| Autor: |
Drange, Marlys R., Nagelberg, Steven B., Braunstein, Glenn D. |
| Zdroj: |
The Endocrinologist; January 2000, Vol. 10 Issue: 1 p6974-6974, 1p |
| Abstrakt: |
Prolactin PRLsecreting pituitary adenomas prolactinomas are the most common type of pituitary tumor. Dopamine agonist pharmacotherapy remains the cornerstone of treatment and usually results in rapid decreases in PRL secretion. Dopaminergic agents, such as bromocriptine, also decrease tumor mass due to degradation of the intracellular protein synthetic machinery and ultimately lactotroph cell size reduction. Generally, bromocriptineinduced tumor regression follows sustained suppression of serum PRL levels. However, approximately onetenth of patients demonstrate uncoupling of responsiveness to the PRLlowering effects of dopamine agonists and prolactinoma shrinkage. Two prolactinoma patients illustrating dissociation of bromocriptineinduced PRL suppression and tumor regression are described. Possible explanations for this observation include physical constraints limiting tumor shrinkage, inconsistent compliance with medications, misclassification of tumor type, or misclassification of bromocriptine responsiveness due to delayed tumor regression. The vast majority of cases in which prolactinomas fail to shrink on dopamine agonist therapy remain unexplained. The molecular mechanisms underlying discordance between successful lowering of serum PRL and tumor shrinkage in bromocriptinetreated prolactinoma patients are unclear and remain to be elucidated. |
| Databáze: |
Supplemental Index |
| Externí odkaz: |
|
