Endocrine Abstracts

Aim: The aim is to study the clinical and hormonal peculiarities of PROL (prolactinoma), manifesting in people under the age of 18 and monitoring the effectiveness of suppressive CAB (Cabergoline, Dostinex) therapy during 12 months period.

Materials and methods: The total study included 11 patients with PROL, manifesting in childhood. There were also examined 54 healthy volunteers (25 males and 29 females) aged 15–19 to determine the range of normal PRL blood values. It were assessed TSA (total secretory activity, ng/ml), PaSA (partial secretory activity, ng/ml/cm³) and SpTG (the speed of tumor growth, cm³/yrs).

Results and their discussion: At initial examination PRL blood levels was (Me=89.6 ng/ml): macroPROL (Me=52.3 ng/ml); microPROL (Me=200.0 ng/ml). Before treatment PaSA in the whole group was (Me=81.3 ng/ml/cm³); in group with macro- and giant PROL(Me=47.1 ng/ml/cm³); with microPROL (Me=98.9 ng/ml/cm³) (P<0.05). SpTG was (Me=0.8 cm³/yrs). Univariate regression analysis showed that the average therapeutic CAB dose was (Me=1.0 mg/week); the average cumulative dose-(Me=44.2 mg/yrs). A statistically significant reduction of PRL levels after 1 month of therapy was found, but the most positive effect was achieved after 3 months therapy (n=9). The high efficiency of high start doses of CAB were confirmed by MRI: after 12 months of therapy the decreasing of the pituitary volume by 50% or more was marked in 5 patients, in 2 patients - by 30–49%, and 2 girls became pregnant.

Conclusion: Prescription of high start doses of CAB is safe and effective in treatment of PROL in children, as evidenced by the absence of side effects, the normalization of the pituitary-gonadal axis and growth hormone function, rapid sustained reduction in the concentration of PRL level to 5 percentile norm age in most patients (90.1%), statistically significant reduction of PaSA in all patients, decrease of pituitary tumors by 50% or more in 54.5% patients.

Keywords: prolactinoma, prolactin, children, adolescents, cabergoline (Dostinex) therapy.