three patients with CSF leakage shortly after initiation of cabergoline treatment for macroprolactinoma. All three patients responded rapidly to cabergoline (CAB) by shrinkage of the tumor and release of the optic chiasm compression. The CSF leakage occurred within 10 days after initiation of treatment. CAB treatment was not discontinued. In one patient the CSF leakage ceased spontaneously, with no additional therapy. The second patient had a surgical repair of the CSF fistula, permitting cabergoline to be continued without a recurrence of the CSF leakage. The third patient refused surgical repair of the sellar defect. In this patient the cabergoline dosage was temporarily decreased with no effect on the CSF leakage. Four years later, the CSF leakage is unchanged in this patient, whilst no other complications occurred during the follow-up. No infectious complications occurred in these three patients. In conclusion, patients with large, invasive macroprolactinomas are at risk of CSF leakage during medical treatment with CAB. It is advisable to warn these patients for occurrence of this complication and to monitor them closely especially during the first months of treatment.
Authors:
R T Netea-Maier; E J van Lindert; H Timmers; E L Schakenraad; J A Grotenhuis; A R Hermus
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of endocrinological investigation     Volume:  29     ISSN:  1720-8386     ISO Abbreviation:  J. Endocrinol. Invest.     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2007-01-29     Completed Date:  2007-02-09     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  7806594     Medline TA:  J Endocrinol Invest     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  1001-5     Citation Subset:  IM    
Affiliation:
Pituitary Center Nijmegen, Department of Endocrinology, Radboud University, Nijmegen, The Netherlands. R.Netea-Maier@endo.umcn.nl
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antineoplastic Agents / adverse effects*
Cerebrospinal Fluid Rhinorrhea / chemically induced*
Dopamine Agonists / adverse effects*
Ergolines / adverse effects*
Female
Humans
Male
Middle Aged
Pituitary Neoplasms / drug therapy*
Prolactinoma / drug therapy*
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 0/Dopamine Agonists; 0/Ergolines; LL60K9J05T/cabergoline

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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