Introduction. Hyperprolactinemia represents a supraphysiological secretion of prolactin. In clinical practice, it is the most frequently encountered anterior pituitary disorder. However, its real prevalence is little ...Introduction. Hyperprolactinemia represents a supraphysiological secretion of prolactin. In clinical practice, it is the most frequently encountered anterior pituitary disorder. However, its real prevalence is little known in Africa. The purpose of this study is to list all cases of hyperprolactinemia over the past four years and to make an inventory of the various etiologies found and their management. Methodology. This is a cross-sectional descriptive study on the files of patients who came for consultation in the internal medicine and endocrinology department with hyperprolactinemia retrospectively collected from January 2017 to December 2020. Included were patients followed or whose the diagnosis of hyperprolactinemia was established in endocrinological consultation during the study period. Results. This study recorded 26 cases of hyperprolactinemia. The female sex represented 73.08% (sex ratio M/F 0.37) and the average age was 33.92 years. The 40 - 50 age group was the most represented with 30.77%. In women, galactorrhea accounted for 73.07%, amenorrhea 57.69% of clinical pictures and infertility 23.08%. In men, infertility accounted for 7.69% of presentations, gynecomastia 11.54% and erectile dysfunction 15.38%. The duration of evolution of the signs was 4 months in 23.08% of the patients. The mean prolactinemia was 702.58 ng/ml. CT was performed in 80.85% of patients. The main etiologies were pituitary adenomas (77%). All our patients were treated with dopaminergic agonists. Cabergoline was prescribed in 77% of patients. The evolution was favorable in 96.25% of patients. Conclusion. Hyperprolactinemia is a pathology that exists in our regions. The main etiology remains pituitary adenomas and treatment with cabergoline.展开更多
BACKGROUND Pituitary metastasis is an uncommon manifestation of systemic malignant tumors.Moreover,hyperprolactinemia and overall hypopituitarism caused by metastatic spread leading to the initial symptoms are rare.CA...BACKGROUND Pituitary metastasis is an uncommon manifestation of systemic malignant tumors.Moreover,hyperprolactinemia and overall hypopituitarism caused by metastatic spread leading to the initial symptoms are rare.CASE SUMMARY A 53-year-old male patient was admitted to our hospital with complaints of bilateral blurred vision,dizziness,polyuria,nocturia,severe fatigue and somnolence,decreased libido,and intermittent nausea and vomiting for more than 6 mo.During the last 7 d,the dizziness had worsened.Laboratory investigations revealed overall hypofunction of the pituitary gland,but the patient had an elevated serum prolactin level(703.35 mg/mL).Preoperative magnetic resonance imaging revealed a tumor in the sellar region,accompanied by intratumoral hemorrhage and calcification.Thus,transnasal subtotal resection of the lesion in the sellar region was performed.The histopathological and immunohistochemical examinations of the resected lesion revealed metastasis of lung adenocarcinoma to the pituitary gland.Oral hydrocortisone(30 mg/d)and levothyroxine(25 mg/d)were given both pre-and postoperatively.Postoperatively,the clinical symptoms were significantly improved.However,4 mo following the surgery,the patient succumbed due to multiple organ failure.CONCLUSION Hyperprolactinemia is one of the markers of poor prognosis in patients with carcinoma that metastasizes to the pituitary gland.Exogenous hormone supplementation plays a positive role in relieving the symptoms of patients and improving quality of life.展开更多
【Objective】To evaluate the clinical efficiency of different treatments cancellation and infertility in women with PCOS and hyperprolactinemia.【Method】We performed retrospective analysis of 502consecutive case hist...【Objective】To evaluate the clinical efficiency of different treatments cancellation and infertility in women with PCOS and hyperprolactinemia.【Method】We performed retrospective analysis of 502consecutive case histories during 5 years of reproductive results of treatment of women is with anovulatory infertility,caused by different factors.Aim of the study was to determine the efficiency of conservative and surgical treatment.【Result】Differentiated application of conservative medical therapy allows to attain the effect of proceeding in a fertile function in 33,8%of patients.It is found that surgical induction of ovulation by ovarian laparoscopic partial degradation is an option in the management of female infertility associated with PCOS,especially as a second-line treatment after the failure of clomiphene citrate treatment,enhancing the efficiency of complex infertility treatment to 40%.【Conclusions】It is feasible to develop an algorithm differentiated use of infertility treatments in women with PCOS and hyperprolactinemia.展开更多
Hyperprolactinemia (an increased blood prolactin level secreted from eosinophilic cells in the anterior lobe of the pituitary gland) is caused by a variety of factors. The elevated level of prolactin will disturb the ...Hyperprolactinemia (an increased blood prolactin level secreted from eosinophilic cells in the anterior lobe of the pituitary gland) is caused by a variety of factors. The elevated level of prolactin will disturb the function of the thalamus-pituitary-ovary axis and lead to amenorrhea, infertility, infrequent menstruation, and dysfunction of corpus luteum, etc. Definite diagnosis can be展开更多
目的系统评价逍遥散加减对比常规西药治疗高泌乳素血症(HPRL)的有效性及安全性。方法检索中国知识资源总库(CNKI)、中文科技期刊数据库(维普网)、中国生物医学文献数据库(CBM)、万方数据知识服务平台(万方数据)、EMbase、PubMed、Cochra...目的系统评价逍遥散加减对比常规西药治疗高泌乳素血症(HPRL)的有效性及安全性。方法检索中国知识资源总库(CNKI)、中文科技期刊数据库(维普网)、中国生物医学文献数据库(CBM)、万方数据知识服务平台(万方数据)、EMbase、PubMed、Cochrane Library、Web of Science建库至2022年1月31日国内外公开发表的关于逍遥散加减治疗HPRL的随机对照试验(RCT)研究,对经筛选纳入的文献进行信息提取、Meta分析及证据质量评价。结果最终纳入13项研究,涉及患者888例,其中试验组447例,对照组441例。试验组干预措施为中药逍遥散组方加减,对照组均使用西药溴隐亭治疗。Meta分析结果:与对照组比较,试验组治疗HPRL的总有效率[OR=1.05,95%CI(0.71,1.54),Z=0.23,P=0.82]、治疗后PRL水平[MD=2.48,95%CI(-0.51,5.48),Z=1.62,P=0.10]、妊娠率[OR=2.19,95%CI(0.82,5.82),Z=1.56,P=0.12]均差异无统计学意义;复发率[OR=0.23,95%CI(0.11,0.47),Z=4.03,P<0.0001]、不良反应发生率[OR=0.03,95%CI(0.01,0.09),Z=6.40,P<0.00001]均低于对照组。结论逍遥散加减治疗HPRL疗效显著,且复发率、不良反应率均低于溴隐亭治疗。但本结果因纳入研究数量有限且水平偏低,今后仍有必要开展更多大范围、高标准的RCT研究以提供更高质量证据支持。展开更多
文摘Introduction. Hyperprolactinemia represents a supraphysiological secretion of prolactin. In clinical practice, it is the most frequently encountered anterior pituitary disorder. However, its real prevalence is little known in Africa. The purpose of this study is to list all cases of hyperprolactinemia over the past four years and to make an inventory of the various etiologies found and their management. Methodology. This is a cross-sectional descriptive study on the files of patients who came for consultation in the internal medicine and endocrinology department with hyperprolactinemia retrospectively collected from January 2017 to December 2020. Included were patients followed or whose the diagnosis of hyperprolactinemia was established in endocrinological consultation during the study period. Results. This study recorded 26 cases of hyperprolactinemia. The female sex represented 73.08% (sex ratio M/F 0.37) and the average age was 33.92 years. The 40 - 50 age group was the most represented with 30.77%. In women, galactorrhea accounted for 73.07%, amenorrhea 57.69% of clinical pictures and infertility 23.08%. In men, infertility accounted for 7.69% of presentations, gynecomastia 11.54% and erectile dysfunction 15.38%. The duration of evolution of the signs was 4 months in 23.08% of the patients. The mean prolactinemia was 702.58 ng/ml. CT was performed in 80.85% of patients. The main etiologies were pituitary adenomas (77%). All our patients were treated with dopaminergic agonists. Cabergoline was prescribed in 77% of patients. The evolution was favorable in 96.25% of patients. Conclusion. Hyperprolactinemia is a pathology that exists in our regions. The main etiology remains pituitary adenomas and treatment with cabergoline.
文摘BACKGROUND Pituitary metastasis is an uncommon manifestation of systemic malignant tumors.Moreover,hyperprolactinemia and overall hypopituitarism caused by metastatic spread leading to the initial symptoms are rare.CASE SUMMARY A 53-year-old male patient was admitted to our hospital with complaints of bilateral blurred vision,dizziness,polyuria,nocturia,severe fatigue and somnolence,decreased libido,and intermittent nausea and vomiting for more than 6 mo.During the last 7 d,the dizziness had worsened.Laboratory investigations revealed overall hypofunction of the pituitary gland,but the patient had an elevated serum prolactin level(703.35 mg/mL).Preoperative magnetic resonance imaging revealed a tumor in the sellar region,accompanied by intratumoral hemorrhage and calcification.Thus,transnasal subtotal resection of the lesion in the sellar region was performed.The histopathological and immunohistochemical examinations of the resected lesion revealed metastasis of lung adenocarcinoma to the pituitary gland.Oral hydrocortisone(30 mg/d)and levothyroxine(25 mg/d)were given both pre-and postoperatively.Postoperatively,the clinical symptoms were significantly improved.However,4 mo following the surgery,the patient succumbed due to multiple organ failure.CONCLUSION Hyperprolactinemia is one of the markers of poor prognosis in patients with carcinoma that metastasizes to the pituitary gland.Exogenous hormone supplementation plays a positive role in relieving the symptoms of patients and improving quality of life.
文摘【Objective】To evaluate the clinical efficiency of different treatments cancellation and infertility in women with PCOS and hyperprolactinemia.【Method】We performed retrospective analysis of 502consecutive case histories during 5 years of reproductive results of treatment of women is with anovulatory infertility,caused by different factors.Aim of the study was to determine the efficiency of conservative and surgical treatment.【Result】Differentiated application of conservative medical therapy allows to attain the effect of proceeding in a fertile function in 33,8%of patients.It is found that surgical induction of ovulation by ovarian laparoscopic partial degradation is an option in the management of female infertility associated with PCOS,especially as a second-line treatment after the failure of clomiphene citrate treatment,enhancing the efficiency of complex infertility treatment to 40%.【Conclusions】It is feasible to develop an algorithm differentiated use of infertility treatments in women with PCOS and hyperprolactinemia.
文摘Hyperprolactinemia (an increased blood prolactin level secreted from eosinophilic cells in the anterior lobe of the pituitary gland) is caused by a variety of factors. The elevated level of prolactin will disturb the function of the thalamus-pituitary-ovary axis and lead to amenorrhea, infertility, infrequent menstruation, and dysfunction of corpus luteum, etc. Definite diagnosis can be
文摘目的系统评价逍遥散加减对比常规西药治疗高泌乳素血症(HPRL)的有效性及安全性。方法检索中国知识资源总库(CNKI)、中文科技期刊数据库(维普网)、中国生物医学文献数据库(CBM)、万方数据知识服务平台(万方数据)、EMbase、PubMed、Cochrane Library、Web of Science建库至2022年1月31日国内外公开发表的关于逍遥散加减治疗HPRL的随机对照试验(RCT)研究,对经筛选纳入的文献进行信息提取、Meta分析及证据质量评价。结果最终纳入13项研究,涉及患者888例,其中试验组447例,对照组441例。试验组干预措施为中药逍遥散组方加减,对照组均使用西药溴隐亭治疗。Meta分析结果:与对照组比较,试验组治疗HPRL的总有效率[OR=1.05,95%CI(0.71,1.54),Z=0.23,P=0.82]、治疗后PRL水平[MD=2.48,95%CI(-0.51,5.48),Z=1.62,P=0.10]、妊娠率[OR=2.19,95%CI(0.82,5.82),Z=1.56,P=0.12]均差异无统计学意义;复发率[OR=0.23,95%CI(0.11,0.47),Z=4.03,P<0.0001]、不良反应发生率[OR=0.03,95%CI(0.01,0.09),Z=6.40,P<0.00001]均低于对照组。结论逍遥散加减治疗HPRL疗效显著,且复发率、不良反应率均低于溴隐亭治疗。但本结果因纳入研究数量有限且水平偏低,今后仍有必要开展更多大范围、高标准的RCT研究以提供更高质量证据支持。
