Drugs and prolactin

Molitch, Mark E.

doi:10.1007/s11102-008-0106-6

Cited by 142 publications

(90 citation statements)

References 122 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…(1,(4)(5)(6)(7)22,(24)(25)(26). Any drug that affects the hypothalamic dopamine system and/or pituitary dopamine receptors can potentially induce hyperprolactinemia (6,26).…”

Section: Physiologic Causesmentioning

confidence: 99%

“…Although PRL elevation is usually mild (25-100 ng/mL), in cases of drug-induced hyperprolactinemia, it is also highly variable (26). Indeed, metoclopramide, risperidone, and phenothiazines can lead to prolactin levels > 200 ng/mL (4,6,26).…”

Section: Systemic Diseases/drugsmentioning

confidence: 99%

“…Indeed, metoclopramide, risperidone, and phenothiazines can lead to prolactin levels > 200 ng/mL (4,6,26). Among 180 cases enrolled in BMSH, most (64%) present PRL levels < 100 ng/mL, but in 5% they exceed 250 ng/mL (range, 28-380; mean, 105.1 ± 73.2) (27).…”

Section: Systemic Diseases/drugsmentioning

confidence: 99%

See 2 more Smart Citations

Challenges and pitfalls in the diagnosis of hyperprolactinemia

Vilar

Fleseriu

Bronstein

2014

Arq Bras Endocrinol Metab

112

View full text Add to dashboard Cite

The definition of the etiology of hyperprolactinemia often represents a great challenge and an accurate diagnosis is paramount before treatment. Although prolactin levels > 200-250 ng/mL are highly suggestive of prolactinomas, they can occasionally be found in other conditions. Moreover, as much as 25% of patients with microprolactinomas may present prolactin levels < 100 ng/mL, which are found in most patients with pseudoprolactinomas, drug-induced hyperprolactinemia, or systemic diseases. On the other hand, some conditions may lead to falsely low PRL levels, particularly the so-called hook effect, that is an assay artifact caused by an extremely high level of PRL, and can be confirmed by repeating assay after a 1:100 serum sample dilution. The hook effect must be considered in all patients with large pituitary adenomas and PRL levels within the normal range or only modestly elevated (e.g., < 200 ng/mL). An overlooked hook effect may lead to incorrect diagnosis and unnecessary surgical intervention in patients with prolactinomas. Another important challenge is macroprolactinemia, a common finding that needs to be identified, as it usually requires no treatment. Although most macroprolactinemic patients are asymptomatic, many of them may present galactorrhea or menstrual disorders, as well as neuroradiological abnormalities, due to the concomitance of other diseases. Finally, physicians should be aware that pituitary incidentalomas are found in at least 10% of adult population. Arq Bras Endocrinol Metab. 2014;58(1):9-22 Keywords Hyperprolactinemia; diagnostic pitfalls; hook effect; macroprolactinemia; pituitary incidentalomas RESUMO A definição da etiologia da hiperprolactinemia muitas vezes representa um grande desafio e um diagnóstico preciso é fundamental antes do tratamento. Embora níveis de prolactina > 200-250 ng/mL sejam altamente sugestivos de prolactinomas, ocasionalmente podem ser encontrados em outras condições. Além disso, até 25% dos pacientes com microprolactinomas podem apresentar-se com níveis de prolactina < 100 ng/mL, os quais são evidenciados na maioria dos pacientes com pseudoprolactinomas, hiperprolactinemia induzida por drogas ou doenças sistêmicas. Por outro lado, deve--se atentar às condições que podem levar a valores de prolactina falsamente baixos, particularmente o chamado efeito gancho. Este último é um artefato causado por um nível extremamente elevado de PRL e que pode ser confirmado pela repetição do exame após diluição do soro a 1:100. O efeito gancho deve ser considerado em todo paciente com grandes adenomas hipofisários e níveis de prolactina dentro da faixa normal ou apenas moderadamente elevados (p. ex., < 200 ng/mL). Um efeito gancho não detectado pode levar a diagnóstico incorreto e intervenção cirúrgica desnecessária em pacientes com prolactinomas. Outro desafio importante é a macroprolactinemia, um achado comum que precisa ser identificado visto que geralmente não requer tratamento. Ainda que a maioria dos pacientes seja assintomática devido à concomitância de outr...

show abstract

“…(1,(4)(5)(6)(7)22,(24)(25)(26). Any drug that affects the hypothalamic dopamine system and/or pituitary dopamine receptors can potentially induce hyperprolactinemia (6,26).…”

Section: Physiologic Causesmentioning

confidence: 99%

Section: Systemic Diseases/drugsmentioning

confidence: 99%

See 1 more Smart Citation

Challenges and pitfalls in the diagnosis of hyperprolactinemia

Vilar

Fleseriu

Bronstein

2014

Arq Bras Endocrinol Metab

112

View full text Add to dashboard Cite

show abstract

“…Препубертатаный гипогонадизм Для препубертатного гипогонадизма характер-ны следующие особенности: высокий рост (при со-хранной секреции СТГ) или карликовость (при де-фиците СТГ), евнухоидные пропорции тела (длин-ные конечности, укороченное туловище), слабо раз-витая скелетная мускулатура, распределение жира по женскому типу, истинная гинекомастия, блед-ность кожных покровов, отсутствие оволосения на лобке, подмышечных впадинах, высокий тембр го-лоса, микропенис (половой член длиной до 5 см), мошонка атоничная, непигментированная, без складчатости, яички до 2 мл или их отсутствие в мо-шонке, синдром «непробужденного» либидо [1,45].…”

Section: клинические последствия гипогонадизмаunclassified

The recommendations on diagnostics and treatment of male hypogonadism (deficit of testosterone). The project

Дедов¹,

Мельниченко²,

Роживанов³

et al. 2015

Probl Endokrinol (Mosk)

View full text Add to dashboard Cite

Male hypogonadism is a condition in which the body doesn’t produce enough testosterone which results in its low serum level in combination with characteristic clinical symptoms and/or signs (see the description below) that can be observed in the patients presenting with pathological changes in testicles and/or hypophysis, such as Kleinfelter’s syndrome, and in men with idiopathic metabolic or iatrogenic disorders leading to androgen deficiency. The present recommendations does not cover the entire set of pathological conditions responsible for the development of hypogonadism (deficit of testosterone); rather, they are focused on its clinical variants that account for the majority of the cases of male hypogonadism.

show abstract

“…If it is not possible to switch or withdraw the drug, hormonal replacement for hypogonadism is indicated, because dopamine agonists (DA) may oppose the beneficial antagonism of antipsychotic drugs (2). Aripiprazole, ziprasidone, and olanzapine are atypical antipsychotic drugs that do not cause hyperprolactinemia.…”

Section: Introductionmentioning

confidence: 99%