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Hyperprolactinemia and prolactinoma.
MedLine Citation:
PMID:  25248588     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Prolactinomas are the most frequent pituitary adenomas. In patients with prolactinomas the primary cause of hyperprolactinemia is excessive and autonomic production of prolactin by lactotroph cells. In other conditions, except in case of macroprolactinemia, hyperprolactinemia is secondary to circumstances that stimulate secretion of prolactin by intrinsically normal lactotroph cells, or, rarely, that are the result of decreased clearance of prolactin. In general, cabergoline is the preferred treatment for micro- and macroprolactinomas, because it is more effective with respect to normalization of prolactin levels and reduction of prolactinoma size and because it has fewer side-effects compared to bromocriptine. Recently, it has been suggested that a standardized, individualized, stepwise, dose-escalating regimen of cabergoline may normalize prolactin levels and reduce prolactinoma size in patients who were otherwise considered to be dopamine agonist resistant. In general, the cardiac adverse effects of dopamine agonists reported in Parkinson's disease are not of clinical concern in the treatment of prolactinomas, which are treated with much lower doses. Nonetheless, there is uncertainty with respect to the dose and duration of cabergoline treatment, which requires echocardiographic follow-up. Although withdrawal of dopamine agonists may be considered in patients with prolactinomas well controlled by dopamine agonists, especially in postmenopausal women, recurrence of signs and symptoms may occur in a considerable portion of patients.
Authors:
Johannes A Romijn
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Handbook of clinical neurology     Volume:  124     ISSN:  0072-9752     ISO Abbreviation:  Handb Clin Neurol     Publication Date:  2014  
Date Detail:
Created Date:  2014-09-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0166161     Medline TA:  Handb Clin Neurol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  185-95     Citation Subset:  IM    
Copyright Information:
© 2014 Elsevier B.V. All rights reserved.
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