BACKGROUND Pituitary metastasis is an uncommon manifestation of systemic malignant tumors.Moreover,hyperprolactinemia and overall hypopituitarism caused by metastatic spread leading to the initial symptoms are rare.CA...BACKGROUND Pituitary metastasis is an uncommon manifestation of systemic malignant tumors.Moreover,hyperprolactinemia and overall hypopituitarism caused by metastatic spread leading to the initial symptoms are rare.CASE SUMMARY A 53-year-old male patient was admitted to our hospital with complaints of bilateral blurred vision,dizziness,polyuria,nocturia,severe fatigue and somnolence,decreased libido,and intermittent nausea and vomiting for more than 6 mo.During the last 7 d,the dizziness had worsened.Laboratory investigations revealed overall hypofunction of the pituitary gland,but the patient had an elevated serum prolactin level(703.35 mg/mL).Preoperative magnetic resonance imaging revealed a tumor in the sellar region,accompanied by intratumoral hemorrhage and calcification.Thus,transnasal subtotal resection of the lesion in the sellar region was performed.The histopathological and immunohistochemical examinations of the resected lesion revealed metastasis of lung adenocarcinoma to the pituitary gland.Oral hydrocortisone(30 mg/d)and levothyroxine(25 mg/d)were given both pre-and postoperatively.Postoperatively,the clinical symptoms were significantly improved.However,4 mo following the surgery,the patient succumbed due to multiple organ failure.CONCLUSION Hyperprolactinemia is one of the markers of poor prognosis in patients with carcinoma that metastasizes to the pituitary gland.Exogenous hormone supplementation plays a positive role in relieving the symptoms of patients and improving quality of life.展开更多
In recent years, rapid progress has been seen in the treatment of hyperprolactinemia with TCM and materia medica. The old pattern of simply using bromocryptine to treat the disease has been changed. Most of the cases ...In recent years, rapid progress has been seen in the treatment of hyperprolactinemia with TCM and materia medica. The old pattern of simply using bromocryptine to treat the disease has been changed. Most of the cases reported in this paper were primary hyperprolactinemia, with other primary diseases excluded. As TCM treatment produces definite therapeutic effects with few side-effects, the methods above reported are worth recommending.展开更多
The rapid increase in consumption of herbal remedies worldwide has been stimulated by several factors, including the notion that all herbal products are safe and effective. Hyperprolactinemia is a major cause of infer...The rapid increase in consumption of herbal remedies worldwide has been stimulated by several factors, including the notion that all herbal products are safe and effective. Hyperprolactinemia is a major cause of infertility, and herbal remedies have been employed locally for treatment. This study was designed to investigate the effects of hydroethanolic extract of Solenostemon monostachyus on the reproductive hormones and metabolic parameters of haloperidol-induced hyperprolactinemic rats. Thirty six female albino rats were divided into 6 groups of 6 in each group. Groups A, B, C, D and E were given increasing doses （2, 3 and 4 mg/kg body weight in five-daily increments） of haloperidol by intramuscular injection for 15 days after which they were treated for another 15 days with either 2.5mg/kg body weight ofbromocriptine （group D only） or 75, 112.5 or 225mg/kg body weight of the extract （groups A, B and C, respectively）. Group F was given distilled water only. After treatment, the animals were sacrificed and blood was taken from each group for plasma analysis of the reproductive hormones and metabolic parameters. The total protein and the lipid profile （total cholesterol and HDL （high-density lipoprotein） and triglycerides were also determined. Phytochemical investigation revealed the presence of saponins, phenols, alkaloids, fiavonoids, and tannins. The result of endocrine investigation showed a dose-dependent, statistically significant reduction in prolactin and testosterone （P 〈 0.05） level by the extract with statistical significant increase （P 〈 0.05） in the levels of the follicle stimulating hormone, LH （luteinizing hormone） and estrogen. There was also a decrease in the levels of the triglycerides and total cholesterol while HDL was increased （P 〉 0.05）. It can be concluded from this study, that hydroethanolic extract has a prolactin reducing activity compared with Bromocriptine and exhibited a corresponding statistical significant difference in other reproductive hormones, with no detectable alteration on metabolic parameters such as＂ albumin, total cholesterol, and high density lipoprotein.展开更多
Introduction. Hyperprolactinemia represents a supraphysiological secretion of prolactin. In clinical practice, it is the most frequently encountered anterior pituitary disorder. However, its real prevalence is little ...Introduction. Hyperprolactinemia represents a supraphysiological secretion of prolactin. In clinical practice, it is the most frequently encountered anterior pituitary disorder. However, its real prevalence is little known in Africa. The purpose of this study is to list all cases of hyperprolactinemia over the past four years and to make an inventory of the various etiologies found and their management. Methodology. This is a cross-sectional descriptive study on the files of patients who came for consultation in the internal medicine and endocrinology department with hyperprolactinemia retrospectively collected from January 2017 to December 2020. Included were patients followed or whose the diagnosis of hyperprolactinemia was established in endocrinological consultation during the study period. Results. This study recorded 26 cases of hyperprolactinemia. The female sex represented 73.08% (sex ratio M/F 0.37) and the average age was 33.92 years. The 40 - 50 age group was the most represented with 30.77%. In women, galactorrhea accounted for 73.07%, amenorrhea 57.69% of clinical pictures and infertility 23.08%. In men, infertility accounted for 7.69% of presentations, gynecomastia 11.54% and erectile dysfunction 15.38%. The duration of evolution of the signs was 4 months in 23.08% of the patients. The mean prolactinemia was 702.58 ng/ml. CT was performed in 80.85% of patients. The main etiologies were pituitary adenomas (77%). All our patients were treated with dopaminergic agonists. Cabergoline was prescribed in 77% of patients. The evolution was favorable in 96.25% of patients. Conclusion. Hyperprolactinemia is a pathology that exists in our regions. The main etiology remains pituitary adenomas and treatment with cabergoline.展开更多
【Objective】To evaluate the clinical efficiency of different treatments cancellation and infertility in women with PCOS and hyperprolactinemia.【Method】We performed retrospective analysis of 502consecutive case hist...【Objective】To evaluate the clinical efficiency of different treatments cancellation and infertility in women with PCOS and hyperprolactinemia.【Method】We performed retrospective analysis of 502consecutive case histories during 5 years of reproductive results of treatment of women is with anovulatory infertility,caused by different factors.Aim of the study was to determine the efficiency of conservative and surgical treatment.【Result】Differentiated application of conservative medical therapy allows to attain the effect of proceeding in a fertile function in 33,8%of patients.It is found that surgical induction of ovulation by ovarian laparoscopic partial degradation is an option in the management of female infertility associated with PCOS,especially as a second-line treatment after the failure of clomiphene citrate treatment,enhancing the efficiency of complex infertility treatment to 40%.【Conclusions】It is feasible to develop an algorithm differentiated use of infertility treatments in women with PCOS and hyperprolactinemia.展开更多
To editor:Craniopharyngioma is a rare,benign brain tumor arising in the sellar and suprasellar regions,accounting for 2-5%of all primary intracranial tumors.1 Craniopharyngioma during pregnancy is uncommon.At the same...To editor:Craniopharyngioma is a rare,benign brain tumor arising in the sellar and suprasellar regions,accounting for 2-5%of all primary intracranial tumors.1 Craniopharyngioma during pregnancy is uncommon.At the same time,disease progression has only been demonstrated in a few reports.2 Furthermore,there is only one reported case of craniopharyngioma with intratumoral hemorrhage during pregnancy.3 This report describes the case of giant craniopharyngioma with intratumoral hemorrhage during pregnancy presenting with non-classic symptoms of status epilepticus and hyperprolactinemia.This report also includes a scoping review of previous reports of craniopharyngioma during pregnancy.Written informed consent has been obtained from the patient.展开更多
目的:系统评价阿立哌唑联合利培酮治疗精神分裂症的疗效和安全性。方法:计算机检索PubMed、Embase、The Cochrane Library、Web of Science、CBM、VIPC、万方和中国知网数据库,搜集有关阿立哌唑联用利培酮治疗精神分裂症的随机对照试验...目的:系统评价阿立哌唑联合利培酮治疗精神分裂症的疗效和安全性。方法:计算机检索PubMed、Embase、The Cochrane Library、Web of Science、CBM、VIPC、万方和中国知网数据库,搜集有关阿立哌唑联用利培酮治疗精神分裂症的随机对照试验,检索时限均从建库至2024年6月30日。由两位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan5.2软件进行Meta分析。结果:本研究纳入14个随机对照试验,共涉及1102例患者,其中治疗组和对照组各551例。Meta分析结果显示,与对照组相比,治疗组血清泌乳素水平明显降低(SMD=-4.25,95%CI:-5.31~-3.19,P<0.01),并可显著改善阳性和阴性症状量表(Positive and Negative Syndrome Scale,PANSS)阴性症状评分(MD=-2.43,95%CI:-3.41~-1.45,P<0.01)。此外,治疗组较对照组血清低密度脂蛋白水平显著降低(MD=-0.32,95%CI:-0.56~-0.08,P=0.03)。结论:阿立哌唑联合利培酮可改善精神分裂症患者的临床症状和降低泌乳素水平,且对血脂水平有改善作用。展开更多
目的:探讨育龄期女性双相障碍躁狂发作患者共病高泌乳素血症的患病率及危险因素,为临床预防、治疗及改善生育能力提供依据。方法:选取2018年12月至2020年8月某院收治的入院时未服药的54例育龄期女性双相障碍躁狂发作患者为研究对象,分...目的:探讨育龄期女性双相障碍躁狂发作患者共病高泌乳素血症的患病率及危险因素,为临床预防、治疗及改善生育能力提供依据。方法:选取2018年12月至2020年8月某院收治的入院时未服药的54例育龄期女性双相障碍躁狂发作患者为研究对象,分为正常泌乳素(Prolactin,PRL)组(29例)和高泌乳素血症(Hyperprolactinemia,HPRL)组(25例),比较两组的临床指标。用Spearman相关分析探讨PRL与各项临床指标的相关性。用Logistic回归分析明确HPRL发生的危险因素。结果:(1)育龄期女性躁狂发作住院患者HPRL的患病率为46.3%;(2)与正常PRL组相较,HPRL组的患者月经更不规律,腰围及BMI更低,游离甲状腺素(Free Thyroxine,FT4)及高密度脂蛋白胆固醇(High Density Lipoprotein Cholesterol,HDL-C)均更高,差异均有统计学意义(P<0.05);(3)Spearman相关分析结果显示,PRL与FT4、HDL-C呈正相关(r=0.385,0.405;P<0.05),PRL与腰围、BMI呈负相关(r=-0.425,-0.408;P<0.05);(4)多元线性回归分析结果显示,PRL与严重躁狂症状呈正相关(B=12.044,P<0.05);(5)Logistic回归分析结果显示,月经越不规律,HPRL的患病风险越高(OR=0.130);FT4越高,HPRL的患病风险越高(OR=1.054),HDL-C越高,HPRL的患病风险越高(OR=1.635)。结论:育龄期女性躁狂发作住院患者HPRL的患病率46.3%,高于一般人群;月经不规律、高FT4及高HDL-C为患轻度HPRL的危险因素;轻度泌乳素水平升高对患者的体质量有保护作用,但会对生育能力及疾病严重程度产生不良影响。展开更多
文摘BACKGROUND Pituitary metastasis is an uncommon manifestation of systemic malignant tumors.Moreover,hyperprolactinemia and overall hypopituitarism caused by metastatic spread leading to the initial symptoms are rare.CASE SUMMARY A 53-year-old male patient was admitted to our hospital with complaints of bilateral blurred vision,dizziness,polyuria,nocturia,severe fatigue and somnolence,decreased libido,and intermittent nausea and vomiting for more than 6 mo.During the last 7 d,the dizziness had worsened.Laboratory investigations revealed overall hypofunction of the pituitary gland,but the patient had an elevated serum prolactin level(703.35 mg/mL).Preoperative magnetic resonance imaging revealed a tumor in the sellar region,accompanied by intratumoral hemorrhage and calcification.Thus,transnasal subtotal resection of the lesion in the sellar region was performed.The histopathological and immunohistochemical examinations of the resected lesion revealed metastasis of lung adenocarcinoma to the pituitary gland.Oral hydrocortisone(30 mg/d)and levothyroxine(25 mg/d)were given both pre-and postoperatively.Postoperatively,the clinical symptoms were significantly improved.However,4 mo following the surgery,the patient succumbed due to multiple organ failure.CONCLUSION Hyperprolactinemia is one of the markers of poor prognosis in patients with carcinoma that metastasizes to the pituitary gland.Exogenous hormone supplementation plays a positive role in relieving the symptoms of patients and improving quality of life.
文摘In recent years, rapid progress has been seen in the treatment of hyperprolactinemia with TCM and materia medica. The old pattern of simply using bromocryptine to treat the disease has been changed. Most of the cases reported in this paper were primary hyperprolactinemia, with other primary diseases excluded. As TCM treatment produces definite therapeutic effects with few side-effects, the methods above reported are worth recommending.
文摘The rapid increase in consumption of herbal remedies worldwide has been stimulated by several factors, including the notion that all herbal products are safe and effective. Hyperprolactinemia is a major cause of infertility, and herbal remedies have been employed locally for treatment. This study was designed to investigate the effects of hydroethanolic extract of Solenostemon monostachyus on the reproductive hormones and metabolic parameters of haloperidol-induced hyperprolactinemic rats. Thirty six female albino rats were divided into 6 groups of 6 in each group. Groups A, B, C, D and E were given increasing doses （2, 3 and 4 mg/kg body weight in five-daily increments） of haloperidol by intramuscular injection for 15 days after which they were treated for another 15 days with either 2.5mg/kg body weight ofbromocriptine （group D only） or 75, 112.5 or 225mg/kg body weight of the extract （groups A, B and C, respectively）. Group F was given distilled water only. After treatment, the animals were sacrificed and blood was taken from each group for plasma analysis of the reproductive hormones and metabolic parameters. The total protein and the lipid profile （total cholesterol and HDL （high-density lipoprotein） and triglycerides were also determined. Phytochemical investigation revealed the presence of saponins, phenols, alkaloids, fiavonoids, and tannins. The result of endocrine investigation showed a dose-dependent, statistically significant reduction in prolactin and testosterone （P 〈 0.05） level by the extract with statistical significant increase （P 〈 0.05） in the levels of the follicle stimulating hormone, LH （luteinizing hormone） and estrogen. There was also a decrease in the levels of the triglycerides and total cholesterol while HDL was increased （P 〉 0.05）. It can be concluded from this study, that hydroethanolic extract has a prolactin reducing activity compared with Bromocriptine and exhibited a corresponding statistical significant difference in other reproductive hormones, with no detectable alteration on metabolic parameters such as＂ albumin, total cholesterol, and high density lipoprotein.
文摘Introduction. Hyperprolactinemia represents a supraphysiological secretion of prolactin. In clinical practice, it is the most frequently encountered anterior pituitary disorder. However, its real prevalence is little known in Africa. The purpose of this study is to list all cases of hyperprolactinemia over the past four years and to make an inventory of the various etiologies found and their management. Methodology. This is a cross-sectional descriptive study on the files of patients who came for consultation in the internal medicine and endocrinology department with hyperprolactinemia retrospectively collected from January 2017 to December 2020. Included were patients followed or whose the diagnosis of hyperprolactinemia was established in endocrinological consultation during the study period. Results. This study recorded 26 cases of hyperprolactinemia. The female sex represented 73.08% (sex ratio M/F 0.37) and the average age was 33.92 years. The 40 - 50 age group was the most represented with 30.77%. In women, galactorrhea accounted for 73.07%, amenorrhea 57.69% of clinical pictures and infertility 23.08%. In men, infertility accounted for 7.69% of presentations, gynecomastia 11.54% and erectile dysfunction 15.38%. The duration of evolution of the signs was 4 months in 23.08% of the patients. The mean prolactinemia was 702.58 ng/ml. CT was performed in 80.85% of patients. The main etiologies were pituitary adenomas (77%). All our patients were treated with dopaminergic agonists. Cabergoline was prescribed in 77% of patients. The evolution was favorable in 96.25% of patients. Conclusion. Hyperprolactinemia is a pathology that exists in our regions. The main etiology remains pituitary adenomas and treatment with cabergoline.
文摘【Objective】To evaluate the clinical efficiency of different treatments cancellation and infertility in women with PCOS and hyperprolactinemia.【Method】We performed retrospective analysis of 502consecutive case histories during 5 years of reproductive results of treatment of women is with anovulatory infertility,caused by different factors.Aim of the study was to determine the efficiency of conservative and surgical treatment.【Result】Differentiated application of conservative medical therapy allows to attain the effect of proceeding in a fertile function in 33,8%of patients.It is found that surgical induction of ovulation by ovarian laparoscopic partial degradation is an option in the management of female infertility associated with PCOS,especially as a second-line treatment after the failure of clomiphene citrate treatment,enhancing the efficiency of complex infertility treatment to 40%.【Conclusions】It is feasible to develop an algorithm differentiated use of infertility treatments in women with PCOS and hyperprolactinemia.
文摘To editor:Craniopharyngioma is a rare,benign brain tumor arising in the sellar and suprasellar regions,accounting for 2-5%of all primary intracranial tumors.1 Craniopharyngioma during pregnancy is uncommon.At the same time,disease progression has only been demonstrated in a few reports.2 Furthermore,there is only one reported case of craniopharyngioma with intratumoral hemorrhage during pregnancy.3 This report describes the case of giant craniopharyngioma with intratumoral hemorrhage during pregnancy presenting with non-classic symptoms of status epilepticus and hyperprolactinemia.This report also includes a scoping review of previous reports of craniopharyngioma during pregnancy.Written informed consent has been obtained from the patient.
文摘目的:系统评价阿立哌唑联合利培酮治疗精神分裂症的疗效和安全性。方法:计算机检索PubMed、Embase、The Cochrane Library、Web of Science、CBM、VIPC、万方和中国知网数据库,搜集有关阿立哌唑联用利培酮治疗精神分裂症的随机对照试验,检索时限均从建库至2024年6月30日。由两位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan5.2软件进行Meta分析。结果:本研究纳入14个随机对照试验,共涉及1102例患者,其中治疗组和对照组各551例。Meta分析结果显示,与对照组相比,治疗组血清泌乳素水平明显降低(SMD=-4.25,95%CI:-5.31~-3.19,P<0.01),并可显著改善阳性和阴性症状量表(Positive and Negative Syndrome Scale,PANSS)阴性症状评分(MD=-2.43,95%CI:-3.41~-1.45,P<0.01)。此外,治疗组较对照组血清低密度脂蛋白水平显著降低(MD=-0.32,95%CI:-0.56~-0.08,P=0.03)。结论:阿立哌唑联合利培酮可改善精神分裂症患者的临床症状和降低泌乳素水平,且对血脂水平有改善作用。
文摘目的:探讨育龄期女性双相障碍躁狂发作患者共病高泌乳素血症的患病率及危险因素,为临床预防、治疗及改善生育能力提供依据。方法:选取2018年12月至2020年8月某院收治的入院时未服药的54例育龄期女性双相障碍躁狂发作患者为研究对象,分为正常泌乳素(Prolactin,PRL)组(29例)和高泌乳素血症(Hyperprolactinemia,HPRL)组(25例),比较两组的临床指标。用Spearman相关分析探讨PRL与各项临床指标的相关性。用Logistic回归分析明确HPRL发生的危险因素。结果:(1)育龄期女性躁狂发作住院患者HPRL的患病率为46.3%;(2)与正常PRL组相较,HPRL组的患者月经更不规律,腰围及BMI更低,游离甲状腺素(Free Thyroxine,FT4)及高密度脂蛋白胆固醇(High Density Lipoprotein Cholesterol,HDL-C)均更高,差异均有统计学意义(P<0.05);(3)Spearman相关分析结果显示,PRL与FT4、HDL-C呈正相关(r=0.385,0.405;P<0.05),PRL与腰围、BMI呈负相关(r=-0.425,-0.408;P<0.05);(4)多元线性回归分析结果显示,PRL与严重躁狂症状呈正相关(B=12.044,P<0.05);(5)Logistic回归分析结果显示,月经越不规律,HPRL的患病风险越高(OR=0.130);FT4越高,HPRL的患病风险越高(OR=1.054),HDL-C越高,HPRL的患病风险越高(OR=1.635)。结论:育龄期女性躁狂发作住院患者HPRL的患病率46.3%,高于一般人群;月经不规律、高FT4及高HDL-C为患轻度HPRL的危险因素;轻度泌乳素水平升高对患者的体质量有保护作用,但会对生育能力及疾病严重程度产生不良影响。
