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Pituitary autonomy in hyperprolactinemic secondary amenorrhea: results of hypothalamic-pituitary testing

Show simple item record Healy, D. L. en_US Burger, Henry G. en_US Pepperell, R. J. en_US Bremner, William J. en_US Stockdale, J. en_US 2008-10-17T20:41:31Z 2008-10-17T20:41:31Z 1977-05 en_US
dc.identifier.citation J Clin Endocrinol Metab. 1977 May;44(5):809-19 en_US
dc.description.abstract Twenty-seven women with secondary amenorrhea of greater than six months duration were subjected to multiple testing of hypothalamo-pituitary function. They were divided into normo-prolactinemic (Group 1 mean serum prolactin (PRL) 9.8 ng/ml; range 6.8 to 13.0 ng/ml; n=9) and hyperprolactinemic (Group 2 mean 37.5 ng/ml; range 19.2 to 93.7 ng/ml; n=18) groups on the basis of 4 weekly baseline determinations. Group 2 had significantly (P less than .05) lower serum LH and urinary pregnanediol levels than did Group 1; there was no statistical difference between the groups in serum FSH, T4, T3 or urinary estrogen measurements. Two women in Group 2 were found to have a pituitary chromophobe adenoma. Group 2 women showed no significant rises in serum PRL following stimulation tests with thyrotropin releasing hormone (TRH, 200 microng iv) and metoclopramide (10 mg orally), which caused significant responses in Group 1. The TSH response to TRH was, however, preserved in Group 2, while it was subnormal in Group 1 subjects. Both groups showed similar FSH and LH responses to luteinizing hormone-releasing hormone (LHRH, 25 microng iv). No significant suppression of serum PRL was seen in Group 2 patients given L-Dopa (500 mg orally),, which produced a significant response (P less than 0.05) in Group 1 subjects, while all patient showed marked reduction in serum PRL values following 2-bromo-alpha-ergocryptine (CB-154, 2.5 mg orally). When compared with other Group 2 members, the 2 cases with proven pituitary adenomata gave similar responses to the stimulation-inhibition tests and were not clearly distinguished on this basis. We conclude: 1. The pattern of PRL responses to dynamic tests, although of pathophysiological interest an autonomous pituitary lesions in patients with hyperprolactinemic secondary amenorrhea. 2. Such dynamic tests, although a pathophysiological interest, provide no clinical information additional to that provided by the mean basal serum PRL value. 3. In clinical practice, such dynamic tests should be confined to patients with mean serum PRL levels at around the upper limit of the normal range. en_US
dc.language.iso en_US en_US
dc.publisher Endocrine Society en_US
dc.subject male contraception en_US
dc.subject andrology en_US
dc.subject 5-alpha reductase inhibitors en_US
dc.subject gonadotropins en_US
dc.subject klinefelter's syndrome en_US
dc.subject spermatogenesis en_US
dc.subject reifenstein's syndrome en_US
dc.subject testosterone en_US
dc.subject colchicine en_US
dc.subject.mesh Hypothalamo-Hypophyseal System, physiopathology en_US
dc.subject.mesh Galactorrhea, physiopathology en_US
dc.subject.mesh Prolactin, blood en_US
dc.subject.mesh Metoclopramide, diagnostic use en_US
dc.subject.mesh Female en_US
dc.subject.mesh Amenorrhea, etiology, physiopathology en_US
dc.subject.mesh Thyrotropin-Releasing Hormone, diagnostic use en_US
dc.subject.mesh Humans en_US
dc.subject.mesh Thyrotropin, blood en_US
dc.subject.mesh Kinetics en_US
dc.subject.mesh Clomiphene, diagnostic use en_US
dc.subject.mesh Bromocriptine, diagnostic use en_US
dc.subject.mesh Adult en_US
dc.subject.mesh Pregnancy en_US
dc.title Pituitary autonomy in hyperprolactinemic secondary amenorrhea: results of hypothalamic-pituitary testing en_US
dc.type Article en_US

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