Abstract

Case Report

Giant prolactinoma case with side effects due to cabergoline

Semiha Çalkaya*, Fahri Bayram, Ali Kurtsoy and Hüseyin Dursun

Published: 16 March, 2020 | Volume 4 - Issue 1 | Pages: 012-014

Dopamine agonists should usually be the first treatment for patients with prolactinomas of all sizes, because these drugs decrease serum prolactin concentrations and decrease the size of most lactotroph adenomas. Cabergoline is preferred first. When cabergoline develops side effects bromokriptin is switched. Cabergoline is more efficient than bromocriptine. Its side effect profile more favorable than bromocriptine. Cabergoline is an ergot dopamine agonist that is administered once or twice a week. Cabergoline can have rarely serious psychiatric adverse effects, including psychosis, impulse control disorders, dyskinesia, pulmonery fibrosis and valvular heart disease.

Prolactinomas are the most common pituitary tumors, 93%-95% of the cases are microadenomas. Macroprolactinomas larger than 40 mm, known as giant prolactinomas, are exceptionally rare, accounting for 0.5% - 4% of all prolactin-hypersecreting adenomas.

In our case, after the 7 x 6 cm giant macroprolactinoma operated we report the manic episode occuring during the second week of cabergoline treatment. In the treatment of patients with prolactinoma, cabergoline is a first choice drug because it has a better tolerance profile and is more effective, however, bromocriptine can be switched to when drug resistance or side effects develop to cabergoline.

Read Full Article HTML DOI: 10.29328/journal.acr.1001031 Cite this Article Read Full Article PDF

Keywords:

Macroprolactinoma; Cabergoline side effects; Bromocriptine

References

  1. Melmed S, Casanueva FF, Hoffman AR, Kleinberg DL, Montori VM, et al. Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011; 96: 273. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21296991
  2. Faje A, Chunharojrith P, Nency J, Biller BM, Swearingen B, et al. Dopamine Agonists Can Reduce Cystic Prolactinomas. J Clin Endocrinol Metab. 2016; 101: 3709. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/27459530
  3. Webster J, Piscitelli G, Polli A, Ferrari CI, Ismail I, Scanlon MF. A comparison of cabergoline and bromocriptine in the treatment of hyperprolactinemic amenorrhea. Cabergoline Comparative Study Group. N Engl J Med. 1994; 331: 904–909. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/7915824
  4. Harris YT, Harris AZ, Deasis JM, Ferrando SJ, Reddy N, Young RC. Cabergoline associated with first episode mania. Psychosomatics. 2012; 53: 595–600. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/22658326
  5. Ciccarelli A, Daly AF, Beckers A. The epidemiology of prolactinomas. Pituitary. 2005; 8: 3–6. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/16411062
  6. Gillam MP, Molitch ME, Lombardi G, Colao A. Advances in the treatment of prolactinomas. Endocr Rev. 2006; 27: 485–534. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/16705142
  7. Tjörnstrand A, Gunnarsson K, Evert M, Holmberg E, Ragnarsson O, et al. The incidence rate of pituitary adenomas in western Sweden for the period 2001–2011. Eur J Endocrinol. 2014; 171: 519–526. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/25084775
  8. Pinzone J J, Katznelson L, Danila D C, Pauler D K, Miller C S, Klibanski A. Primary medical therapy of micro- and macroprolactinomas in men. J Clin Endocrinol Metab. 2000; 85: 3053–3057. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/10999785
  9. Maiter D, Delgrange E. Therapy of endocrine disease: the challenges in managing giant prolactinomas. Eur J Endocrinol. 2014; 170: R213–R227. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/24536090
  10. Moraes AB, Silva CM, Vieira Neto L, Gadelha MR. Giant prolactinomas: the therapeutic approach. Clin Endocrinol. 2013; 79: 447–456. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23662975
  11. Ali S, Klahr K, Freudenreich O. 2015. Management of psychosis associated with a prolactinoma: case and review of the literature. Psychosomatics 51 2010. 370–376. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/20833935
  12. Kvernmo T, Houben J, Sylte I. Receptor-binding and pharmacokinetic properties of dopaminergic agonists. Current Topics in Medicinal Chemistry 8 1049–1067. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/18691132
  13. Noronha S, Stokes V, Karavitaki N, Grossman A. Treating prolactinomas with dopamine agonists: always worth the gamble?. Endocrine In press. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26336835
  14. Chang SC, Chen CH, Lu ML. Cabergoline-induced psychotic exacerbation in schizophrenic patients. Gen Hosp Psychiatry. 2008; 30: 378–380. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26336835
  15. Andujar-Plata P, Villar-Taibo R, Ballesteros-Pomar MD, Vidal-Casariego A, Pérez-Corral B, et al. Long-term outcome of multimodal therapy for giant prolactinomas. Endocrine. 2017: 55: 231–238. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/27704480
  16. Bevan JS, Adams CB, Burke CW, Morton KE, Molyneux AJ, et al. Factors in the outcome of transsphenoidal surgery for prolactinoma and non-functioning pituitary tumour, including pre-operative bromocriptine therapy. Clin Endocrinol (Oxf). 1987; 26: 541–556. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/3665118
  17. Mohan N, Chia YY, Goh GH, Ting E, Teo K, et al. Cabergoline-induced fibrosis of prolactinomas: a neurosurgical perspective. BMJ Case Rep. 2017; 2017: bcr-2017-220971. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/29102970
  18. Garibi J, Pomposo I, Villar G, Gaztambide S. Giant pituitary adenomas: clinical characteristics and surgical results. Br J Neurosurg. 2002; 16: 133–139. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/12046731

Figures:

Figure 1

Figure 1

Similar Articles

Recently Viewed

  • Environmental Factors Affecting the Concentration of DNA in Blood and Saliva Stains: A Review
    Divya Khorwal*, GK Mathur, Umema Ahmed and SS Daga Divya Khorwal*, GK Mathur, Umema Ahmed, SS Daga. Environmental Factors Affecting the Concentration of DNA in Blood and Saliva Stains: A Review. J Forensic Sci Res. 2024: doi: 10.29328/journal.jfsr.1001057; 8: 009-015
  • Why Down-managing Backlog Forensic DNA Case Entries Matters
    JH Smith* and JS Horne JH Smith*, JS Horne. Why Down-managing Backlog Forensic DNA Case Entries Matters. J Forensic Sci Res. 2024: doi: 10.29328/journal.jfsr.1001056; 8: 001-008
  • Scintigraphic non-invasive diagnosis of amyloid cardiomyopathy
    Laroussi Mohamed-Salem*, Tomás E Rodríguez-Locarno, Tatiana Moreno-Monsalve, Isabel Castellón-Sánchez, José F Contreras-Gutiérrez and Antonia Claver-Valderas Laroussi Mohamed-Salem*,Tomás E Rodríguez-Locarno,Tatiana Moreno-Monsalve,Isabel Castellón-Sánchez,José F Contreras-Gutiérrez ,Antonia Claver-Valderas. Scintigraphic non-invasive diagnosis of amyloid cardiomyopathy. J Cardiol Cardiovasc Med. 2019: doi: 10.29328/journal.jccm.1001058; 4: 156-158
  • Anomalies of coronary artery origin: About two cases
    Dioum M*, Sarr EM, Manga S, Mingou JS, Diack A, Diop AD, Bindia D, Diagne PA, Sarr AN and Diop IB Dioum M*,Sarr EM,Manga S,Mingou JS,Diack A,Diop AD,Bindia D,Diagne PA,Sarr AN,Diop IB. Anomalies of coronary artery origin: About two cases. J Cardiol Cardiovasc Med. 2019: doi: 10.29328/journal.jccm.1001051; 4: 117-119
  • Late discover of a traumatic cardiac injury: Case report
    Benlafqih C, Bouhdadi H*, Bakkali A, Rhissassi J, Sayah R and Laaroussi M Benlafqih C,Bouhdadi H*,Bakkali A,Rhissassi J,Sayah R,Laaroussi M. Late discover of a traumatic cardiac injury: Case report. J Cardiol Cardiovasc Med. 2019: doi: 10.29328/journal.jccm.1001048; 4: 100-102

Read More

Most Viewed

Read More

Help ?