[Macroprolactinemia associated with pituitary macroadenoma: treatment with quinagolide].

Abstract

According to current concept, macroprolactin is biologically inactive and, therefore, its accumulation in serum has little, if any, pathological significance. Authors present the history of a 80-year-old man who proved to have, among other associated disorders, an intra- and parasellar pituitary tumor measuring 21x12x12 mm in size which was revealed by pituitary MRI. His hormonal evaluation indicated a marked hyperprolactinemia mainly due to macroprolactinemia (total prolactin, 514 ng/ml; reference range, 1.6-10.7 ng/ml; macroprolactin 436 ng/ml, monomer prolactin 78.2 ng/ml). Tests for function of the pituitary-thyroid axis showed a mild subclinical primary hypothyroidism. The function of the pituitary-adrenal axis was normal, and other hormonal tests revealed low-normal serum gonadotropins and decreased testosterone level, whereas serum insulin-like growth factor I was normal. Although the majority of current guidelines state that dopamine-agonist treatment which is successfully used in prolactin-producing pituitary tumors and in other hyperprolactinemic disorders is unnecessary in patients with macroprolactinemia, the authors introduced a dopamine-agonist, quinagolide. During prolonged treatment, plasma prolactin returned close to the upper limit of normal (12.3 ng/ml) and 9 months after the beginning of treatment pituitary MRI showed a remarkable shrinkage of the pituitary tumor. Authors propose that in this patient the pituitary tumor secreted macroprolactin, and they recommend a treatment trial with dopamine-agonist in pituitary macroadenomas associated with macroprolactinemia.

• Authors: Gergely Lakatos, Nikolette Szücs, Zoltán Kender, Sándor Czirják, Károly Rácz
• Journal: Orvosi hetilap (Orv Hetil) Vol. 151 Issue 26 Pg. 1072-5 (Jun 27 2010) ISSN: 0030-6002 [Print] Hungary
• Vernacular Title: Macroprolactinaemiával társuló hypophysismacroadenoma kezelése quinagoliddal.
• PMID: 20558354 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Aminoquinolines
• Dopamine Agonists
• quinagolide
• Prolactin

Topics

• Aged, 80 and over
• Aminoquinolines (therapeutic use)
• Dopamine Agonists (therapeutic use)
• Humans
• Hyperprolactinemia (blood, etiology)
• Magnetic Resonance Imaging
• Male
• Pituitary Neoplasms (blood, complications, drug therapy)
• Prolactin (blood, drug effects)
• Time Factors
• Treatment Outcome