scholarly journals Hyperprolactinaemia in a patient with kidney failure

2020 ◽  
Vol 23 (1) ◽  
Author(s):  
Amirah Parak ◽  
Reyna Daya ◽  
Saajidah Bulbulia ◽  
Faheem Seedat ◽  
Zaheer Bayat

Hyperprolactinaemia is a common endocrine abnormality in patients with kidney failure. A 43-year-old female, known with kidney failure on maintenance haemodialysis, was referred with symptomatic hyperprolactinaemia. Biochemical investigations revealed a markedly elevated serum prolactin level. Magnetic resonance imaging of the brain (without gadolinium) demonstrated a pituitary macroadenoma. The patient was started on cabergoline therapy. This case discusses hyperprolactinaemia in kidney failure and highlights the importance of investigating markedly elevated prolactin levels. In cases where patients have galactorrhoea, headaches and/or visual disturbances, clinicians should be alert to the possibility of a prolactin-secreting pituitary tumour.

2021 ◽  
Vol 8 (1) ◽  
pp. 27-29
Author(s):  
Rupak Chatterjee ◽  
Prantiki Halder ◽  
Sudeshna Mallik ◽  
Bibhuti Saha

Forbes Albright syndrome is a hyperprolactinemia syndrome characterised by galactorrhea and amenorrhea associated with a pituitary tumour. Here we report a case of 30 years female who was admitted with menstrual irregularities for 4 months, galatorrhea and headache with recurrent episodes of loss of consciousness for 3months. Her serum prolactin level was highly raised. MRI brain (plain plus contrast) showed enlarged pituitary gland- pituitary macroadenoma. She was diagnosed as a case of Forbes Albright Syndrome and was treated with Tablet Cabergoline. With the medication, size of her tumour markedly reduced and symptoms resolved as she was followed up after 3 months.


Author(s):  
Jyothi M Idiculla ◽  
Geoff Beckett ◽  
Patrick F X Statham ◽  
James W Ironside ◽  
Stephen L Atkin ◽  
...  

A 44-year-old woman presented to her GP with excessive tiredness. She had positive thyroid microsomal and thyroglobulin autoantibodies and was found to have an elevated serum thyroid-stimulating hormone (TSH) concentration of 8.37 (normal = 0·15–3·5) mU/L and a low normal total thyroxine (T4) of 86 (reference range 60–145) nmol/L. She was rendered symptom free on a dose of 150μg of thyroxine per day. However, her TSH failed to return to normal, and following a further increase in her thyroxine dose she was referred to the endocrine clinic for further assessment. Her TSH at this stage was 14mU/L, free T4 (fT4) 28 (normal = 10–27) pmol/L and free T3 (fT3) 10 (normal = 4·3–7·6) pmol/L. She denied any problems with adherence to her medication. Her serum prolactin was elevated at 861 (normal = 60–390) mU/L. A pituitary tumour was suspected and an MRI scan showed a macroadenoma of the right lobe of the pituitary, extending into the suprasellar cistern. The tumour was resected trans-sphenoidally. Electron microscopy showed a dual population of neoplastic cells compatible with a thyrotroph cell and prolactin-secreting adenoma. Immunocytochemistry and cell culture studies confirmed the secretion of TSH, prolactin and α-subunit. Postoperative combined anterior pituitary function tests did not demonstrate any deficiency of anterior pituitary hormones. A repeat MRI scan showed no significant residual tumour; however, her serum TSH and prolactin levels remained high and she was given a course of pituitary irradiation. This case illustrates the difficulty of diagnosing a TSHoma when it coexists with autoimmune hypothyroidism. We believe the combination of pathologies reported here is unique.


Neurosurgery ◽  
1988 ◽  
Vol 22 (5) ◽  
pp. 937-941 ◽  
Author(s):  
Steven N. Levine ◽  
Edward C. Benzel ◽  
Marjorie R. Fowler ◽  
John V. Shroyer ◽  
Mansour Mirfakhraee

Abstract Lymphocytic adenohypophysitis is a rare nonneoplastic cause of a pituitary mass. We report the case of an 18-year-old woman who presented with complaints of headaches and visual disturbances after an otherwise uncomplicated pregnancy and delivery. She had an elevated serum prolactin level and a pituitary mass visualized by magnetic resonance imaging (MRI). The tissue removed by transsphenoidal resection was an inflammatory mass composed of lymphocytes, plasma cells, and moderate fibrosis surrounding islands of hyperplastic lactotrophs. This is the first case of lymphocytic adenohypophysitis visualized by MRI. As in this case, lymphocytic adenohypophysitis is frequently confused with a prolactin-secreting pituitary tumor before operation and pathological examination of the tissue. The clinical characteristics and radiological features of and an approach to managing patients with lymphocytic adenohypophysitis are reviewed and discussed.


2020 ◽  
Vol 13 (2) ◽  
pp. 956-961
Author(s):  
Ragnar Hultborn ◽  
Toshima Z. Parris ◽  
Khalil Helou ◽  
Åke Borg ◽  
Shahin De Lara ◽  
...  

We present a young male patient with breast cancer having several risk factors likely acting in consort: irradiation of the breast for gynecomastia in adolescence and a life-long administration of phenothiazine for schizophrenia from the age of 16 years, with elevated serum prolactin level resulting in breast cancer development 24 years after irradiation.


Author(s):  
M. S. Ismail ◽  
G. I. Serour ◽  
U. Torsten ◽  
H. Weitzel ◽  
H.-P. Berlien

2020 ◽  
Vol 2 (1) ◽  
pp. 109-117

Introduction: Prolactin is a hormone secreted from anterior pituitary gland which has different functions throughout the body of the fertile females. Women with polycystic ovary syndrome (PCOS) may exhibit a mild elevation of serum prolactin level. High prolactin level can affect the fertility potential causing ovulatory dysfunction. Even those with normal ovulation, failure of producing a sufficient amount of progesterone after ovulation may occur which resulted in a deficient endometrium; less liable for embryo implantation( luteal phase defect). Thus, this research is aimed to study the frequency of elevated prolactin in women with PCOS and to evaluate its' effect on pregnancy rate. Methods: Fifty-three infertile females were included. They divided in to two major groups: Group I: females with PCOS and Group II: females with no PCOS. Both groups sub-divided in to two subgroups: Group A with serum prolactin more than 20 ng/dl and Group B with normal serum prolactin 2-20 ng/dl. All females were included in ICSI program followed by assessment of pregnancy rate in both groups. Results: The study was showed that 69.44% of women who suffered from PCOS had an elevated serum prolactin level with a mean of 31.17±10.24. Pregnancy rate was lower in the females with high serum prolactin level in both PCOS and non-PCOS women. Conclusion: Hyperprolactinemia is more frequent in the females with PCOS than normal ovulatory females. Elevated serum prolactin level negatively affects implantation and decreases the chance of getting a pregnancy following ICSI.


Author(s):  
Pawan Kumar Saini ◽  
Devendra Yadav ◽  
Rozy Badyal ◽  
Suresh Jain ◽  
Arti Singh ◽  
...  

Background: Psoriasis is an autoimmune chronic inflammatory disorder affecting the skin mediated by T-lymphocytes resulting in production of cytokines which cause hyperproliferation of keratinocytes.  Several factors and hormones like Prolactin have an action similar to these cytokines in promoting the multiplication of keratinocytes and other cells like lymphocytes and epithelial cells may have a role on the etiopathogenesis of psoriasis. Aim:-The aim of study is to compare the serum Prolactin levels in patients of psoriasis with a control group. Setting and study design: This is a case-control study conducted in the department of Dermatology, Venereology and Leprosy GMC, Kota over a period of 1year from July 2017 to June 2018 Material and method: The study included 100 cases of psoriasis (60 males and 40 females) and 100 controls similar for age and sex. Serum Prolactin levels were measured by ECLIA and results were obtained. Statistical analysis: Mean and standard deviation were calculated for each variable. Statistical significance of the results was analyzed using correlation analysis (Pearson correlation coefficient) and independent samples t-test. Statistical significance was assumed at p value<0.05. Result: Serum Prolactin level was significantly higher in cases of psoriasis compared to controls (p-value <0.001). PASI score and serum Prolactin levels were found to have a positive correlation (r value = 0.337; p-value: 0.001). No significant  correlation was found between serum levels of Prolactin and duration of disease r value= -0.034, P value =0.733). Serum Prolactin level was higher in male patients compared to females patients. Conclusion:- High serum Prolactin may be a biological marker of disease severity in psoriasis and may have a role in the pathogenesis of psoriasis. Further studies with large sample size are required to confirm this hypothesis.


2018 ◽  
Vol 7 (3) ◽  
pp. 217-221
Author(s):  
E. V. Shevchenko ◽  
G. R. Ramazanov ◽  
S. S. Petrikov

Background Acute dizziness may be the only symptom of stroke. Prevalence of this disease among patients with isolated dizziness differs significantly and depends on study design, inclusion criteria and diagnostic methods. In available investigations, we did not find any prospective studies where magnetic resonance imaging, positional maneuvers, and Halmagyi-Curthoys test had been used to clarify a pattern of diseases with isolated acute dizziness and suspected stroke.Aim of study To clarify the pattern of the causes of dizziness in patients with suspected acute stroke.Material and methods We examined 160 patients admitted to N.V. Sklifosovsky Research Institute for Emergency Medicine with suspected stroke and single or underlying complaint of dizziness. All patients were examined with assessment of neurological status, Dix-Hollpike and Pagnini-McClure maneuvers, HalmagyiCurthoys test, triplex scans of brachiocephalic arteries, transthoracic echocardiography, computed tomography (CT) and magnetic resonance imaging (MRI) of the brain with magnetic field strength 1.5 T. MRI of the brain was performed in patients without evidence of stroke by CT and in patients with stroke of undetermined etiology according to the TOAST classification.Results In 16 patients (10%), the cause of dizziness was a disease of the brain: ischemic stroke (n=14 (88%)), hemorrhage (n=1 (6%)), transient ischemic attack (TIA) of posterior circulation (n=1 (6%)). In 70.6% patients (n=113), the dizziness was associated with peripheral vestibulopathy: benign paroxysmal positional vertigo (n=85 (75%)), vestibular neuritis (n=19 (17%)), Meniere’s disease (n=7 (6%)), labyrinthitis (n=2 (1,3%)). In 6.9% patients (n=11), the cause of dizziness was hypertensive encephalopathy, 1.9% of patients (n=3) had heart rhythm disturbance, 9.4% of patients (n=15) had psychogenic dizziness, 0.6% of patients (n=1) had demyelinating disease, and 0.6% of patients (n=1) had hemic hypoxia associated with iron deficiency anemia.Conclusion In 70.6% patients with acute dizziness, admitted to hospital with a suspected stroke, peripheral vestibulopathy was revealed. Only 10% of patients had a stroke as a cause of dizziness.


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