Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

30 patients with pituitary tumors were treated in our unit and followed for 26-45 months. 14 patients had nonsecreting adenomas, 7 had acromegaly, 5 had prolactinomas, 3 had Cushing's disease. One patient had a choristoma of the pituitary stalk. The patient with a choristoma, 7 patients with nonsecreting adenomas, 4 with acromegaly, 1 prolactinoma and 3 with Cushing's disease had been operated by transsphenoidal microsurgery prior to Gamma Knife (GK) treatment. From this group, one patient with a nonsecreting adenoma and two with acromegaly had undergone fractional external radiotherapy after surgery. Stereotactic MRI localization had been used in all cases. All the tumors showed either a reduction in volume or cessation of growth; 85% of the patients with acromegaly showed normalization of growth hormone (GH) levels. Normalization of ACTH levels occurred in the 3 patients with Cushing's disease. All the patients with prolactinomas showed reduction of prolactin levels but normalization did not occur. However, in 3 cases the bromocriptine could be withdrawn. Deterioration of vision was not observed. One patient suffered transient paresis of the third cranial nerve that improved with steroids. Panhypopituitarism appeared in one case of Cushing's disease two years after the treatment. In the remaining cases there were no changes in their previous physiological pituitary function. We conclude that GK radiosurgery in pituitary tumors is an effective alternative to transsphenoidal microsurgery when compression of surrounding structures does not exist, and it can efficiently replace conventional irradiation.
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PMID:Pituitary tumors and gamma knife surgery. Clinical experience with more than two years of follow-up. 978 42

A 57-year old patient presented with an 8 week history of headache and diplopia. Left-sided incomplete oculomotor nerve paresis was found, whereas further clinically relevant visual impairment was not seen. Magnetic resonance imaging of the head showed an extensive intra-, para- and suprasellar tumor which in combination with a markedly elevated serum prolactin level was identified as a macroprolactinoma. The symptoms began 7 years ago with a loss of libido and virility. The application of a dopamine agonist lead to a reduction of serum prolactin level to 0.5% of the initial value and a considerable tumor regression within three months. The development of oculomotor nerve paresis is an unusual manifestation of prolactinoma. By contrast, long-term medical history with slowly developing signs and symptoms of hypogonadotropic hypogonadism are often to be found in men. The delayed diagnosis is responsible for the high percentage of macroprolactinomas in male subjects.
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PMID:[57-year-old patient with diplopia and headache]. 1296 89

Domperidone is a prokinetic drug used for diabetic gastro paresis, hiccoughs, and vomiting. It is a peripheral D2 receptor antagonist with selective peripheral activity restricted to the upper gastro intestinal tract. It is not known to cross the blood brain barrier and hence, lacks neurological side effects. We would like to report a case of domperidone induced galactorrhea in a young female who presented with galactorrhea and other symptoms suggestive of prolactinoma.
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PMID:Domperidone induced galactorrhea: an unusual presentation of a common drug. 2383 83

Prolactinomas are a common cause of gonadal dysfunction and infertility. We present the case of a 38-year-old woman with history of amenorrhea and infertility. At seven weeks of pregnancy she presented neuro-ophthalmologic complaints of headaches, diplopia, and right ptosis. The work-up study revealed an invasive pituitary macroadenoma with a maximum diameter of 9 cm and serum prolactin of 25,800 ng/mL (3-20). At 12 weeks, she was referred to the Endocrinology Department of the Coimbra University Hospital and started therapy with bromocriptine, initially 5 mg/day and then at crescent doses. Hyperprolactinemia was rapidly and drastically reduced to 254 ng/mL three weeks after taking bromocriptine 15 mg/day. Tumoral volume was reduced and there was improvement of III pair paresis. At 38 weeks, a male healthy baby was born. This is a relevant clinical case that illustrates the efficacy and safety of bromocriptine therapy during pregnancy, even in severe cases like this one.
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PMID:Giant macroprolactinoma and pregnancy. 2423 22

Prolactinomas account for approximately 40% of all pituitary adenomas. Hyperprolactinemia causes hypogonadism, infertility and galactorrhea. Macroprolactinomas may cause signs of local expansion, such as headache, visual field defects and paresis of oculomotor nerves during suprasellar and parasellar extensions. Compression of healthy pituitary tissue together with the blockade of the flow of hypothalamic released hormones to the pituitary by macroprolactinomas results in the development of hypopituitarism. The aim of treatment is restoration of hypogonadism and fertility in the microprolactinoma patients, as well as tumor shrinkage in macroprolactinoma patients. Primary therapy for prolactinomas is pharmacological treatment with dopamine agonists (DAs). However, surgical or radiation treatment is recommended for prolactinoma patients resistant or intolerant to DAs. In patients with long-term normoprolactinemia and significant tumor shrinkage, a trial of tapering and discontinuation of medical therapy is possible. After discontinuation of DAs, a long-term follow-up is necessary. In cases of recurrence displaying hyperprolactinemia and tumor enlargement, treatment must be resumed.
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PMID:Diagnosis and treatment of prolactinomas. 3078 Aug 62