The role of prolactin in the inhibitory action of bromocriptine on growth hormone secretion in acromegaly

Lamberts, Steven W. J.; Klijn, Jan G.M.; Vroonhoven, C. C. J. Van; Stefanko, S. Z.; Liuzzi, Antonio

doi:10.1530/acta.0.1030446

Cited by 34 publications

(18 citation statements)

References 12 publications

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“…We have previously reported that octreotide treatment for 4 weeks normalised PRL levels in patients with acromegaly and hyperprolactinaemia (7). In accordance with these results treatment with dopamine-D2 agonists suppressed GH secretion more efficiently in acromegalic patients with hyperprolactinaemia compared with those with normoprolactinaemia (8). Determination of serum insulin-like growth factor (IGF)-I levels may prove to be useful as a screening tool for adenomatous GH secretion in patients with prolactinomas (9).…”

Section: Introductionsupporting

confidence: 58%

“…We suspect that more patients could have developed acromegaly as 45 patients were treated with a dopamine-D2 agonist at the last visit and it has been found that GH levels, especially in patients with acromegaly and hyperprolactinaemia, are sensitive to dopamine-D2 agonists (8). Our findings emphasise the need for careful endocrine evaluation of prolactinoma patients including those with microprolactinomas (patient 3).…”

Section: Discussionmentioning

confidence: 72%

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Development of acromegaly in patients with prolactinomas

Andersen

Hagen²,

Frystyk³

et al. 2003

European Journal of Endocrinology

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Objectives: Patients with prolactinomas and patients with acromegaly often have heterogenous adenomas. In this study we have focused on patients with prolactinomas who developed acromegaly and acromegalic patients with hyperprolactinaemia. Our hypothesis is that some patients with hyperprolactinaemia may develop clinical acromegaly. Methods: We have included patients examined at department M, Odense University Hospital between 1996 and 2001. Seventy-eight patients with prolactinomas, 65 females and 13 males, with a median age (range) of 30 years (14-74) and 47 years (20-66), respectively, were included in the study. Results: In females and males the median prolactin (PRL) levels were 90 mg/l (27 -4700; normal values (NV) #23) and 1075 mg/l (24-6500; NV # 14), respectively. The PRL levels were significantly higher in males compared with females (P , 0.002). Fifty-nine patients with acromegaly, 24 females and 35 males, with a median age (range) of 45 years (24-70) and 53 years (19 -70), respectively, were included. Seven of the 24 females had hyperprolactinaemia, with PRL levels of 90 mg/l (27-494). Thirteen of the 35 males had hyperprolactinaemia with PRL levels of 47 mg/l (17-251). Three females with prolactinomas developed acromegaly clinically and biochemically. These patients had a normal low GH level and/or a normal IGF-I level at first diagnosis. Conclusions: Our findings suggest that there is a common group of patients with a pituitary adenoma who secrete PRL and GH unsynchronously. Some of these patients have clinical acromegaly at diagnosis and some patients diagnosed as prolactinomas will develop acromegaly. We suggest an annual IGF-I measurement as a screening test.

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Section: Introductionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 72%

Development of acromegaly in patients with prolactinomas

Andersen

Hagen²,

Frystyk³

et al. 2003

European Journal of Endocrinology

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“…It was reported that an abnormal GH response to TRH and hyperprolactinemia correlates with an acute GH response to the bromocriptine test and that these responses are useful to predict the need for bromocriptine therapy (TRH: Nortier et al, 1984;Scwinn et al, 1977;PRL: Nortier et al, 1984;Lamberts et al, 1982;Lamberts et al, 1983). Furthermore, a correlation between the effect of chronic bromocriptine therapy with hyperplolactinemia and an abnormal GH response to TRH was reported (Nortier et al, 1984).…”

Section: Discussionmentioning

confidence: 99%

Long-term bromocriptine therapy and predictive tests in acromegaly.

et al. 1986

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“…Any macroadenoma with less than 150 ng/ml can be of a different nature, and any suspicion of microadenoma with a moderate hyperprolactinemia can also correspond to a different etiology. In case of a mixed somaiolactotroph adenoma, one should be prudent, as the PRL can return to normal and the ade noma can evolve; one should not be over confident about the prognosis for this type of adenoma with medical treatment even though it is reputed as being sensitive to bro mocriptine [23], The occurrence of preg nancy is not troublesome when the adenoma is enclosed within the sella turcica, the evolu tion then is usually favorable, and the mi croadenoma can even disappear [28],…”

Section: Prognosis O F the Adenoma Under Treatmentmentioning

confidence: 99%

Medical Treatment of Hyperprolactinemia

Fossati¹,

Dewailly²,

Thomas-Desrousseaux³

et al. 1985

Horm Res

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The current treatment of choice for primary hyperprolactinemia is medical. This is true not only for idiopathic forms, but also for micro- and macroprolactinomas, which are the most frequent causes of this pathology. Although questioned by some authors, the slow evolution of the illness, the rarity of transformation of a microadenoma into a macroadenoma, and the possibility of spontaneous cure cause most authors to favor medical treatment, with which they observe both normalization of gonadal function and tumor regression. By retrospective analysis of 95 hyperprolactinemic patients (72 women and 23 men including 26 cases of suspected microadenoma and 44 macroadenomas) treated with 3 dopamine agonists (bromocriptine, metergoline and CU 32085) between 1975 and 1983, and with the help of large series published in the literature, we have tried to review the present knowledge of this subject. After a quick review of different medications, we will consider their prolactin-suppressing effects, their influences upon gonadal and gonadotropic functions, and their antitumoral action. More specific problems will then be discussed: side effects, resistance, possibility of cure, the evolution of the prolactinoma, the place of medical therapy relative to surgery, and contraception in association with dopaminergics.

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The role of prolactin in the inhibitory action of bromocriptine on growth hormone secretion in acromegaly

Cited by 34 publications

References 12 publications

Development of acromegaly in patients with prolactinomas

Development of acromegaly in patients with prolactinomas

Long-term bromocriptine therapy and predictive tests in acromegaly.

Medical Treatment of Hyperprolactinemia

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