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dc.contributor.authorAhmed, S Rafeeq
dc.contributor.authorShalet, Stephen M
dc.date.accessioned2010-11-08T15:40:10Z
dc.date.available2010-11-08T15:40:10Z
dc.date.issued1986-04
dc.identifier.citationDiscordant responses of prolactinoma to two different dopamine agonists. 1986, 24 (4):421-6 Clin Endocrinolen
dc.identifier.issn0300-0664
dc.identifier.pmid3742834
dc.identifier.doi10.1111/j.1365-2265.1986.tb01647.x
dc.identifier.urihttp://hdl.handle.net/10541/115013
dc.description.abstractA 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.
dc.language.isoenen
dc.subjectPituitary Canceren
dc.subject.meshAdult
dc.subject.meshBromocriptine
dc.subject.meshDrug Resistance
dc.subject.meshErgolines
dc.subject.meshFemale
dc.subject.meshHumans
dc.subject.meshPergolide
dc.subject.meshPituitary Neoplasms
dc.subject.meshProlactin
dc.subject.meshTomography, X-Ray Computed
dc.titleDiscordant responses of prolactinoma to two different dopamine agonists.en
dc.typeArticleen
dc.identifier.eissn1365-2265
dc.identifier.journalClinical Endocrinologyen
html.description.abstractA 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.


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