Endocrine Abstracts

The complex etiology of hyperprolactinemia was represented, in our study group (426 cases hospitalized during the period 2000 – 2010; F/M ratio=372/54; age (years)=40.29±15.57), by the following entities: prolactin-secreting pituitary tumors (11.50%), growth hormone and prolactin-secreting pituitary tumors (1.64%), pituitary stalk compression (7.98%), primary myxedema (41.08%), polycystic ovary syndrome – PCOS (24.65%), iatrogenesis (8.69%) and chronic renal insufficiency (4.46%). The cases with prolactin-secreting pituitary adenomas (49 patients, F/M=42/7, age=32.53±11.03) were divided in two groups (by clinical, functional and imaging criteria): macroprolactinomas (18 cases; F/M=11/7; age=32.39±14.25); microprolactinomas (31 cases; F/M=31/0; age=32.61±8.92).

The plasma prolactin levels were significantly higher (P<0.001) in patients with macroprolactinomas comparing with microprolactinomas cases. It was also identified significant higher values of the plasma prolactin levels in prolactinomas in comparison with: iatrogenesis (P<0.001), pituitary stalk compression (P<0.001), primary myxedema (P<0.001), PCOS (P<0.001) and chronic renal insufficiency (P<0.05). The patients with microprolactinomas showed a significant higher prolactin level versus the cases with PCOS.

All the cases with prolactinomas presented signs of hypogonadism and 8 patients with macroprolactinomas (F/M=3/5) presented tumor mass effect. Excepting one case who imposed neurosurgical therapy, all the patients with prolactinomas were treated with dopamine agonist drugs with very good response regarding the lowering of prolactin level and tumor shrinkage (only one case didn’t show a normal prolactin level despite the long term of medical therapy associated with tumor disappearance). Four women with macroprolactinomas became pregnant after one year of treatment with bromocriptine and all of them reached the parturition without any event (continuing during the pregnancy the therapy with bromocriptine).

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.