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 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Four female patients were found to have microadenomas and high prolactin levels, but the symptoms of the syndrome varied among the patients. Three of four patients had overt galactorrhea, obesity, and amenorrhea. One patient was postmenopausal, and another showed menstrual irregularities. Two patients sought medical attention for headaches, and one for visual disturbances. Two patients previously had used psychotropic drugs, and two patients used birth control pills. When tested, all patients had high serum prolactin levels, abnormal sellar tomograms, and the presence of microadenoma of the pituitary was confirmed by computerized tomography.Because of the high incidence of pituitary tumor among these four patients, this study suggests that a complete workup should be done for patients having galactorrhea, amenorrhea, and obesity as a syndrome or as separate entities.
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PMID:Syndrome of galactorrhea, amenorrhea, and obesity as possible indicators of prolactinoma: a case study approach. 380 93

A 37-year-old woman undergoing endocrine evaluation during her seventh pregnancy because of headaches, weakness, and hyponatremia was found to have central hypoadrenalism and hypothyroidism. Computed tomography showed a pituitary mass with suprasellar extension but her visual fields were intact. She was treated conservatively with hydrocortisone acetate and levothyroxine sodium until 38 weeks of gestation, when healthy twins were delivered by cesarean section. A few months later, her pituitary function improved, with a significant increase in the adrenocorticotropic hormone level, normal values of basal thyroid-stimulating hormone, growth hormone, and gonadotropins and of their functional reserves, and only a slight elevation in the prolactin level. A repeated computed tomographic scan showed disappearance of the pituitary mass.
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PMID:Spontaneous postpartum regression of pituitary mass with return of function. 394 2

Hyperprolactinemia is frequent in clinical endocrinology. Its commonest causes are, besides pregnancy and lactation, drugs, mainly involving the generally used psychopharmaca and the equally ubiquitously prescribed estrogens. The single most important cause is a pituitary tumor, the prolactinoma, but lesions of the hypothalamus or pituitary stalk, primary hypothyroidism, liver cirrhosis and chronic renal failure, among others, may also provoke hyperprolactinemia. The clinical features of hyperprolactinemia in women are mainly amenorrhea, or irregular menses, galactorrhea, hirsutism, infertility and loss of libido. In men loss of libido and/or impotence are the most important symptoms, accompanied by infertility. Macroadenoma, more frequently seen in men than in women, may cause tumor symptoms such as headache and ophthalmologic disorders (visual field loss). The main biochemical finding is hyperprolactinemia, which should be repeatedly checked. In general, high concentrations are mainly found in large adenomas, while microadenomas usually involve only mild hyperprolactinemia, though there are numerous exceptions. While dynamic tests of prolactin secretion have provided useful information about the pathophysiology of prolactin secretion, their use in routine clinical work is controversial and of limited value. As a routine neuroradiological examination, high resolution CT of the pituitary area is to be recommended. In all hyperprolactinemic patients with suspicion of macroadenoma, ophthalmologic evaluation of fundus and visual fields should be performed. Dopaminergic drugs such as bromocriptine rapidly reduce serum prolactin levels in hyperprolactinemic women and men with micro- or macroadenoma. With these drugs considerable tumor shrinkage is possible.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Hyperprolactinemia]. 395 83

Neuroendocrine and behavioral effects following an acute or chronic treatment with the calcium antagonist, flunarizine, have been studied in young and old rats. Both in young and old rats, acute administration of flunarizine (2 mg/kg) failed to modify plasma prolactin (PRL) levels, as measured at 8.00 a.m., 4.00 p.m. and 12.00 p.m. A chronic treatment with flunarizine (0.5 mg/kg/day, for 20 days) in young rats was followed by a relevant, albeit statistically not significant, increase in plasma PRL levels, as measured at 8.00 a.m. and 4.00 p.m., and by a significant decrease at 12.00 p.m. A shift of nocturnal peak of plasma PRL levels from 12.00 p.m. to 4.00 a.m. was observed in these animals. A chronic treatment with flunarizine in old rats was followed by a significant increase in plasma PRL levels, as measured at 12.00 p.m. The acquisition of active avoidance behavior was studied in a shuttle-box test. Acute administration of flunarizine failed to change the performance of young and old rats in acquiring the behavioral response, as measured by the total number of conditioned avoidance responses (CARs) and the percentage of learners. When flunarizine was administered chronically, a decrease in CARs and learners was observed both in young and old rats. This was accompanied by a significant increase in the percentage of animals that froze during the acquisition session. No significant effect was found in young and old rats tested in a "despair" test after a chronic treatment with flunarizine.
Cephalalgia 1985 May
PMID:Neuroendocrine and behavioral effects of flunarizine in young and old rats. 401 25

The effect of 30-days of flunarizine (5 mg/day) therapy on pituitary, B-pancreatic, gonadic and adrenal function was studied in five adolescents with common migraine. Baseline concentration of growth hormone was significantly reduced after flunarizine therapy. The response of prolactin to thyrotrophin-releasing hormone was significantly increased after flunarizine therapy. The percentages of HbA1 and HbA1c were significantly higher after flunarizine therapy. The drug had no apparent effect on gonadic and adrenal function. Further studies are needed to confirm the effect of flunarizine on the hypothalamus-pituitary axis and glucose tolerance.
Cephalalgia 1985 May
PMID:Hormonal and metabolic changes induced by flunarizine therapy: preliminary results. 401 33

14 patients (13 women, 1 man) presenting with primary empty sella had endocrinologic and radiological investigations. 8 women are obese, 5 multiparous. Initially, headaches have needed a radiological study of sella turcica in 8 cases (57%). Pneumoencephalography and/or CT scan have led to diagnosis; but in 3 cases, a suspected associated pituitary adenoma justified a surgical exploration. In one case, a GH-secreting microadenoma was found, in both other cases histologic studies revealed fibrous or normal pituitary. Endocrine findings were normal, regarding to gonadotrophs, corticotrophs and thyreotrophs. GH was blunted in four cases, below 5 ng/ml during insulin tolerance test. In 9 cases, GH rose to 19,51 +/- 10,03 ng/ml (mean +/- S.D.). In 13 patients, serum prolactin was normal: 7,1 +/- 3,9 ng/ml (normal values 2 -20 ng/ml), elevated in the last case: 112,5 ng/ml. One year later, two patients did not show any modification on clinical, radiological or endocrine data. Physiopathology of intrasellar arachnoidocele is discussed: intrasellar extension of subarachnoid space may be due to diaphragm insufficiency and disturbances of dynamics of cerebrospinal fluid, flattening the otherwise normal pituitary gland.
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PMID:[Primary empty sella turcica. Analysis of 14 cases and review of the literature]. 403 6

A 33-year-old male was admitted to the Department of Neurosurgery, Fukui Medical School with a complaint of headache. There were no neurological deficits on admission. Craniogram demonstrated a so-called "phantom sella". A computed tomography revealed a high density mass lesion and the mass was enhanced well, that mainly extended from the sella to the left middle cranial fossa. The left carotid angiogram revealed an avascular mass lesion extending from the sella to the left middle cranial fossa. Pituitary function tests revealed an extremely high serum prolactin (PRL) levels (70, 100 ng/ml). PRL response to TRH was delayed in peak and the high level continued. Serum PRL levels elevated to 90, 800 ng/ml at 180 min after injection of TRH. A biphasic response was demonstrated in response to CB-154 suppression test to PRL secretion, that is, CB-154 stimulated PRL release initially (up to 90 min) and suppressed thereafter. Serum PRL levels (178, 400 ng/ml) reached to peak about 90 min after CB-154 administration. Response of growth hormone (GH) and adrenocorticotropic hormone (ACTH) to insulin were also impaired. Craniotomy was performed. The tumor was partially removed and was diagnosed as a prolactinoma histologically. Tumor tissue removed was subjected to the monolayer culture and electron microscopic study. Their observations demonstrated hyperactive PRL secretion of the individual cells. A total dose of 5,000 rads was irradiated postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of male prolactinoma presenting extremely high serum prolactin levels and biphasic response to CB-154 suppression test]. 404 Dec 91

Cultural, psychological, and biochemical explanations for depression in users of oral contraceptives are discussed. The suppression of taboos against sexuality cannot be expected to bring about instant psychological adjustment, as shown by the large numbers of women who are afraid to take the pill or who develop psychosomatic disorders and depression. Incidence of depression as reported in the literature ranges from 5% to 45%. Some authors attribute psychogenic causes for depression associated with the pill, such as temporary castration, instant sexual liberation, or womens' undeniable maternal instinct. Others present evidence for biochemical causes of depression. General explanations for pill-related depression include imbalance of hypothalamic amines and consequently of releasing factor, prolactin-inhibiting factor, decreased brain serotonin due to inhibition of tryptophan hydroxylase by progestagens, or diminished brain biogenic amines because of lowered pyridoxal levels. From clinical work with neuroleptic drugs it is known that drugs, stress, or anxiety can disturb the biochemical balance and result in amenorrhea. High progestin levels may be responsible for premenstrual anxiety and headaches.
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PMID:[Oral contraception and induced depressive states]. 444 85

In order to clarify the mechanism of the analgesic effect of ceruletide (CRL), the peptides B-endorphin (BE), ACTH, prolactin (PRL), growth hormone (GH) and substance P were determined in the basal state and following IV CRL administration in 11 patients. CRL, at the dose of 2 ng/kg/min, significantly augmented BE levels in the plasma, and in CSF. Substance P levels were significantly augmented by CRL in the plasma, while ACTH levels were significantly augmented in CSF. GH and PRL levels were not affected by CRL. Placebo had no effect on any of the measured peptides. The effect of CRL on mood and anxiety, known to be affected by opioids, was studied in 14 patients with psychogenic headache. The effect of histamine induced headache on State trait anxiety inventory and on Mood adjective check list was studied before and after administration of placebo or CRL. CRL significantly diminished anxiety when compared to placebo. Elation, surgency and egotism were significantly augmented while skepticism was significantly diminished by CRL. The CRL effect on mood and pain may be mediated by augmented levels of neurohormones both in the plasma and in CSF.
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PMID:Effect of ceruletide on pituitary-hypothalamic peptides and on emotion in man. 617 96

A group of 78 women with sudden flushes and associated disorders (pruritus vulvae, headache, anxiety, instability, depression, libido disturbances) related to the menopause were treated with one or two capsules of veralipride daily for 20 days. Excellent or good results were obtained in 54 of the 69 patients (78 p. cent) with sudden flushes, and 29 of the 57 cases (51 p. cent) with associated disorders. The difference in scores before and after treatment is very highly significant (p < 0.001). Clinical tolerance was good as only 2 cases of minimal galactorrhea. 2 cases of mastodynia, 3 cases with mild drowsiness, 2 patients with nervous tension or insomnia, 3 with digestive disorders, 1 with vertigo, and 1 with mild visual disturbances were observed. No modifications in the biological parameters studied were noted. Blood prolactin levels increased during treatment but returned to normal levels 4 days after discontinuation of therapy. No significant modifications in FSH, LH, E2, or E3 plasma levels were noted at the end of the study. Veralipride appears, therefore, to be the prototype for non-hormonal therapy of menopausal disorders.
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PMID:[A new therapeutic approach to menopausal sudden flushes and psychofunctional disorders (author's transl)]. 625 60


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