Circulating nitric oxide changes throughout the menstrual cycle in healthy women and women affected by pathological hyperprolactinemia on dopamine agonist therapy

2002 ◽  
Vol 16 (5) ◽  
pp. 407-412
Author(s):  
M. Giusti ◽  
L. Fazzuoli ◽  
D. Cavallero ◽  
S. Valenti
Keyword(s):  
Nitric Oxide ◽  
Menstrual Cycle ◽  
Dopamine Agonist ◽  
Agonist Therapy ◽  
Healthy Women ◽  
Dopamine Agonist Therapy ◽  
Pathological Hyperprolactinemia

Update Treatment for Prolactinoma

2018 ◽  
Vol 3 (06) ◽  
Author(s):  
Chávez Hernández María Margarita ◽  
Jiménez Báez María Valeria ◽  
Armijo Medina María Fernanda ◽  
Domínguez Leyva Jorge Miguel ◽  
Góngora Valencia Karen Alejandra ◽  
...  
Keyword(s):  
Dopamine Agonist ◽  
Safety Profile ◽  
Pituitary Tumor ◽  
Common Type ◽  
Treatment Modalities ◽  
First Line ◽  
Agonist Therapy ◽  
Dopamine Agonist Therapy ◽  
Gonadal Dysfunction

Prolactinomas are the most common type of functional pituitary tumor. The present manuscript is an update on the treatment modalities for prolactinomas. Effective hyperprolactinemia treatment is of great importance, due to its potential deleterious effects including infertility, gonadal dysfunction and osteoporosis. Dopamine agonist therapy is the first line of treatment for prolactinomas; recurrence of disease after cessation of the drug may occur in patients. Its safety profile remains high, allowing its use during pregnancy.

scholarly journals EGFR/ErbB2-Targeting Lapatinib Therapy for Aggressive Prolactinomas

2020 ◽  
Author(s):  
Odelia Cooper ◽  
Vivien S Bonert ◽  
Jeremy Rudnick ◽  
Barry D Pressman ◽  
Janet Lo ◽  
...  
Keyword(s):  
Dopamine Agonist ◽  
Tumor Response ◽  
Kinase Inhibitor ◽  
Growth Factor Receptor ◽  
Multicenter Trial ◽  
Tumor Diameter ◽  
Her2 Expression ◽  
Agonist Therapy ◽  
End Point ◽  
Dopamine Agonist Therapy

Abstract Context Approximately 10% to 20% of prolactinomas are resistant to dopamine agonist therapy. The ErbB signaling pathway may drive aggressive prolactinoma behavior. Objective We evaluated lapatinib, an ErbB1-epidermal growth factor receptor (EGFR)/ErbB2 or human EGFR2 (HER2) tyrosine kinase inhibitor (TKI), in aggressive prolactinomas. Design A prospective, phase 2a multicenter trial was conducted. Setting This study took place at a tertiary referral pituitary center. Patients Study participants included adults with aggressive prolactinomas showing continued tumor growth despite maximally tolerated dopamine agonist therapy. Intervention Intervention included oral lapatinib 1250 mg/day for 6 months. Main Outcome Measures The primary end point was 40% reduction in any tumor dimension assessed by magnetic resonance imaging at study end; tumor response was assessed by Response Evaluation Criteria in Solid Tumors criteria. Secondary end points included prolactin (PRL) reduction, correlation of response with EGFR/HER2 expression, and safety. Results Owing to rigorous inclusion criteria, of 24 planned participants, only 7 consented and 4 were treated. None achieved the primary end point but 3 showed stable disease, including 2 with a 6% increase and 1 with a 16.8% decrease in tumor diameter. PRL response was not always concordant with tumor response, as 2 showed 28% and 59% increases in PRL. The fourth participant had a PRL-secreting carcinoma and withdrew after 3 months of lapatinib because of imaging and PRL progression. EGFR/HER2 expression did not correlate with treatment response. Lapatinib was well tolerated overall, with reversible grade 1 transaminitis in 2 patients, grade 2 rash in 2 patients, and grade 1 asymptomatic bradycardia in 2 patients. Conclusions An oral TKI such as lapatinib may be an effective option for a difficult-to-treat patient with an aggressive prolactinoma.

scholarly journals Transsphenoidal surgery for prolactinomas: results and prognosis

Medicina ◽  
2007 ◽  
Vol 43 (9) ◽  
pp. 691 ◽  
Author(s):  
Kęstutis Šinkūnas ◽  
Daiva Rastenytė ◽  
Vytenis Deltuva ◽  
Robertas Knispelis ◽  
Arimantas Tamašauskas
Keyword(s):  
Surgical Treatment ◽  
Dopamine Agonist ◽  
Remission Rate ◽  
Visual Field Defects ◽  
Plasma Prolactin ◽  
Long Term Outcomes ◽  
Agonist Therapy ◽  
Dopamine Agonist Therapy ◽  
Younger Age

Objective. The aim of this study was to explore the long-term outcomes of surgery for transsphenoidal prolactinomas and the factors that influence them. Material and methods. Transsphenoidal approach for pituitary adenomas has been applied to 329 patients in the Department of Neurosurgery of Kaunas University of Medicine Hospital in the period of 1995 to 2006. Of these, 85 patients were operated for prolactinomas. Results. Of the 85 patients operated on for prolactinomas, 68 (80%) were females and 17 (20%) were males. Thirty-two microprolactinomas and 36 macroprolactinomas were diagnosed in women and 16 and 1, respectively, in men. Twenty (23.5%) patients (16 women and 4 men) had visual field defects before the operation. Dopamine agonist therapy was administered in 50 patients (38 women and 12 men) before the operation. Of 10 women, in whom microadenoma was diagnosed and no dopamine agonist therapy was prescribed, remission was achieved in 9 (90%) patients after the operation, while of 22 women, who was treated with dopamine agonists before the operation, remission was achieved only in 10 (45.5%) (P=0.01). Each year of age decreased the chance of remission by 8%. Conclusions. Remission after the surgical treatment was achieved in 11.8% of men and 47.1% of women hyperprowith prolactinomas. Remission rate was very high (90%) among women with microprolactinoma not treated with dopamine agonist before the surgical treatment. The probability of a good outcome of surgery among women with prolactinoma was related to younger age of the patient, noninvasive tumor growth, plasma prolactin level less than 2309 mU/L, and no use of dopamine agonist before the surgical treatment.

scholarly journals Untreated Giant Macroprolactinoma with Chronic Cerebrospinal Fluid Leakage: An Unusual Complication

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Mohamad Nazrulhisham Mad Naser ◽  
Nor Azizah Aziz ◽  
Noor Khairiah A. Karim
Keyword(s):  
Cerebrospinal Fluid ◽  
Dopamine Agonist ◽  
Cerebrospinal Fluid Leak ◽  
Serum Prolactin ◽  
Cerebrospinal Fluid Leakage ◽  
Unusual Complication ◽  
Agonist Therapy ◽  
Fluid Leakage ◽  
Dopamine Agonist Therapy ◽  
Fluid Leak

Macroprolactinoma has the potential to cause base of skull erosion and often extends into the sphenoid sinus. Rapid shrinkage of this invasive tumor following dopamine agonist therapy has been postulated to cause unplugging of the eroded area, leading to cerebrospinal fluid leakage. To the best of our knowledge, the occurrence of spontaneous cerebrospinal fluid leak in treatment-naive prolactinomas is very rare, the majority of which involve undiagnosed macroprolactinomas. We describe here a lady presented late with giant macroprolactinoma, complicated by cerebrospinal fluid leakage. This case raised the dilemma in the management pertaining to the role of either pharmacotherapy or surgical intervention, or combination of both. As she strictly refused surgery, she was treated with bromocriptine which was later changed to cabergoline. On follow-up, there was cessation of cerebrospinal fluid leak, marked reduction of serum prolactin level, and imaging evidence of tumor shrinkage. The majority of patients with medically induced cerebrospinal fluid leakage will require surgical procedures to overcome this complication; however, there are isolated cases of leakage resolution on continuing dopamine agonist therapy while awaiting surgery. The use of dopamine agonist does not necessarily cause worsening of cerebrospinal fluid leakage and instead may produce spontaneous resolution as in this case.

Sign in / Sign up

Export Citation Format

Share Document