Changes in plasma GH levels and clinical activity during bromocriptine therapy in acromegaly. The value of predictive tests
| Autor: | G. H. Donker, J. W. R. Nortier, Jos H.H. Thijssen, F. Schwarz, Croughs Rj |
|---|---|
| Rok vydání: | 1984 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Endocrinology Diabetes and Metabolism Urinary system chemistry.chemical_compound Basal (phylogenetics) Endocrinology Oral administration Internal medicine Acromegaly medicine Humans Thyrotropin-Releasing Hormone Bromocriptine Aged Creatinine business.industry Hyperprolactinaemia General Medicine Glucose Tolerance Test Middle Aged medicine.disease Prolactin Somatostatin chemistry Growth Hormone Female business medicine.drug |
| Zdroj: | Acta Endocrinologica. 106:175-183 |
| ISSN: | 1479-683X 0804-4643 |
| Popis: | Twenty-seven patients with active acromegaly despite previous treatment by surgery and/or radiotherapy received bromocriptine in a dose of 10–20 mg daily for a period of 6–9 months. The results of chronic bromocriptine treatment were evaluated by measurement of plasma growth hormone (GH) levels during the day and by subjective and objective criteria of clinical activity. The results of chronic bromocriptine treatment were also compared with four biochemical criteria obtained before treatment e.g. basal plasma prolactin (Prl) levels and the plasma GH response to oral administration of 2.5 mg bromocriptine respectively iv administration of 200 μg TRH and 500 μg somatostatin. The main observations may be summarized as follows: 1) The mean pre-treatment GH levels during the day ranged from 6–207 mU/l. Hyperprolactinaemia was present in 6 patients. 2) During bromocriptine treatment mean plasma GH levels decreased to less than 50% in 11 patients (GH responders) whereas in 19 patients changes of mean plasma GH and of subjective criteria of clinical activity were concordant. 3) Glucose tolerance improved significantly (P < 0.01) in 10 GH-responders and the urinary hydroxyproline/creatinine ratio decreased significantly (P < 0.05) in 8 GH-responders. 4) Five out of 6 patients with hyperprolactinaemia belonged to the group of GHresponders. 5) A single dose of 2.5 mg bromocriptine induced a more than 50% decrease of plasma GH in 8 of 11 GH-responders and in 5 of 16 GH non-responders. 6) The iv injection of 200 μg TRH was followed by a rise of plasma GH of more than 100% in 9 of 11 GHresponders and in 6 of 16 non-responders. 7) Responsiveness to both a single dose of bromocriptine and TRH was found in 8 of 11 GH-responders and in 3 of 16 GH non-responders. Conclusions Bromocriptine is effective as adjunctive therapy when active acromegaly persists after treatment with surgery and/or radiotherapy. In general, a good correlation is found between GH responsiveness and subjective and objective criteria of clinical activity during bromocriptine treatment. Hyperprolactinaemia predicts GH responsiveness to chronic bromocriptine treatment with high specificity. The combination of a bromocriptine test and a TRH test are of best predictive value with respect to the results of chronic bromocriptine therapy in normoprolactinaemic acromegalics. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|