Although somatostatin analogues (SSAs) are recommended as the first-line medical therapy for acromegaly, dopamine agonists (DAs) are also a therapeutic option for treatment. We aimed to assess and compare the efficacies of DAs and SSAs in treating acromegaly in clinical practice. We included 89 patients with acromegaly who took DAs (bromocriptine [BCT], n = 63; cabergoline [CAB], n = 11) or SSAs (n = 15) as a primary medical therapy for more than 3 months in the Seoul National University Hospital. Read More
J Clin Pathol 2017 Oct 17;70(10):827-831. Epub 2017 Mar 17.
Department of Pathology, Affiliated Calmaette Hospital of Kunming Medical University, Kunming, Yunnan, PR China.
Aims: The aetiology and treatment options for idiopathic granulomatous mastitis (IGM) are controversial. The aim was to study the clinical and diagnostic features and discuss medical and surgical treatment for IGM in our patients.
Methods: Sixty-five patients who met the histological criteria for IGM were retrospectively studied. Read More
Prolactin-producing uterine leiomyomas are very rare. Although hyperprolactinemia rapidly improves after removal of such leiomyomas, no preoperative diagnostic test has been established for prolactin-producing uterine leiomyomas. A 45-year-old Japanese woman, gravida 3 para 3, was referred to our hospital for further examination of hyperprolactinemia resistant to a dopamine agonist. Read More
Hypogonadotropic hypogonadism (HH) is common and occurs prematurely in HIV-infected men. However, HH with very low testosterone has not been described. Three men with normal pubertal development and HIV1 diagnosis at the ages of 22, 34 and 35 years. Read More
Service d'Endocrinologie, CHU Farhat Hached de Sousse, Tunisie.
Prolactin-secreting adenoma is rare in elderly women. Patient's clinical picture may be confused with that of menopause, making diagnosis sometimes difficult. We report the case of a 57-year old woman with a 2-year history of secondary amenorrhea without hot flushes associated with galactorrhea in order to highlight the peculiarities of prolactin-secreting microadenomas. Read More
Rationale: Hyperprolactinemia is a highly prevalent adverse effect of many antipsychotic agents, with potentially serious health consequences. Several guidelines have been developed for the management of this condition; yet, their concordance has not been evaluated.
Objectives: The objectives of this paper were (1) to review current clinical guidelines; (2) to review key systematic evidence for management; and (3) based on our findings, to develop an integrated management recommendation specific to male and female patients who are otherwise clinically stabilised on antipsychotics. Read More
Objective: To investigate the impact of autoimmune thyroiditis (AIT) on pregnancy outcomes in patients with polycystic ovary syndrome (PCOS) following the in vitro fertilization and embryo transfer (IVF-ET) by analyzing their pregnancy outcomes. Methods: The patients undergoing IVF-ET treatment diagnosed with PCOS in Peking University Third Hospital from May 2010 to December 2014 were investigated. According to the anti-thyroid antibodies (TPOAb or TGAb), patients were divided into AIT group and non-AIT group. Read More
We present unexpected neuropathological findings in a 37 year old woman who underwent surgery for removal of an epidermoid cyst. A first brain MRI at the age of 27 years (due to hyperprolactinemia) showed a cystic lesion in the right prepontine region involving the cisterna ambiens with supratentorial extension. The lesion remained stable until she was 32 year, when it increased in size causing partial compression of the parahippocampal gyrus, midbrain peduncle and lateral pons (Fig. Read More
J Obstet Gynaecol India 2017 Oct 24;67(5):363-369. Epub 2017 Jun 24.
Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Purpose: Polycystic ovarian syndrome (PCOS) is a common reproductive disorder. Increasing serum prolactin in these patients could be detected in both follicular and luteal phase of the normal and stimulated cycles. Hyperprolactinemia affects the hypothalamic-pituitary-ovarian axis causing anovulation and abnormal uterine bleeding. Read More
Open Forum Infect Dis 2017 6;4(2):ofx096. Epub 2017 May 6.
Queen Mary Hospital, Hong Kong.
This retrospective study of patients with Corynebacterium kroppenstedtii infections revealed a predominance of mastitis and a potential association with psychiatric illnesses. At least one third of our patients with C kroppenstedtii mastitis had psychiatric illness, and >92% received antipsychotic medications. Drug-induced hyperprolactinemia may be an important modifiable risk factor in these patients. Read More
There is increasing evidence associating idiopathic granulomatous mastitis (IGM) with hyperprolactinemia. All documented cases have involved the patient having at least one operative procedure before the association has been made. We present a 55 year old female with IGM associated with risperidone induced hyperprolactinemia. Read More
Objectives: The indication for screening for valvular heart disease in patients taking cabergoline is based on evidence from patients with Parkinson's disease on high-dose medication. However, current patients take much lower doses for indications such as hyperprolactinaemia disorders. Contemporary guidelines for echocardiogram monitoring in patients taking cabergoline are conflicting. Read More
Purpose: Internal carotid artery (ICA) aneurysms have rarely been found in association with marked hyperprolactinemia in the absence of prolactinoma; the cause of hyperprolactinemia has never been investigated. We aimed to determine if the observed hyperprolactinemia is due to a vascular-derived or known prolactin secretagogue from the injured ICA, analogous to pregnancy-associated hyperprolactinemia putatively due to placental factors.
Methods: We conducted a case series and literature review of individuals with severe hyperprolactinemia in association with ICA aneurysms. Read More
A female hemodialysis patient with galactorrhea due to hyperprolactinemia was treated with different dialysis modalities to assess the effect on prolactin levels. A single session of both high-flux hemodialysis and hemodiafiltration resulted in decreased prolactin levels (16,6% and 77,2%, resp.). Read More
Primary empty sella (PES) is characterized by the herniation of the subarachnoid space within the sella, which is often associated with variable degree of flattening of the pituitary gland in patients without previous pituitary pathologies. PES pathogenetic mechanism are not well known but seem due to a sellar diaphragm incompetence, associated to the occurrence of upper sellar or pituitary factors, as intracranial hypertension and change of pituitary volume. As PES represents in majority of cases a neuroradiological findings, without any clinical implication, the occurrence of endocrine, neurological and opthalmological symptoms, due to the above describes anatomical alteration, delineates the so called PES syndrome. Read More
Background Metabolic syndrome (MS) in adolescents is a risk factor for type 2 diabetes and cardiovascular diseases. Objective The present study aimed to determine the prevalence of MS in 14-18-year-old girls. Methods This analytical case-control study was conducted on 3200 high school students with polycystic ovarian syndrome (PCOS). Read More
Unusual forms of pulmonary hypertension include pulmonary hypertension related to mediastinal fibrosis and the use of serotonergic drugs. Here, we describe a patient with diffuse mediastinal fibrosis and pulmonary hypertension while she was on dopamine agonist therapy. A young woman, who was treated with cabergoline and bromocriptine for hyperprolactinemia, presented with progressive dyspnea over several months. Read More
Idiopathic granulomatous mastitis (IGM) is a rare benign disease, characterized by chronic inflammation and granulomatous disease process. A middle aged lady with breast lump for six months with equivocal mammographic and ultrasound results underwent lumpectomy and biopsy. Ruling out all other possible granulomatous diseases and malignancy, a diagnosis of IGM was made. Read More
This study aimed to investigate the effects of anti-tumor necrosis factor (TNF)-α antibody (Ab) on alteration of penile structure in the hyperprolactinemia (hyperPRL) rat model. HyperPRL was induced in 8-week-old male Sprague-Dawley rats by allografting anterior pituitary (AP) glands under the renal capsule (+AP rats). Rats implanted with cerebral cortex (CX) were used as sham control (+CX rats). Read More
Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK. Electronic address:
Little is known about hyperprolactinaemia (HPL) in first episode psychosis (FEP) patients. We investigated longitudinal changes in serum prolactin in FEP, and the relationship between HPL, and antipsychotic medication and stress. Serum prolactin was recorded in FEP patients at recruitment and again, 3 and 12months later. Read More
For many years, Tourette syndrome (TS) was considered to be a rare disorder, but tics and TS are now recognized as fairly common childhood-onset conditions. Children and adolescents with TS are frequently treated with antipsychotics, either as monotherapy or in combination with psychostimulants, melatonin and selective serotonin reuptake inhibitors (SSRIs). Antipsychotics are most often used in schizophrenia and related psychotic disorders, and in these conditions hyperprolactinemia is one of the most common adverse effects associated with antipsychotics, occurring in 40-50% of patients. Read More
Background: The potent immunomodulatory action of prolactin has been demonstrated in many experimental in vitro studies. In accordance with these data, our retrospective analyses revealed higher prevalence of autoimmune thyroid diseases in prolactinoma patients compared to general population.
Purpose: A cross-sectional case-control study was carried out in a single tertiary referral centre. Read More
Background: Endocrine dysfunction is known to occur in various infectious diseases of the brain. The neuroendocrine dysfunction is not well studied in patients of Tuberculous meningitis (TBM). In this study, we aimed at knowing pattern of endocrine dysfunction in newly diagnosed patients of tuberculous meningitis, structural changes occurring in hypothalamic-pituitary region, assessing its predictors and correlative factors related to outcome. Read More
Objective: To examine incidence of adverse health outcomes and associated factors among preschoolers (under age 6) who received antipsychotic treatment through the Florida Medicaid Prior Authorization (PA) program.
Methods: Using Florida's PA registry linked to the state's Medicaid claims data, we ascertained incident outcomes during PA-approved antipsychotic use between April 2008 and September 2015 (7.5 years). Read More
Context Management of prolactinomas during pregnancy has always been a challenge. There is a concern about the risk of tumor growth, as well as the effects of the treatment on the developing fetus. Another issue that has been less studied is the outcome of women with prolactinoma after pregnancy and lactation. Read More
Rheumatoid arthritis (RA) is a chronic autoimmune disease that affects females three times more frequently than males. A potential role for hormones, such as prolactin (PRL), may in part explain this phenomenon. The risk of developing RA is increased in women who are lactating after the first pregnancy, which might be related to breastfeeding and the release of PRL. Read More
Introduction: Pituitary hyperplasia due to primary hypothyroidism is rare and underdiagnosed.
Case Report: We report an 18-year-old patient referred for a pituitary mass revealing primary hypothyroidism. Biological parameters confirmed severe primary hypothyroidism and hyperprolactinemia. Read More
Atypical antipsychotic (AA) drugs, including risperidone (RIS), are used to treat schizophrenia, bipolar disorder, and autism, and are prescribed off-label for other mental health issues. AA drugs are associated with severe metabolic side effects of obesity and type 2 diabetes. Cross-sectional and longitudinal data also show that risperidone causes bone loss and increases fracture risk in both men and women. Read More
The aging female rat constitutes an interesting model of spontaneous and progressive age-related dopaminergic dysfunction as it allows assessing new therapeutic strategies for Parkinson's disease. Insulin-like growth factor I (IGF-I) is emerging as a powerful neuroprotective molecule, strongly induced in the central nervous system after different insults. We constructed a helper-dependent recombinant adenoviral vector (HDRAd-IGFI) harboring the gene for rat IGF-I. Read More
Background It has been recently suggested that second-generation antipsychotic long-acting injection (SGA-LAIs) are underutilized in clinical practice, despite that their costs significantly impact on national health system budgets. Hence, an updated analysis of safety data shown by SGA-LAIs may contribute to clarify their role in clinical practice. Materials and methods English-language, peer-reviewed articles reporting updated, primary findings on the SGA-LAI safety were identified (updated through an electronic search of five databases - PubMed, EMBASE, PsycInfo, DARE and the Cochrane Library). Read More
Background And Objective: Hyperprolactinemia affects the reproductive endocrine axis; however, the degree of dysfunction may vary depending on etiology. The aim of the present study was to analyze menstrual cyclicity in patients with prolactinoma and drug-induced hyperprolactinemia (DIH).
Methodology: Patients with prolactinoma and DIH were retrospectively analyzed for menstrual cyclicity at presentation and response to therapy. Read More
Aim: The objective of the present study was to evaluate the influence of the comprehensive spa and health resort-based treatment on the system of hormonal regulation in the women presenting with bacterial vaginosis and concomitant chronic inflammatory diseases of the pelvic organs depending on the plasma prolactin level.
Material And Methods: We investigated the indicators of hormonal regulation in 186 women suffering from bacterial vaginosis and concomitant chronic inflammatory diseases of the pelvic organs depending on the level of prolactin in blood plasma. The first group consisted of 128 women with the normal plasma prolactin levels whereas the second group was comprised of 58 women having hyperprolactinemia. Read More
Background: Elevated prolactin levels (hyperprolactinemia) are a frequent adverse effect of antipsychotic medications, especially in young populations. Prolonged hyperprolactinemia may affect sexual functioning and the onset and progression of puberty.
Objective: This study assessed potentially prolactin-related treatment-emergent adverse events (PPRL-TEAEs) and sexual maturation during long-term treatment of adolescents with paliperidone extended-release (ER). Read More
POEMS syndrome (Peripheral neuropathy, Organomegaly, Endocrinopathy, M protein, Skin changes) is a rare plasma cell disorder with multisystem involvementA 40-year-old man with a chronic history of unexplained peripheral neuropathy , presented with exudative ascites.He was found to have an incidental osteolytic lesion of the sacrum proven to be a plasmacytoma. Immunoelectrophoresis for monoclonal protein was negative. Read More
From the *Pharmacology Department, School of Medicine, University of Buenos Aires; †Hospital de Emergencias Psiquiátricas Torcuato de Alvear; ‡Bipolar Disorder Program, Neuroscience Institute, Favaloro University; §Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; and ∥Kaiser Permanente Center for Health Research, Portland, OR.
Background: Treatment with antipsychotic (AP) agents is associated with incident thromboembolic events. However, the underpinnings of this association remain unknown. We sought to evaluate the effect of AP agents-categorized by their metabolic/sedative and hyperprolactinemia adverse effect profile-on the risk of venous thromboembolic disease during long-term follow-up. Read More
Cabergoline, a dopamine agonist agent, is commonly used in the treatment of hyperprolactinemia, Parkinson's disease, restless leg syndrome, and antipsychotic-induced prolactin elevation. It is generally well tolerated as compared to other dopamine agonist agents due to its more selective D2 receptor agonistic effect. We present a case of a 25-year-old female who developed manic episode, following the use of cabergoline for treatment of pituitary microadenoma. Read More
Participation of Na+/K+-ATPase in the natriuretic effect of prolactin in a cholestasis of pregnancy model was investigated. The Na+/K+-ATPase activity in rat kidney medulla, where active sodium reabsorption occurs, decreased in the model of cholestasis of pregnancy and other hyperprolactinemia types compared with intact animals. This effect was not connected with the protein level of α1- and β-subunits of Na+/K+-ATPase measured by Western blotting in the kidney medulla. Read More
Background: Xanthomatous hypophysitis (XH) is extremely rare. Only 27 cases have been reported in the literature. No XH patient presenting with diabetes insipidus (DI) has been completely cured through surgery. Read More
Topiramate has been used increasingly in the management of psychiatric conditions. Clinical trials demonstrated that topiramate augmentation was effective in controlling negative symptoms in schizophrenia. This case report presents a case of a 38-year-old man with schizophrenia who achieved full negative symptom remission upon the adjunctive use of topiramate. Read More
Dopamine (DA) is a neurotransmitter in the central nervous system as well as in peripheral tissues. Emerging evidence however points to DA also as a key transmitter between the nervous system and the immune system as well as a mediator produced and released by immune cells themselves. Dopaminergic pathways have received so far extensive attention in the adaptive branch of the immune system, where they play a role in health and disease such as multiple sclerosis, rheumatoid arthritis, cancer, and Parkinson's disease. Read More
Asian J Psychiatr 2017 Jun 24;27:69-70. Epub 2017 Feb 24.
Oregon Heath & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, United States; Supervising Psychiatrist & Chair GME Committee, Oregon State Hospital, 2600 Center Street NE, Salem, OR 97301, United States. Electronic address:
Background: The relative efficacy and tolerability of antipsychotics for schizophrenia are considerably well studied. This study aimed to examine whether previous findings could be replicated in a genetically distinct and homogenous group (ie, Japanese patients with schizophrenia) and whether previous findings could be extended to a broader range of antipsychotics with previously unclear relative efficacy and tolerability.
Methods: Bayesian network meta-analysis was performed in which randomized trials comparing any of the following interventions were included: second-generation antipsychotics, haloperidol, or placebo. Read More
Hyperprolactinaemia especially affects women in reproductive age (90/100,000) but also often is diagnosed in menopause age and leads to disturbances in functioning of LH-RH neurons and, as a consequence, to a decrease of FSH and LH, which causes inhibition of oestradiol production. Prolactin is a peptide hormone, phylogenetically one of the oldest, stimulating cells of various organs, which is produced and secreted mainly by lactotrophic acidophilic cells of the anterior lobe of the pituitary. It influences the increase in the mass of the mammary glands, and stimulation and maintenance of lactation after delivery. Read More
Background: High-security hospital patients are often complex in presentation and are characterized by treatment resistance, medication nonadherence and history of violence. Paliperidone is licensed both as an oral and depot antipsychotic medication in the treatment of schizophrenia. Clinical trials have shown that paliperidone depot is well tolerated with similar efficacy to risperidone depot but with additional practical advantages. Read More
Objective: It is unclear whether selective serotonin-reuptake inhibitors (SSRIs) can significantly increase the prolactin level. The purpose of this study was to identify the relationship between the prolactin level and the administration of SSRIs such as escitalopram and sertraline. An additional purpose was to determine whether the elevation of prolactin differs between escitalopram and sertraline treatment. Read More
Background: Prevalence of hyperprolactinemia in children with subclinical hypothyroidism (ScH) is not known. This study aimed to determine the occurrence and predictors of hyperprolactinemia in children with euthyroidism, ScH and overt primary hypothyroidism (OPH).
Methods: Consecutive children <18 years age, diagnosed to have normal thyroid function, ScH or OPH underwent serum prolactin estimation. Read More
Objective: Bipolar disorder (BD) is burdensome for patients and healthcare systems. This study evaluated changes in concomitant medication patterns, healthcare utilization, and costs after the initiation of risperidone long-acting injection (RLAI) treatment among BD patients.
Method: 287 BD patients receiving regular RLAI treatment for 1 year were identified from the Taiwan National Health Insurance Research database during 2007-2012. Read More