Galactorrhea in a 14-year-old girl.

The authors report a 14-year-old girl who had galactorrhea with regular menstruation. Furthermore, this galactorrhea case was associated with hyperprolactinemia and prolactinoma. The patient tolerated and responded well to therapy with bromocriptine. The serum prolactin levels decreased from 103.27 ng/mL to 24.25 ng/mL after 8 weeks of treatment and 12.48 ng/mL after 6 months of treatment. No pituitary tumor was demonstrated after 12 months of therapy and the galactorrhea had not recurred 1 year after ending the bromocriptine treatment.

Clinical and etiological profile of hyperprolactinemia--data from a tertiary care centre.

OBJECTIVE: To study the clinical presentation and etiology of hyperprolactinemia, a common disorder encountered in endocrine practice. METHODS: We analyzed the clinical data, hormone profile and imaging reports of 187 females with documented hyperprolactinemia, over a period of 6 years (5 years retrospective analysis and one year prospective study). RESULTS: Majority of the 187 subjects studied presented in 3rd or 4th decade. Galactorrhoea was the commonest presenting symptom occurring in 159 subjects (85%), followed by amenorrhea in 68.9%; both amenorrhea and galactorrhea were seen in 45.4%. A microprolactinoma was demonstrated in 67 patients (35.8%), a nonfunctioning pituitary macroadenoma with stalk hyperprolactinemia occurred in 30 patients (16%) and polycystic ovarian disease was documented in 24 (12.8%). In 52 patients (27.8%) no apparent cause could be ascertained. CONCLUSIONS: Syndrome of amenorrhea and/or galactorrhea is the commonest presentation in hyperprolactinemia. Microprolactinoma was the most frequent identifiable etiology followed by idiopathic and stalk hyperprolactinemia in our series.

Management of nipple discharge by clinical finding

Management of nipple discharge by clinical finding. All of the data on patients referred for nipple discharge in period from 1990-2000 at the Department of Surgery IMAM REZA Hospital were reviewed. The breast nodularity and duct ectasia was seen in 73% of patients. The age of the patient in this group was 30-40 years. Only 10 of 249 patients [5%] who presented with nipple discharge were proved to have carcinoma of the breast. Breast nodularity and duct ectasia is the most cause of nipple discharge [73%]. Nipple discharge was not commonly associated with carcinoma and when it was the carcinoma was almost always palpable

Del Castello syndrome--an unusual presentation.

Del Castello syndrome in a 28-year-old female, characterised by bilateral galactorrhoea, amenorrhoea and hyperinvoluted uterus, has been described. She had hyperprolactinaemia without any demonstrable pituitary tumour. She was successfully treated with two short courses of bromocriptine and was spontaneously cured after her second conception. The case is discussed with a brief review of the literature.

Hiperprolactinemia: a proposito de tres casos / Hyperprolactinemia: on purpose of three cases

Presentamos tres casos de hiperprolactinemia admitidos en el Hospital Obrero Nº 1 dependiente de la Caja Naciona de Salud de La Paz entre 1997 y 1999. Todas ellas mujeres con edades comprendidads entre 24 y 42 años. El cuadro clínico fue diferente en las tres, la primera preentó trastornos menstruales (ciclos irregulares), aumento de peso y sintomas relacionados con alteraciones visuales en ojo izquierdo. La segunda presento oligomenorrea, amenorrea, galactorrea y aumento de peso; la tercera galactorrea, alteraciones mesntruales e infertilidad. En todas se realizaron exámenes complementarios que incluyeron: Hematimetría, química sanguinea con pruebas de función hepatica y renal, hormonas tiroideas, FSH, LH, Prolactina, Estrógenos. Radiográfia de cráneo lateral (silla turca), TAC cerebral contrastada y en un caso Resonancia Magnetica. La causa en las tres pacientes due microadenoma hipofisario. Todas fueron sometidas a tratamiento con Bromocriptina con dosis entre 7.5 y 10 mg por dia en una sola toma. La intolerancia oral fue llamativa al inicio del tratamiento y una sola presentó congeston nasal. La adenoctomía transeptoesfenoidal (técnica de elección) fue rechazada por la paciente con alteraciones comprensivas.

Ressonância magnética da sela turca: avaliaçäo de pacientes com galactorréia, amenorréia e hiperprolactinemia / Magnetic ressonance imaging of sella turcica: evalution of patients with galactorthea, amenorhea and hyperprolactinemia

Resumo: Selecionamos 135 casos de pacientes que realizaram exame de ressonância magnética da sala turca, no período de setembro de 1991 a agosto de 1996, e que apresentavam galactorréia (G), amenorréia (A) e hiperprolactemia, (H), isoladamente ou em associaçäo. Esses pacientes foram divididos em sete grupos, com base na presença desses sinais e sintomas. Todos os exames foram feitos em clínica privada na cidade do Rio de Janeiro. Correlacionamos os pacientes com os achados de ressônancia magnética e encontramos57 casos de microadenomas, 31 exames normais, 22 macroadenomas, 11 hiperplasias, 7 selas vazias e 7 casos incluídos em "outros achados". O microadenoma predominou nos grupos 1 (GAH), 2(GH), 3(HA) E 5(H), ou seja em todos os que apresentaram hiperprolactenemia. Nos macroadenomas a presença de hipersinal nas sequencias ponderadas em T1 é indicado de apoplexia hipofisária com sangramento intramural. Concluindo, a ressonância magnética é excelente método na avaliaçäo de pacientes com alteraçöes no eixo hipotálamo-hipofisário.

Conducta frente a la descarga por el pezón / Management on nipple discharge

La descarga por el pezón es la tercera causa de consulta en el Policlínico de Mamas de nuestra Institución. Esta sintomatología puede ser manifestación de una neoplasia. En esta revisión se comentan las causas y características semiológicas destacando que si la descarga es hemática, espontánea, acompañada de masa y en pacientes mayores de 50 años está más frecuentemente asociada a neoplasia. Finalmente se expone y comenta nuestro esquema de manejo ante las pacientes con este problema

Pubertad retrasada constitucional o hipogonadismo hipogonadotrófico? / Constitutional puberty delay or hypogonadotrophic hypogonadism?

This review is focused on the diagnosis, clinical and general therapeutic approach of constitutional growth and puberty delay and hypogonadotrophic hypogonadism in males, 2 entities that are difficult to distinguish. Clinical history and physical examination must be carefully performed. Delayed puberty is due to constitutional growth and puberty delay in the vast majority children. These must be distinguish from a small fraction of boys with hypogonadism, a pathological condition. A number of laboratory test allow the prediction of puberty onset and progression. Nevertheless, the advent of highly sensitive immnuessay and radiometric immunoassay systems for LH, FSH and testosterone has not entirely solved the problem, since their values may overlap between normal and pathological conditions

Efeitos terapêuticos do hidrogênio lisurida na hiperprolactinemia: resposta clínica e hormonal / Therapeutic effects of lisuride hydrogen in hyperprolactinemia: clinical and hormonal response

O hidrogênio maleato de lisurida é de um novo derivado semi-sintético do ergot. Apresenta propriedades agonista dopaminérgico e antagonista seratoninérgico. É cerca de dez vezes mais potente potente que a bromoergocriptina e apresenta a vantagem adicional de possuir estrutura molecular mais simples, sem cadeia peptídica lateral, o que lhe assegura menor custo de síntese e de tratamento. Seis mulheres, portadoras da galactorréia e hiperprolactinemia, foram tratadas com a droga na dose máxima de 0,3mg/dia por 30 dias ou de 0,4mg/dia por 60 dias. A prolactina foi reduzida a níveis normais em 4 pacientes. A galactorréia cessou em todas, ciclos menstruais ocorreram em duas. A cefaléia foi melhorada em uma. Houve boa tolerància do medicamento.

Hiperprolactinemia / Hyperprolactinemia

Se presenta los casos de 4 pacientes con galactorrea, tratadas exitosamente con bromokriptina, tratamiento que, ademàs, permitio gestar a 2 de ellas. Se hace, asi mismo, varias consideraciones sobre hiperprolactinemia, su diagnòstico y tratamiento