Difference between revisions of "PITUITARY-PROLACTINOMA"
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<br/>2. Serum prolactin concentration > 200 ng/mL is indicative of a prolactinoma. Level of 21-40 ng/mL may be caused by drugs, pregnancy & lactation, food intake, hypothyroidism, CKD, chest wall injuries. | <br/>2. Serum prolactin concentration > 200 ng/mL is indicative of a prolactinoma. Level of 21-40 ng/mL may be caused by drugs, pregnancy & lactation, food intake, hypothyroidism, CKD, chest wall injuries. | ||
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<br/>3. Inc PRL ⟹ dec GnRH ⟹ dec LH + FSH. This causes dec libido, galactorrhea (less common in men, more in women); amenorrhea, hirsuitism, decreased skeletal bone mineralization in both sexes. | <br/>3. Inc PRL ⟹ dec GnRH ⟹ dec LH + FSH. This causes dec libido, galactorrhea (less common in men, more in women); amenorrhea, hirsuitism, decreased skeletal bone mineralization in both sexes. | ||
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<br/>4. Microadenoma management: dopamine agonist (bromocriptine, cabergoline). Both bromocriptine and cabergoline are FDA pregnancy | <br/>4. Microadenoma management: dopamine agonist (bromocriptine, cabergoline). Both bromocriptine and cabergoline are FDA pregnancy | ||
Latest revision as of 02:29, 21 March 2023
SUMMARY
1. Most common microadenomas (< 1 cm).
2. Serum prolactin concentration > 200 ng/mL is indicative of a prolactinoma. Level of 21-40 ng/mL may be caused by drugs, pregnancy & lactation, food intake, hypothyroidism, CKD, chest wall injuries.
3. Inc PRL ⟹ dec GnRH ⟹ dec LH + FSH. This causes dec libido, galactorrhea (less common in men, more in women); amenorrhea, hirsuitism, decreased skeletal bone mineralization in both sexes.
4. Microadenoma management: dopamine agonist (bromocriptine, cabergoline). Both bromocriptine and cabergoline are FDA pregnancy
category B drugs.
5. Cabergoline is contraindicated in valvular, lung or retroperitoneal fibrotic diseases.
6. Macroadenoma management in threatened vision: surgery.
7. 1/3 of macroadenomas increase in pregnancy. Bromocriptine or surgery may be options in pregnancy.
Reference(s)
Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].
