Bromocriptine treatment of prolactin secreting macroadenomas: a radiological, ophthalmological and endocrinological study

1986 ◽  
Vol 112 (4) ◽  
pp. 487-493 ◽  
Author(s):  
Johanna W. van 't Verlaat ◽  
Ronald J. M. Croughs ◽  
Martin J. Hendriks ◽  
Nicolaas J. Bosma ◽  
Johan W. R. Nortier ◽  
...  
Keyword(s):  
Tumour Size ◽  
Empty Sella ◽  
List Type ◽  
Plasma Prolactin ◽  
Oculomotor Palsy ◽  
Normal Range ◽  
Plasma Prolactin Level ◽  
Basal Plasma ◽  
Bitemporal Hemianopia ◽  
Tumour Reduction

Abstract. Twelve patients, six women and six men, with macroprolactinomas characterized by extrasellar extension and basal plasma prolactin levels >6 U/l were treated with 10–20 mg bromocriptine daily in four divided doses for a mean period of 2.4 years (range 0.5–3.5 years). The following observations were made: Plasma prolactin levels fell dramatically in all patients and values in the low normal range were obtained in 10 patients. Tumour size was reduced by more than 75% in 11 patients and by 50–75% in one patient. Tumour-reduction was associated with the development of a partial empty sella in eight cases. In four cases the pituitary became visible. Diminished visual acuity (three patients), bitemporal hemianopia (three patients), unilateral or bilateral central scotomas (three patients) and oculomotor palsy (two patients) restored to normal. Hypogonadism (all patients), hypothyroidism (six patients) and hypocorticism (three patients) improved or normalized in most cases. It is concluded that in the medical treatment of macroprolactinomas 10–20 mg bromocriptine in four divided doses effectively reduces both plasma prolactin level and tumour size.

Primary treatment of macroprolactinomas with Parlodel LAR®

1988 ◽  
Vol 119 (1) ◽  
pp. 51-55 ◽  
Author(s):  
Johanna W. van 't Verlaat ◽  
Ioana Lancranjan ◽  
Martin J. Hendriks ◽  
Ronald J. M. Croughs
Keyword(s):  
Oral Treatment ◽  
Tumour Size ◽  
Primary Treatment ◽  
Plasma Prolactin ◽  
Normal Range ◽  
Basal Plasma ◽  
Nerve Dysfunction ◽  
Long Acting ◽  
Bitemporal Hemianopia ◽  
Tumour Reduction

Abstract. Five patients, 3 women and 2 men, with macroprolactinomas characterized by extrasellar extension and basal plasma prolactin levels ranging from 4.6 to 102 U/I received six monthly injections of 50–100 mg Parlodel LAR®, an injectable long-acting repeatable form of bromocriptine. The following observations were made: 1. Plasma prolactin levels fell dramatically in all patients and values in the normal range were obtained in 3 patients. 2. In all patients, the onset of tumour reduction was visible on CT scans made one week after the first Parlodel LAR injection. After six Parlodel LAR injections, tumour size was reduced by more than 75% in 3 patients and by 50–75% in two patients. 3. Diminished visual acuity (one patient), bitemporal hemianopia (2 patients), and oculomotor and trochlear nerve dysfunction (one patient) were restored to normal after the first Parlodel LAR injection. 4. Hypogonadism normalized in 2 patients and improved in one patient, whereas plasma gonadotropins remained low in the 2 postmenopausal women. In one patient with hypothyroidism and hypocorticism, thyroid and adrenal functions normalized. It is concluded that bromocriptine retard (50–100 mg monthly) is a useful alternative for oral treatment of patients with prolactinomas, especially in those patients with compliance problems on oral bromocriptine therapy.

scholarly journals Results of Primary Treatment with Bromocriptine of Prolactinomas with Extrasellar Extension

1990 ◽  
Vol 17 (1) ◽  
pp. 71-73 ◽  
Author(s):  
Johanna W. van't Verlaat ◽  
Ronald J.M. Croughs ◽  
Martin J. Hendriks ◽  
Nicolaas J. Bosma
Keyword(s):  
Tumor Size ◽  
Primary Treatment ◽  
Empty Sella ◽  
Fixed Dose ◽  
Plasma Prolactin ◽  
Oculomotor Palsy ◽  
Normal Range ◽  
Tumor Reduction ◽  
Continued Use ◽  
Bitemporal Hemianopia

ABSTRACT:Nineteen patients, seven women and twelve men, with macroprolactinomas characterized by extrasellar extension and basal prolactin levels above 6 U/I were treated with 10-20 mg bromocriptine daily in four divided doses for a mean period of 3.4 years (range 1.5-5.5 years). Plasma prolactin levels fell dramatically in all patients and values in the low normal range were obtained in sixteen patients. Tumor size was reduced by more than 75% in seventeen patients and by 50-75% in two patients. Tumor reduction was associated with the development of a partial empty sella in fourteen cases. In seventeen cases the pituitary became visible. Diminished visual acuity (six patients), bitemporal hemianopia (nine patients), unilateral and bilateral central scotomas (three patients) and oculomotor palsy (two patients) improved or normalized in all cases. Hypogonadism (all patients), hypothyroidism (nine patients) and hypocorticism (four patients) improved or normalized in most cases. It is concluded that in the medical treatment of macroprolactinomas 10-20 mg bromocriptine in four divided doses effectively reduces both plasma prolactin level and tumor size. The good results in this study may be related to the continued use of a fixed dose regimen of bromocriptine regardless of the plasma prolactin lowering effect.

Changes in plasma GH levels and clinical activity during bromocriptine therapy in acromegaly. The value of predictive tests

1984 ◽  
Vol 106 (2) ◽  
pp. 175-183 ◽  
Author(s):  
J. W. R. Nortier ◽  
R. J. M. Croughs ◽  
G. H. Donker ◽  
J. H. H. Thijssen ◽  
F. Schwarz
Keyword(s):  
Single Dose ◽  
Previous Treatment ◽  
High Specificity ◽  
Clinical Activity ◽  
List Type ◽  
Plasma Prolactin ◽  
Basal Plasma ◽  
Active Acromegaly ◽  
Pre Treatment ◽  
Plasma Gh

Abstract. Twenty-seven patients with active acromegaly despite previous treatment by surgery and/or radiotherapy received bromocriptine in a dose of 10–20 mg daily for a period of 6–9 months. The results of chronic bromocriptine treatment were evaluated by measurement of plasma growth hormone (GH) levels during the day and by subjective and objective criteria of clinical activity. The results of chronic bromocriptine treatment were also compared with four biochemical criteria obtained before treatment e.g. basal plasma prolactin (Prl) levels and the plasma GH response to oral administration of 2.5 mg bromocriptine respectively iv administration of 200 μg TRH and 500 μg somatostatin. The main observations may be summarized as follows: 1) The mean pre-treatment GH levels during the day ranged from 6–207 mU/l. Hyperprolactinaemia was present in 6 patients. 2) During bromocriptine treatment mean plasma GH levels decreased to less than 50% in 11 patients (GH responders) whereas in 19 patients changes of mean plasma GH and of subjective criteria of clinical activity were concordant. 3) Glucose tolerance improved significantly (P < 0.01) in 10 GH-responders and the urinary hydroxyproline/creatinine ratio decreased significantly (P < 0.05) in 8 GH-responders. 4) Five out of 6 patients with hyperprolactinaemia belonged to the group of GHresponders. 5) A single dose of 2.5 mg bromocriptine induced a more than 50% decrease of plasma GH in 8 of 11 GH-responders and in 5 of 16 GH non-responders. 6) The iv injection of 200 μg TRH was followed by a rise of plasma GH of more than 100% in 9 of 11 GHresponders and in 6 of 16 non-responders. 7) Responsiveness to both a single dose of bromocriptine and TRH was found in 8 of 11 GH-responders and in 3 of 16 GH non-responders. Conclusions Bromocriptine is effective as adjunctive therapy when active acromegaly persists after treatment with surgery and/or radiotherapy. In general, a good correlation is found between GH responsiveness and subjective and objective criteria of clinical activity during bromocriptine treatment. Hyperprolactinaemia predicts GH responsiveness to chronic bromocriptine treatment with high specificity. The combination of a bromocriptine test and a TRH test are of best predictive value with respect to the results of chronic bromocriptine therapy in normoprolactinaemic acromegalics.

Correlation between the number of thyroliberin binding sites, the tumour size and the plasma prolactin level in human prolactin-secreting adenomas

1985 ◽  
Vol 108 (4) ◽  
pp. 464-467 ◽  
Author(s):  
M. Le Dafniet ◽  
P. Pagesy ◽  
A. M. Brandi ◽  
J. Racadot ◽  
F. Peillon
Keyword(s):  
Binding Sites ◽  
Tumour Size ◽  
High Plasma ◽  
Plasma Prolactin ◽  
Lower Plasma ◽  
Basal Plasma ◽  
Grade Ii ◽  
Plasma Prl ◽  
Grade Iii ◽  
Trh Receptors

Abstract. Basal plasma prolactin (Prl) level, tumour size and [3H]thyroliberin (TRH) binding to tumour membranes were studied in 18 patients bearing Prl-secreting adenomas. Big tumours (grade III) were associated with high plasma Prl levels (median value: 1929 (range: 207–3570) ng/ml) and possessed numerous membrane TRH receptors (median value: 508 (range: 0–1200) fmol/mg of protein). By contrast, smaller tumours (grade II and I) were associated with lower plasma Prl levels (median values: 1085 (range: 40–1890) and 295 (range: 98–788) ng/ml, respectively) and possessed fewer membrane TRH receptors (median values 122 (range: 11–328) and 13 (range: 0–52) fmol/mg of protein, respectively). A direct positive correlation was demonstrated between the plasma Prl level and the number of [3H]TRH binding sites (ϱ: 0.729 P < 0.001). That the higher number of TRH receptors is associated with the largest tumours may be of importance in hyperprolactinaemia and should be taken in account when speculating on the pathogenesis of human Prl-secreting adenomas.

Short- and long-term fluctuations in plasma prolactin concentration in normal subjects

1981 ◽  
Vol 97 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Henning Djursing ◽  
Claus Hagen ◽  
Jan Møller ◽  
Claus Christiansen
Keyword(s):  
Plasma Concentration ◽  
Menstrual Cycle ◽  
Normal Subjects ◽  
Plasma Prolactin ◽  
Menopausal Women ◽  
Normal Menstrual Cycle ◽  
Basal Plasma ◽  
Short And Long Term ◽  
Post Menopausal

Abstract. The physiological changes in plasma prolactin concentration were studied in 447 normal subjects, including 65 men, 75 pre-menopausal women and 307 post-menopausal women. The within-day and day-to-day variation as well as the circadian and circannual rhythm of plasma prolactin levels were determined. Furthermore, the relationship between changes in prolactin and oestradiol-17β levels during the normal menstrual cycle and in the climacteric was studied. Pre-menopausal women had significantly (P<0.01) higher basal plasma prolactin concentration than men and post-menopausal women. Furthermore, they had significantly (P < 0.01) higher day-to-day variation than men. This suggests that prolactin in women is secreted in a pulsatile fashion. Only small seasonal variations in both sexes were seen. The levels of plasma prolactin during the ovulatory and the luteal phase in the cycle were significantly (P < 0.02) higher than that of the follicular phase, and a positive correlation between changes in plasma concentration of oestradiol-17β and prolactin was found. Also in post-menopausal women a relationship between plasma concentration of prolactin and oestradiol-17β was seen. It is concluded that the assessment of prolactin concentration in blood is dependent on the physiological variation recorded during sleep in both sexes. However, only in women day-to-day changes and the changes related to the menstrual cycle and the climacteric are of importance.

Suppressed plasma prolactin response to thyrotropin-releasing hormone in hyperthyroidism reproduced by thyroxine but not by triiodothyronine administration to normal subjects

1988 ◽  
Vol 117 (2) ◽  
pp. 241-248 ◽  
Author(s):  
Eva Marie Erfurth ◽  
Pavo Hedner
Keyword(s):  
Control Level ◽  
Normal Subjects ◽  
Sex Hormone Binding Globulin ◽  
Plasma Prolactin ◽  
Serum Free ◽  
Basal Plasma ◽  
Normal Women ◽  
Prolactin Response ◽  
Plasma Prl ◽  
Hyperthyroid Patients

Abstract. In 10 hyperthyroid women studied in the follicular phase of the menstrual cycle, basal plasma PRL was normal, but PRL release after TRH was significantly suppressed compared with that in 11 control women. The suppressed PRL response to TRH was not explained by changes in serum estradiol or sex hormone-binding globulin. It recovered after treatment of hyperthyroidism. When normal women were treated with T4 (0.5 mg daily for 6 to 10 days), their mean serum free T4 level increased to about 70% of that in the hyperthyroid patients, whereas their serum free T3 levels increased to a lesser degree. During T4 administration, these women had PRL changes similar to those of the hyperthyroid patients. When the normal women took T3 (60–120) μg for 6 to 8 days), their serum free T3 increased to almost the level of the hyperthyroid patients, but the TRH stimulated PRL release remained close to the control level. The PRL increase after dopaminergic blockade with metoclopramide was significantly suppressed in hyperthyroid patients, and they had no PRL response to TRH after pretreatment with metoclopramide. In conclusion, the PRL changes in hyperthyroidism were reproduced by administration of T4, but not by administration of T3 to healthy women. The site of action is suggested to be pituitary, but additional hypothalamic effects cannot be excluded.

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