ABSTRACT
A 24 year old female with amenorrhea-galactorrhea due to a pituitary macroprolactinoma that eventually responded to bromocriptine with improvement of visual fields and intracranial hypertension syndrome is presented. After 2 years of treatment with bromocriptine her symptoms relapsed and she underwent transphenoidal hypophysectomy. The high serum prolactin levels detected initially decreased under bromocriptine to ward normal levels and was not modified after surgery, while gonadotropin production remain scarce. Growth hormone (GH) serum levels despite its normal concentration decreased significantly (p = less than 0.5) after pituitary ablation. We assume that the lack of response to bromocriptine in this case could have been due to a mixed hormonal nature of the tumor without overproduction or clinical expression of GH activity.
Subject(s)
Bromocriptine/therapeutic use , Pituitary Neoplasms/drug therapy , Prolactinoma/drug therapy , Adult , Drug Resistance , Female , Growth Hormone/blood , Humans , Pituitary Neoplasms/blood , Prolactin/blood , Prolactinoma/bloodSubject(s)
Chorionic Gonadotropin/blood , Glycoprotein Hormones, alpha Subunit/blood , Peptide Fragments/blood , Pregnancy Complications, Neoplastic/blood , Pregnancy/blood , Trophoblastic Neoplasms/blood , Uterine Neoplasms/blood , Chorionic Gonadotropin, beta Subunit, Human , Female , Humans , Postpartum Period/blood , Radioimmunoassay , Reference ValuesABSTRACT
Preeclampsia-eclampsia and trophoblastic disease have been associated with a wormlike organism, Hydatoxi lualba, recently discovered in smears from circulating blood, trophoblastic tumor tissue, and placental tissue of toxemic patients. To investigate these findings peripheral blood smears from patients with preeclampsia-eclampsia, patients with hydatidiform mole, normal pregnant patients, and nonpregnant subjects were studied. The smears were stained with toluidine blue-O and Giemsa. The average size of wormlike forms found was 2.5 by 0.23 mm. None stained with Giemsa. The frequency of positivity for toxemic patients was 56.5% and 81.8% for normal pregnant patients. Samples from molar pregnancies were negative. Observations performed directly in fresh blood were also negative. The forms were observed not only in peripheral blood but also in serum obtained after centrifugation or passage through Millipore filters. No evidence of reproductive elements was found, and electron microscopy revealed no particular structure. The results suggest that the organism is an artifact.
