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    Discordant responses of prolactinoma to two different dopamine agonists.

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    Authors
    Ahmed, S Rafeeq
    Shalet, Stephen M
    Issue Date
    1986-04
    
    Metadata
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    Abstract
    A 19-year-old woman presented with headaches, temporal lobe epilepsy and primary amenorrhoea. There was a family history of multiple endocrine adenomatosis. Investigation revealed normal visual fields and acuity, hyperprolactinaemia (48 000 mU/l) and a very large pituitary tumour with extrasellar spread. Treatment with bromocriptine reduced the tumour size and the prolactin level to 2440 mU/l. Six months after the start of therapy, resistance to bromocriptine developed and the prolactin concentration progressively rose to pretreatment levels, despite increasing the dose of bromocriptine to 40 mg/d. At this stage treatment with a second dopamine agonist, pergolide, was effective in reducing the prolactin concentration to normal within four months. Serial CT scans at 1, 6 and 12 months on dopamine agonist therapy showed a progressive decrease in tumour size, which seemed to be maintained even during the period of rising prolactin concentrations due to bromocriptine resistance. This case illustrates that during dopamine agonist therapy a discrepancy may exist in the clinical response as judged by reduction in tumour size and decrease in the circulating prolactin level. Furthermore, in patients with prolactinomas, pergolide may induce a response when resistance to bromocriptine develops.
    Citation
    Discordant responses of prolactinoma to two different dopamine agonists. 1986, 24 (4):421-6 Clin Endocrinol
    Journal
    Clinical Endocrinology
    URI
    http://hdl.handle.net/10541/115013
    DOI
    10.1111/j.1365-2265.1986.tb01647.x
    PubMed ID
    3742834
    Type
    Article
    Language
    en
    ISSN
    0300-0664
    EISSN
    1365-2265
    ae974a485f413a2113503eed53cd6c53
    10.1111/j.1365-2265.1986.tb01647.x
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