A hyperprolactinaemiás állapotok diagnózisa, differenciáldiagnózisa és kezelése

Iván Gabriella, Góth Miklós

Research output: Review article

Abstract

Hyperprolactinaemia is one of the most common endocrine diseases. Besides hypothyroidism-associated hyperprolactinaemia and that arising as a side effect of certain drugs, the most common cause of hyperprolactinaemia is a pituitary microadenoma (<10 mm in diameter) or macroadenoma (≥ 10 mm) that produces prolactin (prolactinoma). In addition, several physiological conditions can elevate (mostly temporarily) the serum prolactin level, therefore, setting up the precise diagnosis requires careful evaluation of the patient's history and the laboratory, clinical, and imaging findings. Moreover, macroprolactinaemia, which is usually not a pituitary tumour-related disease, should also be ruled out. Prolactinomas represent the most common form of functioning pituitary adenomas, accounting for 30-40% of such tumours. The typical clinical symptoms of hyperprolactinaemia may be modulated by the mass effect of macroadenomas. In women the disease typically manifests as menstrual disturbance of various degree, including primary or secondary amenorrhoea, oligomenorrhoea, short luteal phase, infertility and galactorrhoea. In men reduced libido, impotence, infertility, gynaecomastia and, rarely, galactorrhoea are the typical symptoms. Dopamine agonist therapy is the first choice of treatment. Dopamine agonist therapy (bromocriptine and the recently developed quinagolide and cabergoline) successfully lowers the serum prolactine level in nearly 90% of cases, and, importantly, it also reduces the size of the tumour in the majority of cases. This explains why today surgery and radiotherapy are only used in rare special cases of prolactinoma.

Translated title of the contributionDiagnosis, differential diagnosis and treatment of hyperprolactinaemia
Original languageHungarian
Pages (from-to)715-721
Number of pages7
JournalLege Artis Medicinae
Volume16
Issue number8-9
Publication statusPublished - szept. 1 2006

Keywords

  • Dopamine agonist therapy
  • Hyperprolactinaemia
  • Prolactinoma

ASJC Scopus subject areas

  • Medicine(all)

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