NEUROLOGICAL MANIFESTATIONS OF PROLACTINOMA (CASE REPORT).

This article describes a clinical case of prolactinoma, the onset of which was diagnosed after long-term use of eglonil, after the appearance of such side effects as galactorrhea. This clinical case is a unique one because of the peculiarities of diagnostic search. The first complaints of the patient were anxiety and fear, fatigue, frequent mood swings, memory disoders. She was examined by a family physician and prescribed eglonil (sulpiride) 200mg for 7 days. Because of the positive effect the patient decided on her own to continue treatment for another several weeks. But suddenly she revealed a leakage of milk from the mammary glands. The family physician assessed galactorrhea as a side effect of long-term use of eglonil, and cancelled this prescription. Simultaneously the family doctor canceled COCs, that the patient used for the last several years, because of pregnancy planning. But three months later the mensis didn't occur. The menstrual cycle did not resume and pregnancy did not occur even 6 months later. Thus the doctor started to perform complete examination of the patient. Unfortunately, during the diagnostic search the patient rejected to do the contrast and primarily was performed MRI without contrast. The doctor revealed abnormal prolactin level - 423 ng/ml (normal range <25 ng/ml). Finally MRI of the pitutary including dynamic contrast was done. It has demonstrated an 8 x 11 mm mass in pituitary gland. The patient was prescribed conservative treatment according to the protocol. As a result, subsequent monthly control laboratory tests of prolactin levels in blood indicated gradual decrease of its level. Thus the first symptoms of prolactinoma may be atypical and can be detected only by a detailed survey and observation of the patient. It is also known that the severity of symptoms depends on the size of prolactinomas. Large prolactinomas cause symptoms of central nervous system lesion: headaches, depression, anxiety, irritability, emotional instability but in our clinical case, the prolactinoma was small but manifests with severe symptoms of the central nervous system lesion (according to the results of HADScale and MoCA scale). The presence of concomitant pathology can mask or distort the symptoms of another disease that complicates the diagnosis. On the other hand, treatment of one of the comorbidities and improving its course leads to a reduction in the manifestations of the others.

VITAMIN D CONTENT IN POPULATION OF RADIOLOGICALLY CONTAMINATED AREAS IN CHERNIVTSI OBLAST (pilot project). / VMIST VITAMINU D U NASELENNIa RADIOAKTYVNO ZABRUDNENYKh TERYTORII ChERNIVETs'KOÏ OBLASTI (pilotnyi proekt).

OBJECTIVE: To study the status of vitamin D in population of Chernivtsi region living on the radioactively contami-nated territories. MATERIALS AND METHODS: In a cross-sectional study under a pilot project the 180 people aged 19 to 78 years old per-manently residing in 3 regions of Chernivtsi oblast, namely in the village of Kyseliv in Kitsman district, which isattributed to the IIIrd zone of radiololgical contamination due to the Chornobyl catastrophe, as well as in the cityof Chernivtsi and the city of Vyzhnytsia were surveyed in summer. Assay of the 25(OH)D in blood serum was per-formed using the immune chemiluminescence method «ECLIA¼ on the Elecsys 2010 (Roche Diagnostics, Germany)analyzer using Cobas test systems. RESULTS: The average level of 25(OH)D in serum was (16.2 ± 0.8) ng/mL, the incidence of vitamin D deficiency was46.9%, and the incidence of vitamin D lack was 53.8%. Severe vitamin D deficiency has been detected in 6 cases inthe village of Kyseliv. At the same time, its share among the surveyed in this region was the highest (11.5%) beingsignificantly different from the proportion of severe deficits in Chernivtsi and Vyzhnytsia. A reliable correlationbetween the body mass index (BMI) and the blood serum level of 25(OH)D was found among persons with BMI of25-29.9 kg/m2. At the same time, the average value of 25(OH)D level among obese subjects (BMI greater than30 kg / m2) was practically the same as in subjects with normal body mass. CONCLUSIONS: Content of vitamin D was significantly lower among the population of radiologically contaminatedarea vs. the inhabitants of Chernivtsi and Vyzhnytsia. Status of vitamin D among the population of Chernivtsi regionremains far from optimal and requires urgent action for correction and prevention.